HIV infection does not raise risk of cervical cancer

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HIV infection does not raise risk of cervical cancer
HIV infection does not raise risk of cervical cancer

Women with human immunodeficiency virus (HIV) who have normal Papanicolaou (Pap) test results and who test negative for oncogenic human papillomavirus (HPV) were not shown to have a greater risk of cervical cancer than HIV-negative women through 5 years of follow-up in a recent study.

In March 2012, the United States Preventive Services Task Force revised its guidelines for cervical cancer screening in HIV-negative women aged 30 years and older, increasing the suggested interval between Pap tests from 3 years to 5 years if the woman has normal cervical cytology (Pap test) results and is oncogenic-HPV-negative. Whether a 3-year or 5-year screening interval could be applied to HIV-positive women who are cytologically normal and oncogenic-HPV-negative is unknown, but the question was explored in a study of 420 women with HIV and 279 without.

The women were studied to determine the risk of cervical precancer or cancer defined cytologically (high-grade squamous intraepithelial lesions or greater [HSIL+]) or histologically (cervical intraepithelial neoplasia 2 or greater [CIN-2+]). All participants had normal cervical cytology upon study enrollment, which took place from October 2001 through September 2002, with follow-up through April 2011. During that time the women underwent semiannual Pap testing and, if indicated, cervical biopsy.

At the 5-year mark, the cumulative incidence of HSIL+ and CIN-2+ was similar between the HIV-positive and HIV-negative women. No oncogenic HPV was detected in 369 (88%) of the HIV-infected patients or in 255 (91%) of the HIV-negative patients.

Data from four of the six clinical sites involved in the study revealed the 5-year cumulative incidence of HSIL+ to be 0.3% for the HIV-positive women and 0.4% for the HIV-negative group. Nine cases of CIN-2+ in 219 HIV-positive women and six cases in 145 HIV-negative women translated to a cumulative incidence of 5% in each group (JAMA. 2012;308[4]:362-369).

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