Abstract
Global data on cervical lesion incidence and progression in HIV-positive women are essential for understanding the natural history of cervical neoplasia and informing screening policy. A systematic review was performed summarizing the incidence and progression of cervical lesions in HIV-positive women. Of 5882 HIV-positive women from 15 studies, incidence ranged from 4.9 to 21.1 cases per 100 woman-years for any cervical lesion and 0.4 to 8.8 cases per 100 woman-years for high-grade cervical lesions. HIV-positive women showed a median three-fold higher incidence of cervical lesions compared to HIV-negative women. Of 1099 HIV-positive women from 11 studies, progression from low- to high-grade lesions ranged from 1.2 to 26.2 cases per 100 woman-years. Both incidence and progression rates increased with lower CD4 counts. The effect of antiretroviral therapy on the natural history of cervical neoplasia remains unclear. HIV-positive women have higher incidence and progression of cervical neoplasia. Cervical cancer screening should be integrated into HIV treatment programmes.
Original language | English (US) |
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Pages (from-to) | 163-177 |
Number of pages | 15 |
Journal | International Journal of STD and AIDS |
Volume | 25 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2014 |
Keywords
- AIDS
- CIN
- HIV
- SIL
- cervical cancer
- cervical lesions
- incidence
- progression
- review
- screening
- squamous epithelial lesions
- women
ASJC Scopus subject areas
- Dermatology
- Public Health, Environmental and Occupational Health
- Pharmacology (medical)
- Infectious Diseases