Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
Early regression of cervical lesions in HIV-seropositive women receiving highly active antiretroviral therapy.
AIDS. 1998 Aug 20;12(12):1459-64. Unique Identifier : AIDSLINE MED/98394549 Heard I; Schmitz V; Costagliola D; Orth G; Kazatchkine MD; INSERM U 430 and Universite Pierre et Marie Curie, Hopital; Broussais, Paris, France.
Abstract:
OBJECTIVE: Advanced HIV disease is associated with a high prevalence of cervical squamous intra-epithelial lesions (SIL) and of infection with oncogenic human papillomavirus (HPV) genotypes. Triple-combination antiretroviral therapy results in decreased plasma HIV viral load, increased CD4 cell counts and partial restoration of immune functions in patients with severe HIV disease. This study investigated the outcome of SIL in HIV-seropositive women undergoing triple combination antiretroviral treatment. METHODS: Forty-nine women who started triple-combination antiretroviral therapy, including a protease inhibitor, were examined prior to and after a median 5-month treatment. We collected cytological, colposcopic and histologic data and assessed the presence of HPV DNA in cervical smears by PCR and Southern blot hybridization (SBH). RESULTS: The prevalence of SIL decreased from 69 to 53% during follow-up (P < 0.0001). Among 13 women who initially presented with high-grade SIL, conversion to lower grade was observed in two women and a full regression to normality was observed in one. Cytology also returned to normality in nine out of 21 women who initially presented with low-grade SIL. The high prevalence of HPV infection as detected by SBH and PCR was similar at the first and second examinations and the same high-risk viral genotypes were identified at both examinations in all infected patients but one. There was a higher increase in absolute CD4 cells in the subgroup of patients whose lesions regressed (99 versus 50 x 10(6)/l, P=0.03). CONCLUSION: Our observations demonstrate that active antiretroviral therapy may result in a reduced prevalence of cervical squamous intra-epithelial lesions despite the absence of clearance of HPV infection.
Keywords: JOURNAL ARTICLE Adult Anti-HIV Agents/*THERAPEUTIC USE Blotting, Southern Carcinoma, Squamous Cell/*COMPLICATIONS/*DRUG THERAPY Cervical Intraepithelial Neoplasia/*COMPLICATIONS/*DRUG THERAPY Cervix Neoplasms/*COMPLICATIONS/*DRUG THERAPY CD4 Lymphocyte Count DNA, Viral/ANALYSIS Female Human HIV/PHYSIOLOGY HIV Seropositivity/*COMPLICATIONS/*DRUG THERAPY Middle Age Papillomavirus, Human/ISOLATION & PURIF Papovaviridae Infections/*COMPLICATIONS/*DRUG THERAPY/VIROLOGY Polymerase Chain Reaction/METHODS Prospective Studies RNA, Viral/BLOOD Support, Non-U.S. Gov't Treatment Outcome Vaginal Smears Viral Load 990130
A9911036
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Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
