[Frequency, persistence and recurrence of HPV lesions of the uterine cervix in HIV-seropositive women].
OBJECTIVE
The aim of this study was to determine the frequency, persistence and risk of recurrence of human papillomavirus (HPV) lesions of the uterine cervix in human immunodeficiency virus (HIV)-infected women.


METHODS
To determine the frequency of such lesions, we compared 148 HIV-positive patients with 4862 HIV-negative patients who had a cervical smear test in Toulouse university hospital. To determine the persistence and recurrence rate of the lesions, we prospectively followed 63 of the HIV-positive patients. Their follow-up was compared with that of 227 of the HIV-negative patients.


RESULTS
Abnormal smears were much more frequent in HIV-positive patients (42 versus 5%, P<0.001). Persistence or aggravation of the lesions was also greater in HIV-positive patients (82 versus 43%, P<0.001). Lastly, the recurrence rate of dysplastic lesions after treatment was significantly higher in HIV-positive patients (64 versus 11%, P<0.001).


CONCLUSIONS
As the frequency, persistence and risk of recurrence of cervical HPV lesions are very high in HIV-positive women, close gynecological surveillance of these patients is indispensable. Surveillance must not be restricted to the uterine cervix because of the frequency of multifocal lesions: vagina, vulva, perineum and anus. It must also be adapted to the severity of immunodeficiency and the patient's history.
Berrébi
A
A
Service de gynécologie-obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 09, France. berrebi.a@chu-toulouse.fr
Badiou
W
W
Duclusaud
A
A
D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D016867:Immunocompromised Host; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D018571:Sentinel Surveillance; D014412:Tumor Virus Infections / Q000453:epidemiology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears