HAART lowers CIN recurrence risk in HIV-positive women

Highly active antiretroviral therapy (HAART) lowers the risk of recurrence, persistence, and progression of cervical intraepithelial neoplasia (CIN) after standard treatment in HIV-positive women, according to a report published in the March issue of the American Journal of Obstetrics and Gynecology.

Dr. William R. Robinson from Harrington Cancer Center in Amarillo, Texas and colleagues compared the clinical outcomes of 56 HIV-positive women with CIN to those of 62 similar women without HIV infection.

Persistent or recurrent and progressive CIN after excisional therapy was significantly more common among HIV-positive women than among HIV-negative women, the authors state.

In the HIV-positive group, low CD4+ cell count and margin involvement of loop excision specimens were risk factors for recurrence. HAART use, was associated with lower recurrence or persistence rate and a lower progression rate.

“The finding that HIV-positive women had higher rates of CIN recurrence and progression than HIV-negative women has been shown in studies before,” Dr. Robinson told Reuters Health. “The new finding was that HIV-positive women who received HAART had much lower rates of CIN recurrence and progression than HIV-positive women who did not receive HAART,” he stated.

“Other studies have shown that HIV-positive patients with KS or non-Hodgkin’s lymphoma do better when they receive HAART, irrespective of the specific treatment that they receive for their malignancy,” Dr. Robinson pointed out. “We wondered if the same might hold true for CIN.”

Dr. Robinson believes that “the message for physicians is that HIV-positive women who have cervical disease should be motivated to take HAART because it improves the outcome of their cervical disease as well as their overall health.”