Antiretroviral therapy and the clinical evolution of human papillomavirus-associated genital lesions in HIV-positive women.
The effect of antiretroviral therapy on the natural history of human papillomavirus (HPV)-associated genital lesions was evaluated in 201 human immunodeficiency virus (HIV)-infected women who were followed-up for 1-6 years. Gynecologic examinations were performed every 6-12 months. HPV sequences in cervico-vaginal cells, analyzed by polymerase chain reaction and typed by restriction fragment-length polymorphism analysis, were repeatedly detected in 126 women; 29 had transient HPV infection. Genital lesions were found in 137 patients; prevalence was comparable in women who were receiving different antiretroviral regimens. Regression of low-grade lesions was more prevalent among patients receiving highly active antiretroviral therapy than among those receiving other regimens; high-grade lesions regressed in the majority of cases, regardless of antiretroviral therapy. HPV infection persisted in nearly 80% of the cases. In conclusion, our data show that antiretroviral therapy does not prevent the development of HPV-associated lesions and does not eliminate HPV infection; therefore, early and strict gynecologic follow-up of HIV-infected women is warranted.
Servizio Citologia Diagnostica Molecolare Oncologica, Azienda Ospedaliera di Padova, Padua, Italy. annarosa.delmistro@unipd.it
Annarosa
A
Del Mistro
Roberta
R
Bertorelle
Marzia
M
Franzetti
Annamaria
A
Cattelan
Angela
A
Torrisi
Maria Teresa
MT
Giordani
Roberto
R
Sposetti
Emanuela
E
Bonoldi
Lolita
L
Sasset
Laura
L
Bonaldi
Daria
D
Minucci
Luigi
L
Chieco-Bianchi
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D015658:HIV Infections / Q000150:complications / Q000473:pathology; D006679:HIV Seropositivity; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000187:drug effects; D030361:Papillomavirus Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000821:virology
D000998:Antiviral Agents