Gynecological neoplasias in the patient with HIV infection

HIV infection has been associated with progressive deterioration of the immune system and the development of opportunistic infections and various malignancies. As more experience has been accumulated on the nature and complications of AIDS, the gynecological implications of neoplasia developing in the HIV-positive patient became apparent. A type of cervical malignancy that takes a very aggressive course is being increasingly reported. Other lower genital tract tumors such as vaginal and vulvar neoplasia are also more prevalent in HIV-positive women and a closer follow-up is probably indicated in these patient population. Gestational trophoblastic disease in AIDS patients has also been reported to be more resistant to chemotherapy and may have a grave prognosis. Finally, nongynecological malignancies such as non-Hodgkin's lymphoma (NHL) and Kaposi's sarcoma (KS) may have their first site of appearance in the genital organs, thus simulating gynecological tumors. In this survey, we review the current knowledge accumulated in the English literature, and suggest guidelines for surveillance, diagnosis, and treatment by the practicing gynecologist.