Cervical Cancer in Human Immunodeficiency Virus (HIV) Positive Patients

Abstract

The clinical management of cervical cancer in human immunodeficiency virus (HIV) positive patients is associated with challenges mainly due to the state of their immunity. They are managed like their HIV seronegative counterparts with surgery or chemoradiotherapy. HIV, cervical cancer, radiotherapy and chemotherapy lower immunity through reduction in CD4 cell counts. A perspective on the management of HIV positive patients with cervical cancer is hereby provided. Available studies were reviewed and peculiar characteristics of HIV patients with cervical cancer were examined. Strategies for managing such patients were identified. HIV positive patients are younger and have more aggressive disease. They have more treatment related toxicities, poorer disease control with higher rates of incomplete and treatment delays than their HIV negative counterparts. Highly active anti-retroviral therapy (HAART) improves treatment outcome in such patients. HIV positive patients with cervical cancer should be commenced on HAART at diagnosis. There should be closer monitoring of CD4 cell counts and viral load while on oncology treatment towards early recognition of need for prophylaxes against opportunistic infections. The dosage of the treatment modalities should also be adjusted according to CD4 cells count status. Possible interactions between antiretroviral therapy (ART) with chemotherapy and radiotherapy should not be overlooked.