Highly active antiretroviral therapy enhances regression of cervical intraepithelial neoplasia in HIV-seropositive women

Abstract

The positive impact of HAART on CIN regression may be associated with some restoration of specific immune reactivity. This is not sufficient enough, however, to modify the gynecological follow-up of HIV-infected women.

Cost effectiveness of high-risk HPV DNA testing for cervical cancer screening in South Africa

“…There are conflicting data on the impact of ART on HPV infection, CIN, and cervical cancer. While some studies have shown a slight reduction in CIN and cervical cancer rates among HIV-positive patients receiving ART, it is likely that this benefit depends on viral load and CD4 count [34][35][36]49]. However, our analysis suggests that cervical cancer screening using HPV DNA testing remains cost effective over the entire possible range of assumptions on this issue.…”

“…We assumed that 50k of patients with acquired immunodeficiency syndrome (AIDS) (defined as CD4 count b200 cells/mm 3 ) would receive antiretroviral therapy (ART). Based on input from clinical experts, we assumed that the relative risk of progression and regression of HPV and CIN among patients receiving ART for HIV infection is mid-way between the relative risk for HIVnegative patients and untreated HIV-positive patients [34][35][36]. Natural history data were used to estimate risk of death due to AIDS (Table 1) [23,37].…”

Human Papillomavirus Infection in Human Immunodeficiency Virus Positive Women Under Routine Pap Smear

“…Antiretroviral treatment is a controversial factor in reducing genital lesions linked to HPV infection. While some authors described an inverse correlation between these lesions and CD4 counts, other investigations did not confirm these findings in patients with recovered immune status promoted by anti-HIV therapy (Palefsky 2006, Lillo et al 2001, Heard et al 2002.…”

Neoplasias en pacientes con infección por VIH: Estudio descriptivo de 129 casos en el período 1993-2010

“…Por un lado, se sabe que la propia infección por el VIH condiciona defectos en la inmunidad celular, con la subsiguiente alteración en los sistemas de vigilancia y supresión de aquellos virus con potencial oncogénico 15 , teniendo en cuenta que muchos de estos pacientes están co-infectados por otros virus como el papiloma humano (VPH), Epstein Barr (VEB), hepatitis B (VHB) y hepatitis C (VHC). Interesantes estudios han mostrado la asociación de determinados virus con cáncer, como el caso del LH con el VEB 16,17 , el hepatocarcinoma con el VHB y el VHC 18,19 o el cáncer de ano /pene /vulva /cavidad oral con el VPH [20][21][22][23][24][25][26][27][28][29] . Por otro lado, se cree que el propio tratamiento anti-retroviral conlleva una activación crónica del sistema inmune, y por tanto, podría contribuir a incrementar el riesgo de algunos tumores.…”