title: Impact of Highly Active Antiretroviral Therapy on the Natural History of Cervical Precancerous Lesions: A 17-Year Institutional Longitudinal Cohort Study.
abstract: We performed an observational cohort study in order to assess the correlation between precancerous cervical lesions (cervical intraepithelial neoplasia [CIN]) and immunological state in human immunodeficiency virus (HIV)-positive women treated by highly active antiretroviral therapy (HAART). We analyzed 194 HIV-infected women referred to the Parma-Universitary Hospital for early detection of human papilloma virus-induced CINs. We analyzed cytology, colposcopy, and CIN degree according to HAART: group A untreated and group B treated. We compared the CD4+ count and viral load at the time of CIN onset and the time interval between diagnosis of HIV and the onset of CIN. Group A and group B showed homogeneous results for general features, CD4+ count, viral load, and Papanicolaou test features. Differences were not found in terms of histology and CD4+ value, viral load count, pharmacological treatment, years since the diagnosis of HIV, age, smoking, sexual promiscuity, previous intravenous narcotics abuse, prostitution, sexually transmitted diseases, ethnicity, and age at diagnosis. Histology and the clinical stage of HIV showed significant concordances between the high degree of cervical dysplasia and advanced stage of HIV disease.
authors: Department of Surgical Sciences, University of Parma, Parma, Italy.
authors: Tito Silvio
authors: TS
authors: Patrelli
authors: Department of Woman and Child Health, University of Padua, Padua, Italy ginecologia_padova@libero.it.
authors: Salvatore
authors: S
authors: Gizzo
authors: Department of Surgical Sciences, University of Parma, Parma, Italy.
authors: Francesca
authors: F
authors: Peri
authors: Department of Surgical Sciences, University of Parma, Parma, Italy.
authors: Laura
authors: L
authors: Franchi
authors: Department of Surgical Sciences, University of Parma, Parma, Italy.
authors: Lavinia
authors: L
authors: Volpi
authors: Department of Woman and Child Health, University of Padua, Padua, Italy.
authors: Federica
authors: F
authors: Esposito
authors: Department of Public Health, University of Parma, Parma, Italy.
authors: Giuseppe
authors: G
authors: Pedrazzi
authors: Division of Infectious Diseases and Hepatology, University of Parma, Parma, Italy.
authors: Anna Degli
authors: AD
authors: Antoni
authors: Department of Surgical Sciences, University of Parma, Parma, Italy.
authors: Alberto Bacchi
authors: AB
authors: Modena
keywords: HAART effect; HIV clinical stage; HIV pharmacological therapy; HIV-related comorbidity; gynecological screening; precancerous cervical lesions