Abstract
The interaction between human papilloma virus (HPV) and human immunodeficiency virus (HIV), both sexually transmitted infections appears to be related to the alteration in cell-mediated immunity in HIV infected persons. Linkage studies of HIV/AIDs and cancer registries have indicated a 2 to 22 fold increase in cervical cancer in HIV positive women compared to HIV negative women. Data on the prevalence of HPV types in invasive cervical carcinoma (ICC) suggest that the proportion of infection with types HPV16/18 (responsible for over 70% of all cervical cancers) is similar in HIV negative and HIV positive women. The biological interaction between HIV and HPV needs further elucidation, although there is some evidence that the presence of HPV infection may be associated with increased HIV transmission. Adolescents perinatally infected by HIV are known to have higher rates of HPV infection and also have been shown to seroconvert in response to HPV vaccination with the quadrivalent vaccine, albeit to lower titers than HIV negative individuals. Anal cancer incidence is greatly increased in HIV positive individuals, particularly in HIV positive men who have sex with men. Screening for anal cancer precursors is feasible and effective; however, the impact on reduction of anal cancer remains to be demonstrated. There are ongoing studies on the safety, immunogenicity, and efficacy of current HPV vaccines in HIV positive individuals and mature data are awaited. Key words: human immunodeficiency virus (HIV), human papilloma virus (HPV), cervicovaginal cancer.
Highlights
Human papilloma virus (HPV) infection has been linked to both cervical and anal cancer and genital warts
Loop electrosurgical excision procedure (LEEP) is a preferred treatment of CIN
The burden of disease associated with infection with HPV, high-risk types, is considerable and there is a strong association between human immunodeficiency virus (HIV) infection and genital cancers and their precursors
Summary
Human papilloma virus (HPV) infection has been linked to both cervical and anal cancer and genital warts. J. AIDS HIV Res. been reported to range between approximately 12 and 40% (Sha et al, 1995; Massad et al, 1999) and adolescent HIV infected women have high prevalence rates of HPV infection (77.4%) (Moscicki et al, 2000) and SIL (55%) (Fuller et al, 1996). Among HIV infected women, HPV disease, as manifested by findings of SIL or CIN (cervical intra-epithelial neoplasia) on cervical studies, is influenced by HIV induced immune suppression.
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