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CMAJ • September 2, 2003; 169 (5)
© 2003 Canadian Medical Association or its licensors

Review
Synthèse

Human papillomavirus and HIV coinfection and the risk of neoplasias of the lower genital tract: a review of recent developments

Alex Ferenczy, François Coutlée, Eduardo Franco and Catherine Hankins

From the Department of Pathology, McGill University and Sir Mortimer B. Davis Jewish General Hospital (Ferenczy); the Département de Microbiologie-Infectiologie et Centre de Recherche, Centre hospitalier de l'Université de Montréal (Coutlée); the Division of Epidemiology, Department of Oncology, McGill University (Franco); and the Departments of Epidemiology and Biostatistics and of and Occupational Health, McGill University (Hankins), Montréal, Que.

Correspondence to: Dr. Alex Ferenczy, Department of Pathology, Sir Mortimer B. Davis Jewish General Hospital, 3755 Côte Ste-Catherine Rd., Montréal QC H3T 1E2; fax 514 340-7542; alex.ferenczy{at}mcgill.ca

Abstract

ONE OF THE RISK FACTORS FOR HUMAN PAPILLOMAVIRUS (HPV) INFECTION and subsequent lower genital tract neoplasias and cancers is impaired cell-mediated immunity. HIV-positive women with severe immunosuppression are 5 times more likely than HIV-negative women to have lower genital tract neoplasias. A corresponding increase in the risk of invasive vulvar and anal cancers, but not of cervical cancer, has also been observed among HIV-positive women. Treatment failure and recurrence of neoplasia occur much more frequently among HIV-positive than among HIV-negative women. In this review, we discuss recent advances in the understanding of the relation between HIV and HPV coinfection and the development of lower genital tract neoplasias and cancers in women. In addition, we present strategies for monitoring and treating noninvasive and invasive neoplasias of the lower genital tract in HIV-positive women.




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