The increased frequency of cervical dysplasia-neoplasia in women infected with the human immunodeficiency virus is related to the degree of immunosuppression

Schäfer, Axel; Friedmann, W.; Mielke, Martin; Schwartländer, Bernhard; Koch, Meinrad A.

doi:10.1016/s0002-9378(11)80029-3

Cited by 232 publications

(47 citation statements)

References 18 publications

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“…140 HPV infection is thought to transform anal epithelia through low-grade SIL dysplasia to high-grade SIL. Development and progression of SIL is more common in HIV-infected persons and is correlated with low CD4 counts, 145,146 but only some patients will progress to frank SCC in situ or SCC.…”

Section: Anal Sccmentioning

confidence: 99%

Cutaneous malignancy and human immunodeficiency virus disease

Wilkins

Turner

Dolev

et al. 2006

Journal of the American Academy of Dermatology

135

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Section: Anal Sccmentioning

confidence: 99%

Cutaneous malignancy and human immunodeficiency virus disease

Wilkins

Turner

Dolev

et al. 2006

Journal of the American Academy of Dermatology

135

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“…153 Many immunosuppressed HIV-infected women, especially those practicing certain behaviors, have been found to be at especially high risk for lower genital tract neoplasia. [154][155][156][157] These behaviors include having multiple sex partners, having first intercourse at an early age, having sex with men who have had many partners, smoking, and showing poor compliance in obtaining routine Pap smears. 155 However, not all studies have found positive correlations between SIL occurrence and the risk behaviors noted above.…”

Section: Clinical Care Issues For Women With Hiv and Aidsmentioning

confidence: 99%

“…[159][160][161] Some studies have shown a link between increased severity of CIN and lower peripheral CD4 1 counts. 157,162,163 Others have suggested that localized immunosuppression may play a greater role than systemic immunosuppression in allowing growth of neoplastic cells. 154 Finally, studies of non-HIV-associated CIN have found that persistent dysplasia is associated with a decrease in the number of Langerhans cells and helper T cells, suggesting a depressed local immune response in persistent CIN.…”

Section: Clinical Care Issues For Women With Hiv and Aidsmentioning

confidence: 99%

“…165 167 Since 1991, several studies have confirmed the greater frequency of cervical carcinoma in HIV-infected women compared with that found in the general population of women. 155,157,168 A recent study of AIDS-related malignant disorders found that among HIV-infected women who had not yet been diagnosed with AIDS, the risk of ICC was five-fold greater than that found in the general population. 169 The researchers examined the incidence rates of ICC versus in situ cervical cancer and found that among HIV-infected women, the incidence of in situ cervical cancer increased throughout a 7-year period spanning 5 years before AIDS diagnosis through 2 years after AIDS diagnosis.…”

Section: Why Has It Been Important To Include Icc In the Cdc's Aids-dmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Care Issues for Women Living with HIV and AIDS in the United States

Marlink

Kao

Hsieh

2001

AIDS Research and Human Retroviruses

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As the number of women infected with HIV in the United States continues to increase, the medical community is faced with the challenge of providing adequate and appropriate care to them. This paper reviews key questions concerning the state of knowledge on the epidemiology, biology, and clinical care of women living with HIV and AIDS in the United States. Because heterosexual transmission accounts for a growing number of cases among women, biological factors and cofactors that may enhance women's susceptibility to HIV infection are also reviewed. HIV-related gynecological issues are presented separately to evaluate whether gynecological complications are distinct in HIV-uninfected and HIV-infected women. Questions of whether there are sex-specific differences in the efficacy and adverse effects of new antiviral agents are discussed. In addition, significant gaps are highlighted that still exist in our understanding of both the effects of HIV and HIV-related drugs upon pregnancy. Finally, the psychiatric stresses and complications that affect women living with HIV and AIDS are also discussed. In each section of this review, gaps in our knowledge of these issues are identified. To properly address these disparities in knowledge, not only do efforts to gather sex-specific biomedical data need to be more exacting, but there is a distinct need to conduct more sex-specific research concerning HIV.

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“…The prevalence of cervical intraepithelial neoplasia (CIN) in HIV-infected women exceeds community levels tenfold, depending on the techniques used for detection of HPV (77,107,110). For example, 23 of 33 women (70%) with symptomatic HlV disease had HPV DNA demonstrated in specimens from the cervix, as compared with 4 of 18 (22%) asymptomatic and 10 of 45 (22%) HIV -seronegative women with similar demographic and behavioral profiles (121).…”

Section: Effect Of Hiv Infection On Genital and Cervical Wartsmentioning

confidence: 99%