Malignancies in women with HIV infection.
Women with HIV infection have an increased risk of developing certain malignancies. These malignancies are commonly human papillomavirus (HPV)-related, reflecting the high rate of coinfection with HPV in women with underlying HIV infection. These women also have a high incidence of premalignant HPV-related changes, such as high-grade squamous intraepithelial lesions as diagnosed on Pap smears and cervical intraepithelial neoplasia on cervical biopsy. Screening recommendations for HIV-infected women reflect the need for vigilance in detecting and treating these lesions early. In addition, recent interest has focused on the use of cervical cancer screening, employing HPV-testing techniques, and on HPV vaccination in younger women to prevent initial infection and the subsequent development of cervical and other HPV-related cancers. The incidence of other types of malignancies, such as Hodgkin's and non-Hodgkin's lymphoma, is also increased in HIV-infected individuals. When these lymphomas occur, they tend to be of advanced stage and high-grade histologies. The advent of highly active antiretroviral therapy has been associated with a marked decrease in the incidence of some of these cancers. The use of therapy has been associated with marked improvement in response rates and overall survival of affected patients.
Krishnan
Amrita
A
City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA. akrishnan@coh.org
Levine
Alexandra M
AM
D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006689:Hodgkin Disease / Q000453:epidemiology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D016387:Women's Health