Pantanowitz Liron, Michelow Pam
Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01199, USA.
Diagn Cytopathol. 2011 Jan;39(1):65-72. doi: 10.1002/dc.21364.
With heterosexual transmission becoming the primary mode of transmission, more women are being infected with human immunodeficiency virus (HIV). Accrued data from around the world indicate that these HIV-infected women exhibit higher rates of persistent HPV infection with multiple oncogenic viruses, more abnormal Pap tests, more prevalent cervical intraepithelial neoplasia (CIN) lesions, and aggressive invasive cervical cancer compared with their HIV-negative counterparts. In countries where HAART was introduced more than a decade ago, HPV-related disease is increasing among ageing HIV-positive women. The high rate of cervical disease seen in HIV-positive women has prompted recommendations for more aggressive surveillance. The best strategy to screen HIV-infected women, particularly in resource-poor nations, remains challenging. This article reviews the collective literature regarding HIV and squamous lesions of the cervix and highlights these key issues.
随着异性传播成为主要传播方式,越来越多的女性感染了人类免疫缺陷病毒(HIV)。来自世界各地的累积数据表明,与未感染HIV的女性相比,这些感染HIV的女性持续性感染多种致癌性人乳头瘤病毒(HPV)的比例更高,巴氏试验异常更多,宫颈上皮内瘤变(CIN)病变更普遍,且侵袭性宫颈癌更具侵袭性。在十多年前就引入高效抗逆转录病毒治疗(HAART)的国家,与年龄相关的HPV相关疾病在HIV阳性女性中呈上升趋势。HIV阳性女性中宫颈癌的高发病率促使人们建议进行更积极的监测。对于HIV感染女性,尤其是资源匮乏国家的女性,最佳的筛查策略仍然具有挑战性。本文回顾了有关HIV与宫颈鳞状病变的相关文献,并突出了这些关键问题。