Issues in cervical cancer incidence and treatment in HIV.
OBJECTIVE
Cervical disease burden continues to be especially high in HIV-infected women, even in the era of effective antiretroviral medications. This review discusses the multiple issues surrounding HIV-associated cervical cancer. Also, the unique treatment-related issues in HIV-associated cervical cancer are addressed.


RESULTS
The incidence of invasive cervical cancer has remained stable in industrialized nations; however, it is only estimated in developing countries secondary to a relative lack of data collection and registries. Trends in HIV-associated cervical cancer have changed in the highly active antiretroviral therapy (HAART) era. Recent molecular pathways suggest that the natural progression of human papillomavirus infection, the causal agent in all cervical cancers, may be related to immune system dysfunction as well as HIV/human papillomavirus synergistic mechanisms. When highly active retroviral therapies are used, invasive cervical cancer treatments are impacted by concomitant drug toxicities that could potentially limit therapeutic benefit of either HAART or the standard of care treatment for locally advanced cervical cancer, concomitant chemoradiotherapy.


CONCLUSIONS
The significance and care of the patient with invasive cervical cancer is becoming a geographically relevant phenomenon such that it may be time to re-address the global definition. Further studies in treatment issues and drug-drug interactions with cervical cancer treatments in the setting of HIV are paramount.
Einstein
Mark H
MH
Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, Bronx, New York, USA.
Phaëton
Rébécca
R
D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D006678:HIV / Q000472:pathogenicity*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000821:virology*
D044966:Anti-Retroviral Agents