Improved Outcome of Cervical Neoplasia in HIV-Infected Women in the Era of Highly Active Antiretroviral Therapy

Abstract

Cervical neoplasia has been associated with human immunodeficiency virus (HIV) infection. Both preinvasive disease and invasive cervical cancer have been reported to have a much poorer outcome in HIV-infected women than in the general population. The use of highly active antiretroviral therapy (HAART) has resulted in significant improvements in the treatment of HIV infection, including a decrease in the incidence and severity of several acquired immune deficiency syndrome (AIDS)-related malignancies. Two cases of cervical dysplasia in HIV-infected women are presented, one from the pre-HAART era, who subsequently developed invasive cervical cancer and died, and one in whom HAART was used with good outcome. Data from several reports of the use of HAART in HIV-infected women indicates that the prognosis for cervical neoplasia is improved. Possible reasons for this improvement include better immune function seen in HAART-treated women, as well as increased surveillance for cervical neoplasia in HIV-infected women in recent years. However, the future impact of improved HIV care, including HAART, on cervical neoplasia is unclear.