Vonau B, Boag F
St Stephen's Centre, Chelsea and Westminster Hospital, London, UK.
Int J STD AIDS. 2000 Dec;11(12):767-73. doi: 10.1258/0956462001915192.
To date the management of HIV-positive women regarding the prevention of cervical cancer remains controversial. There are different approaches to cervical screening in different health authorities in the UK and worldwide due to different funding and healthcare provision in general, the official disease prevalence and the attempt to tailor the screening programme according to a perceived risk for the population covered, but most of all in the diverse evidence provided to aid the development of a screening programme. The advent of high active antiretroviral therapy (HAART) may also have altered the natural history of cervical intraepithelial neoplasia (CIN) before it became sufficiently understood and future studies have to take this into account when investigating the impact of human papillomavirus (HPV) and CIN on the risk of developing cervical cancer. This article aims to summarize the available evidence to date and provide a basis on which an effective and acceptable screening programme for HIV-positive women can be developed.
迄今为止,对于感染HIV的女性预防宫颈癌的管理仍存在争议。在英国以及全球范围内,不同的卫生当局对宫颈癌筛查有不同的方法,这主要是由于总体上资金和医疗服务的提供情况不同、官方疾病患病率不同,以及试图根据所覆盖人群的感知风险来调整筛查计划,但最重要的是由于用于辅助制定筛查计划的证据多种多样。高效抗逆转录病毒疗法(HAART)的出现,可能也改变了宫颈上皮内瘤变(CIN)的自然病程,而在此之前人们对此尚未有充分的了解。未来在研究人乳头瘤病毒(HPV)和CIN对患宫颈癌风险的影响时,必须将这一点考虑在内。本文旨在总结迄今为止可用的证据,并为制定一项针对感染HIV女性的有效且可接受的筛查计划提供依据。