Human immunodeficiency virus (HIV) infection may not have a contributory effect on the incidence of invasive cervical cancer (ICC) in women as they age, according to a study published in the International Journal of Cancer.
Women with HIV may experience increased risk for a number of comorbidities, including human papillomavirus (HPV) infections, cervical intraepithelial neoplasia (CIN), CIN recurrence after treatment, abnormal Pap test results, and ICC.
Although previous studies show that the incidence of ICC remains low during the first 10 years after initial HIV diagnosis, the risk of ICC over a longer period has not been studied.
This multicenter prospective study reported the outcomes of 2295 patients who were at risk for or were infected with HIV, and followed them for 20 years. Patients’ demographic, health, and behavioral information was tracked every 6 months. Physical examinations and Pap smears were administered, HIV status was confirmed by Western blot, and any diagnoses of ICC were reported.
The average follow-up time for HIV seronegative patients was 17.4 years and 10.6 years for women who were HIV seropositive. No new cases of ICC were reported from women who were seronegative. Four new cases of ICC were reported in seropositive women, but the rate of ICC incidence did not have any significant correlation to HIV status (HIV seronegative: 0/100,000 person-years vs HIV seropositive: 19.5/100,000 person-years; P =0.53).
Results from this cohort study indicate that the risk of ICC in HIV seropositive and seronegative patients does not differ significantly even after 20 years. The researchers however, do believe that an increased risk of ICC in seropositive patients as observed in prior studies is real and confounding variables may have contributed to the lower rates observed in this study. Study authors conclude saying that “vigilance and repeated therapy may be required to reduce ICC rates among women with HIV.”
1. Massad LS, Hessol NA, Darragh TM, et al. Cervical cancer incidence after up to 20 years of observation among women with HIV [published online July 17, 2017]. Int J Cancer. doi: 10.1002/ijc.30866