A Berrébi1, W Badiou, A Duclusaud. 1. Service de gynécologie-obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 09, France. berrebi.a@chu-toulouse.fr
Abstract
OBJECTIVE: The aim of this study was to determine the frequency, persistence and risk of recurrence of human papillomavirus (HPV) lesions of the uterine cervix in human immunodeficiency virus (HIV)-infected women. PATIENTS AND METHODS: To determine the frequency of such lesions, we compared 148 HIV-positive patients with 4862 HIV-negative patients who had a cervical smear test in Toulouse university hospital. To determine the persistence and recurrence rate of the lesions, we prospectively followed 63 of the HIV-positive patients. Their follow-up was compared with that of 227 of the HIV-negative patients. RESULTS: Abnormal smears were much more frequent in HIV-positive patients (42 versus 5%, P<0.001). Persistence or aggravation of the lesions was also greater in HIV-positive patients (82 versus 43%, P<0.001). Lastly, the recurrence rate of dysplastic lesions after treatment was significantly higher in HIV-positive patients (64 versus 11%, P<0.001). DISCUSSION AND CONCLUSION: As the frequency, persistence and risk of recurrence of cervical HPV lesions are very high in HIV-positive women, close gynecological surveillance of these patients is indispensable. Surveillance must not be restricted to the uterine cervix because of the frequency of multifocal lesions: vagina, vulva, perineum and anus. It must also be adapted to the severity of immunodeficiency and the patient's history.
OBJECTIVE: The aim of this study was to determine the frequency, persistence and risk of recurrence of human papillomavirus (HPV) lesions of the uterine cervix in human immunodeficiency virus (HIV)-infectedwomen. PATIENTS AND METHODS: To determine the frequency of such lesions, we compared 148 HIV-positivepatients with 4862 HIV-negative patients who had a cervical smear test in Toulouse university hospital. To determine the persistence and recurrence rate of the lesions, we prospectively followed 63 of the HIV-positivepatients. Their follow-up was compared with that of 227 of the HIV-negative patients. RESULTS: Abnormal smears were much more frequent in HIV-positivepatients (42 versus 5%, P<0.001). Persistence or aggravation of the lesions was also greater in HIV-positivepatients (82 versus 43%, P<0.001). Lastly, the recurrence rate of dysplastic lesions after treatment was significantly higher in HIV-positivepatients (64 versus 11%, P<0.001). DISCUSSION AND CONCLUSION: As the frequency, persistence and risk of recurrence of cervical HPV lesions are very high in HIV-positivewomen, close gynecological surveillance of these patients is indispensable. Surveillance must not be restricted to the uterine cervix because of the frequency of multifocal lesions: vagina, vulva, perineum and anus. It must also be adapted to the severity of immunodeficiency and the patient's history.
Authors: Valeria Stuardo; Cristina Agustí; José Manuel Godinez; Alexandra Montoliu; Aureli Torné; Antoni Tarrats; Carmen Alcalde; Dolores Martín; Eulalia Fernández-Montoli; Cristina Vanrell; Josefa Solé; Yolanda Canet; José Manuel Marqueta; Jadiyettu Mohamed; Isabel Cuenca; Montserrat Lonca; Guillem Sirera; Elena Ferrer; Pere Domingo; Belen Lloveras; Josep María Miro; Silvia De Sanjosé; Jordi Casabona Journal: PLoS One Date: 2012-10-30 Impact factor: 3.240