The increased frequency of cervical dysplasia-neoplasia in women infected with the human immunodeficiency virus is related to the degree of immunosuppression

Article Abstract:

Several lines of evidence indicate that human papillomavirus (HPV) may be a causal agent in cervical pathology, including cancer (cervical dysplasia-neoplasia). HPV infection is more prevalent among women infected with human immunodeficiency virus (HIV), which causes AIDS, and a greater proportion of these women also have cervical dysplasia-neoplasia. These disorders may result from an impaired immune system, and it was suggested that the degree of immunosuppression may be associated with the risk of cervical abnormalities in HIV-infected women. This was tested by examining 111 HIV-positive women (who tested positive for the antibody against HIV), 84 of whom had a history of drug use, sharing drug injection paraphernalia, and promiscuity. Results from these subjects were compared with results from 76 drug-addicted women who were HIV-negative, and with results from 526 controls (women with minor gynecologic complaints). Pap smears were obtained from all subjects to evaluate cervical cells, and were rated as normal (1), dysplastic (2; all degrees of dysplasia), or showing invasive cancer (3). HIV-induced disease was classified according to clinical findings (group I, acute HIV infection; group IV, AIDS-related conditions). Function of white blood cells (lymphocytes), the cells of the immune system, was also evaluated. Results showed that the prevalence of cervical dysplasia-neoplasia among HIV-infected women (41 percent) was ten times higher than among controls (4 percent), and four times higher than among non-infected intravenous drug users (9 percent). This risk increased as lymphocyte function became progressively impaired, measured both by decreased numbers of CD4-positive T cells (which are depleted in HIV infections) and by a poorer proliferative response (cell division) to normal test substances. The results suggest that impairment of the immune response by HIV infection is a factor in the development of cervical dysplasia-neoplasia. HIV-infected women should be examined regularly for cervical abnormalities, particularly if the disease is advanced. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Papillomavirus infections, Immunosuppression

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Outpatient excisional management of cervical intraepithelial neoplasia: a prospective, randomized comparison between loop diathermy excision and laser excisional conization

Article Abstract:

Loop diathermy excision may be more effective than laser excisional conization for outpatient treatment of patients with cervical intraepithelial neoplasia, or CIN. Loop diathermy excision and laser excisional conization are different methods to remove cells from the cervix that can be performed on an outpatient basis under local anesthesia. Among 300 women with CIN treated as outpatients, 150 underwent loop diathermy excision and 150 underwent laser excisional conization under local anesthesia. Loop diathermy took an average of 2 1/2 minutes to complete treatment and hemostasis, compared with an average of 24 minutes for laser conization. Women who underwent loop diathermy experienced less pain and discomfort than those who underwent laser conization. Patients treated with loop diathermy also suffered less blood loss than those treated with laser conization.

Care and treatment, Management, Usage, Lasers in surgery, Laser surgery, Surgery, Outpatient, Ambulatory surgery, Diathermy

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Effect of excisional therapy and highly active antiretroviral therapy on cervical intraepithelial neoplasia in women infected with human immunodeficiency virus

Article Abstract:

Women with HIV infection are more likely than those without to have cervical intraepithelial neoplasia, which is considered a precursor of cervical cancer. Highly active antiretroviral therapy (HAART) can lower the risk of developing this condition and prevent it from getting worse.

Complications

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