Keller Marla J
Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
Top Antivir Med. 2015 Oct-Nov;23(4):142-5.
HIV-infected women have higher rates of persistence of human papillomavirus (HPV) infection, of abnormal cervical cytology results, and of cervical cancer than uninfected women. It is currently recommended that HIV-infected, sexually active women have a Papanicolaou (Pap) test performed at the time of initial diagnosis of HIV infection, followed by annual Pap testing if the previous test result is normal. Women whose test results show abnormalities greater than atypical squamous cells of undetermined significance (ASCUS) should be referred for colposcopy. Those with ASCUS should undergo immediate colposcopy or repeat cervical cytology in 6 months to 12 months, and those whose repeat cervical cytology results show ASCUS or greater abnormalities should undergo colposcopy. Recent findings indicate that screening intervals can be lengthened for HIV-infected women whose Pap test results are persistently normal and who are engaged in routine care, and that HPV DNA testing may have a role in screening. This article summarizes a presentation by Marla J. Keller, MD, at the IAS-USA continuing education program, Improving the Management of HIV Disease, held in Atlanta, Georgia, in March 2015.
与未感染HIV的女性相比，感染HIV的女性人乳头瘤病毒（HPV）持续感染率、宫颈细胞学检查结果异常率以及宫颈癌发病率更高。目前建议，初次诊断为HIV感染时，有性行为的感染HIV女性应进行巴氏试验（Pap试验），如果之前的检测结果正常，则随后每年进行一次Pap试验。检测结果显示异常程度大于意义未明的非典型鳞状细胞（ASCUS）的女性应转诊接受阴道镜检查。ASCUS女性应立即接受阴道镜检查或在6至12个月后重复进行宫颈细胞学检查，重复宫颈细胞学检查结果显示ASCUS或更严重异常的女性应接受阴道镜检查。最近的研究结果表明，对于Pap试验结果持续正常且接受常规护理的感染HIV女性，可以延长筛查间隔时间，并且HPV DNA检测可能在筛查中发挥作用。本文总结了医学博士玛拉·J·凯勒于2015年3月在佐治亚州亚特兰大举行的IAS-USA继续教育项目“改善HIV疾病管理”上的一次演讲。
