title: 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.
abstract: 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.
authors.affiliation: Department of Gynecology, Perinatology and Child Health, University of Rome La Sapienza, Rome, Italy. a.frega@tin.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Frega
authors.forename: Alberto
authors.initials: A
authors.lastname: Biamonti
authors.forename: Luca
authors.initials: L
authors.lastname: Maranghi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vetrano
authors.forename: Antonella
authors.initials: A
authors.lastname: Palazzo
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacovelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Corosu
authors.forename: Deborah
authors.initials: D
authors.lastname: French
authors.forename: Massimo
authors.initials: M
authors.lastname: Moscarini
authors.forename: Aldo
authors.initials: A
authors.lastname: Vecchione
mesh_terms: 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*