HIV infection is associated with an increased risk of abnormalities in the cervix called squamous intraepithelial lesions (SIL). In healthy women, the low-grade form of this type of abnormality often disappears on its own without treatment. Also, women who are HIV-positive are at an increased risk of infection with human papillomavirus (HPV), which are known to cause cervical cancer and its precursor lesions.
Highly active antiretroviral therapy (HAART) is a combination of several antiretroviral drugs that reduces the number of HIV particles in the bloodstream and helps boost immune system function. However, it is unclear whether the boost in immune status afforded by HAART improves the regression rates of SIL.
Linda Ahdieh-Grant, Ph.D., of Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues analyzed data from the Women's Interagency HIV Study to examine the long-term effects of HAART on the regression of cervical SIL. Of the approximately 2,000 women who participated in the study, there were 312 women who had normal Pap smears at the time they entered the study and then, at some point during the 7 years of follow-up, were diagnosed with SIL.
The introduction of HAART was associated with a regression of SIL. Compared with women whose abnormality regressed, women whose lesions did not regress had more advanced HIV disease, including lower T-cell counts. Before women started HAART, the rate of disease regression was 0.0%; after HAART was introduced, the regression rate was 12.5%. However, the authors point out that the majority of the lesions in HIV-infected women, even among th
Contact: Sarah L. Zielinski
Journal of the National Cancer Institute