Cervical cancer screening in HIV

2017-11-15

The risk of biopsy confirmed cervical high grade squamous intraepithelial neoplasia or worse (bHSIL+) in HIV-positive women in the Women´s Interagency HIV Study was calculated and compared to specific management strategies in the general population. 2,423 HIV-positive women were included in the study which was conducted between 2000 and 2015. Average 3 year bHSIL+ risk in the general population was estimated to be 0.69 % for a three year return after normal cytology. In HIVpositive women with three negative cytology tests or one negative cytology/ oncogenic papilloma cotest and > 500 CD4 cells the 3 year risk was 0.96 (0.31 -1.6) %. The conclusion is that the risk is comparable to the general population in these women. With low CD4 counts (less than 500) the risk is higher at 1.3 (0.52-2.1) %.

Robbins et al. AIDS 20017;31:1035-1044

Comment: As the risk of developing cervical cancer is approaching the risk in the general population in treated HIV-positive women with high CD4 counts it seems reasonable to apply the same screening programs as for the general population.