Cervical neoplasia in the patient with HIV infection

With heterosexual transmission of HIV becoming the primary mode of transmission to women in the USA, and a high rate of human papillomavirus (HPV) and cervical neoplasia in HIV-infected women, obstetrician-gynecologists have become primary care providers for HIV-infected women. Reports of a high rate of recurrence and progression of cervical neoplasia in this population suggest that gynecologists must strive to identify those women with cervical neoplasia who are HIV infected. Alterations in local immune response of the genital tract caused by HIV infection may be responsible for higher prevalence, recurrence rates, and progression rates of cervical neoplasms in these women. Since cervical cancer may have a more fulminant course in HIV-infected women and has become an AIDS-defining illness, the surveillance and treatment of cervical neoplasia may need to be more aggressive.