[Cervical cancer screening of HIV-positive women: is a prolongation of the screening interval meaningful?].
OBJECTIVE
Cervical cancer screening guidelines stated recently that the screening interval of healthy women can be extended up to 3 years. Can those recommendations be applied for high risk populations?


METHODS
In a prospective setting 305 HIV-positive women have been enrolled in this analysis between September 2000 and December 2003. Patients have been characterized according to HPV (human papilloma virus) prevalence, CIN (cervical intraepithelial neoplasia) incidence and CD4 cell count.


RESULTS
41 % of all HIV-positive women were HPV positive (oncogene subtypes). In patients with diminished CD4 cells the HPV prevalence increased to 60 % (54/90). CIN was found in 27 % (83/305) women. CIN was more frequent by HPV-positive women with a CD4 cell count < 200 mm (3) (52 %, 38/72). The CIN incidence was also high in HIV-positive women with negative HPV infection and diminished CD4 cell count (39 %, 7/18 vs.7 %, 11/161).


CONCLUSIONS
The current cervical cancer screening guidelines are not helpful in HIV-positive women. The CIN incidence is significantly higher as in the HIV-positive population. For this reason this high risk population as e. g. HIV-infected women need an intensive care of diagnostic tools and short screening intervals to detect CIN.
Ahr
A
A
Gynäkologische Praxis am Ziegelturm, Gelnhausen. ahr@em.uni-frankfurt.de
Rody
A
A
Cimposiau
C
C
Faul-Burbes
C
C
Kissler
S
S
Kaufmann
M
M
Gätje
R
R
D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification; D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology