Incidence and progression of cervical lesions in women with HIV: A systematic global review

Sheri A. Denslow, Anne Rositch, Cynthia Firnhaber, Jie Ting, Jennifer S. Smith

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)163-177
Number of pages15
JournalInternational Journal of STD and AIDS
Volume25
Issue number3
DOIs
Publication statusPublished - Mar 2014

    Fingerprint

Keywords

  • AIDS
  • cervical cancer
  • cervical lesions
  • CIN
  • HIV
  • incidence
  • progression
  • review
  • screening
  • SIL
  • squamous epithelial lesions
  • women

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases

Cite this