Human papillomavirus-associated anogenital neoplasia and other solid tumors in human immunodeficiency virus-infected individuals.

Abstract

The incidence and variety of solid tumors reported among human immunodeficiency virus (HIV)-infected individuals are increasing. Among the most common of these tumors are anogenital malignant and premalignant tumors associated with human papillomavirus infection. Cervical intraepithelial neoplasia is one such human papillomavirus-associated lesion and appears to be more common among women with HIV infection than HIV-negative women. Cervical intraepithelial neoplasia also appears to progress more rapidly among HIV-positive women, and these women are at high risk for progression to invasive cervical cancer in the absence of rigorous screening, treatment, and follow-up. Likewise, HIV-positive men with a history of receptive anal intercourse have a high prevalence of anal intraepithelial neoplasia and a rapidly increasing incidence of invasive anal cancer. The approach to the prevention of anal cancer is similar to that of cervical cancer, although experience with diagnostic and treatment measures is still limited for anal disease. As individuals with advanced immunosuppression live longer due to improvements in the medical therapy for HIV infection, it is expected that the incidence of human papillomavirus-associated neoplasia, as well as that of other tumors, will continue to increase.