Follow-up of high-grade squamous intra-epithelial lesions (H-SIls) in human immunodeficiency virus (HIV)-positive and human papillomavirus (HPV)-positive women. analysis of risk factors.
BACKGROUND
Human immunodeficiency virus (HIV)-positive women are at high risk of co-infection from human papillomavirus (HPV) and of developing squamous intraepithelial lesions of the cervix.


METHODS
From April 1997 to March 1999, 86 women, affected by high-grade squamous intra-epithelial lesions (H-SILs), were enrolled: 41 were HIV+ (CD4+ count >500/ml) and 45 were HIV-. The diagnosis of high-grade squamous intra-epithelial lesion (H-SIL) was established for each patient by Pap test, colposcopy and guided biopsy. For all samples, the HPV/DNA test was also performed by PCR. The patients' lesions and recurrence were treated by cone biopsy or large loop excision (LEEP). Annual controls were performed for 5 years.


RESULTS
A high rate of alcohol and drug use (60.7% vs. 31.4%; p=0.004; 80% vs. 27.5%; p<0.001, respectively) and number of male partners (4.5 vs. 3.0; p<0.001) were found in the HIV+ patients, compared to the HIV- patients. Both groups were HPV+ for high-risk types. No difference was found in the percentage of patients who had received a second LEEP.


CONCLUSIONS
Our findings suggest the treatment of H-SIL in HIV-positive women, for a longer disease-free survival, or a lower risk of developing cervical cancer.
Frega
Antonio
A
Department of Gynecology, Perinatology and Child Health, University of Rome La Sapienza, Rome, Italy. a.frega@tin.it
Biamonti
Alberto
A
Maranghi
Luca
L
Vetrano
Giuseppe
G
Palazzo
Antonella
A
Iacovelli
Roberto
R
Corosu
Roberto
R
French
Deborah
D
Moscarini
Massimo
M
Vecchione
Aldo
A
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000276:immunology; D006679:HIV Seropositivity / Q000150:complications* / Q000473:pathology / Q000821:virology; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications* / Q000473:pathology / Q000821:virology; D012307:Risk Factors; D012725:Sexual Behavior; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*