High recurrence rate of cervical dysplasia and persistence of HPV infection in HIV-1-infected women.
OBJECTIVE
A) evaluation of the recurrence of cervical dysplasia after surgical treatment and of the rate of HPV persistence of HIV-infected women and b) the influence of antiretroviral therapy on the recurrence.


METHODS
In a retrospective analysis, the follow-up data of HIV-positive women visiting our outpatient clinic regarding results of cervical cytology, cervical HPV detection, cervical biopsy, patient history of dysplasia and antiretroviral therapy were assessed. A total of 388 HIV-positive women had a mean follow-up of 2.7 years and a median of 2.5 outpatient visits.


RESULTS
Out of the 344 patients (57.3%) tested for HPV, 197 showed at least one positive HPV result. Of the same group, 136 women had four or more HPV tests which showed that 84 of them (61.8%) had a persistent HPV-infection. Overall, 157/388 had cervical dysplasia and 70 needed surgery. Forty-one of the 70 patients (58.6%) received more than one surgical treatment because of a recurrence, all of this group had persistent HPV.


CONCLUSIONS
The recurrence of cervical dysplasia in HIV-positive women after surgical treatment was found to be very high as was the associated long-term persistence of HPV-infection. HPV persistence represented an excellent marker for relapsing cervical dysplasia.
Gingelmaier
Andrea
A
First Department of Obstetrics and Gynecology, Ludwig-Maximilians University, Munich, Germany. andrea.gingelmaier@med.uni-muenchen.de
Grubert
Thomas
T
Kaestner
Ralph
R
Mylonas
Ioannis
I
Weissenbacher
Tobias
T
Bergauer
Florian
F
Barthell
Lisa
L
Friese
Klaus
K
D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D014412:Tumor Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000150:complications* / Q000473:pathology* / Q000821:virology
D044966:Anti-Retroviral Agents