Cervical schistosomiasis and neoplasia in HIV-infected patients

We report two HIV-positive women with schistosomiasis of the uterine cervix, a disease that is being increasingly seen in developed countries. In both cases, there were no schistosoma ova in the cervical Papanicolaou smears. Both patients underwent LLETZ procedures that revealed an absence of a granulomatous response to the schistosoma ova, a finding that should alert the pathologist to the possibility of HIV infection. The absence of ova on cervical smears of HIV-infected women with schistosomiasis is probably related to the absence of granulomatous inflammation in these patients. A diligent search should be made for schistosoma ova in the cervical biopsy of patients from endemic areas. Treatment of schistosomiasis in HIV-infected patients should be prompt and complete to prevent recurrent high-risk HPV infection.