HIV infection and invasive cervical carcinoma in an Italian population: the need for closer screening programmes in seropositive patients.

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

HIV infection and invasive cervical carcinoma in an Italian population: the need for closer screening programmes in seropositive patients.

AIDS. 1995 Aug;9(8):909-12. Unique Identifier : AIDSLINE MED/96014965
Zanetta G; Maneo A; Colombo A; Ragusa A; Gabriele A; Placa F; Mangioni C; Department of Obstetrics and Gynaecology, S. Gerardo Hospital,; University of Milan, Monza, Italy.

Abstract: OBJECTIVE: To evaluate in an Italian population the prevalence, characteristics at first diagnosis and outcome of HIV-seropositive individuals with cervical carcinoma referred to a tertiary-care institution. DESIGN: A retrospective evaluation of all patients referred for invasive cervical carcinoma from 1991 to 1994. SETTING: The departments of obstetrics and gynaecology, and radiotherapy at San Gerardo Hospital, University of Milan, Italy. PATIENTS: A total of 340 women were treated over a 3-year period (186 aged < 50 years). Six patients were found to be HIV-seropositive. INTERVENTIONS: Seropositive patients were treated according to current institutional protocols, irrespective of HIV status. Four underwent radiotherapy and two radical hysterectomy as primary treatment. RESULTS: Although five HIV-seropositive patients were known to be infected 13-81 months before diagnosis of cervical cancer, none had received a PAP smear in the last year and only one in the last 2 years. HIV patients were younger than general population (P = 0.02), with a significant history of intravenous drug use (P = 0.000001) and with more advanced disease (P = 0.04). Two HIV-positive patients also received polychemotherapy (one adjuvant and one salvage treatment) and both completed the planned treatment. Within 24 months two patients had died of cancer and one of AIDS; one is alive with AIDS and cancer and two are free of disease. CONCLUSIONS: This study confirms that in a southern European population, HIV-seropositive women present to tertiary-care institutions with more advanced disease and have a poorer prognosis than the general population. Strict screening programs for cervical dysplasia and cancer are warranted for HIV-seropositive patients.

Keywords: Adult Cervix Neoplasms/*COMPLICATIONS/EPIDEMIOLOGY/PREVENTION & CONTROL Female Human HIV Infections/*COMPLICATIONS/EPIDEMIOLOGY Italy/EPIDEMIOLOGY Mass Screening Middle Age Prognosis Retrospective Studies JOURNAL ARTICLE
960228
M9621064

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