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NEOPLASIA CERVICAL Y PACIENTES INFECTADAS POR HIV

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La observación cercana continua, asociada con por lo menos un examen citológico anual, y el tratamiento adecuado, en caso de una lesión escamosa intraepitelial de alto grado, son de suma importancia.
stier9.jpg Autor:
Elizabeth Stier
Columnista Experto de SIIC

Institución:
Assistant Attending Surgeon General Gynecology Section Gynecology Service Department of Surgery Memorial Sloan-Kettering Cancer Center New York, USA

Artículos publicados por Elizabeth Stier
Recepción del artículo
22 de Octubre, 2004 		Aprobación
5 de Noviembre, 2004
Primera edición
5 de Julio, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

NEOPLASIA CERVICAL Y PACIENTES INFECTADAS POR HIV

Resumen
El propósito de esta revisión es resumir los estudios existentes sobre la infección cervical por el virus del papiloma humano (HPV) y la neoplasia cervical intraepitelial (CIN) en las mujeres infectadas por el virus de la inmunodeficiencia humana (HIV). Además, esta revisión discute el manejo del extendido de Papanicolaou (Pap) anormal y las recomendaciones de tratamiento para la displasia cervical en las pacientes infectadas por el HIV. La infección por HPV y la CIN están claramente incrementadas en las mujeres HIV positivas, en comparación con las mujeres HIV negativas de riesgo equiparable. Cualquier Pap anormal debería ser investigado con detenimiento, mediante evaluación colposcópica. El tratamiento es recomendable en los casos de CIN 2-3. Sin embargo, los índices de recurrencia luego del tratamiento son muy altos. Las repercusiones del tratamiento antirretroviral de gran actividad (TARGA) sobre la incidencia de la infección por HPV, la displasia cervical y el índice de recurrencia luego del tratamiento no son todavía claras. La información vigente sugiere que debería continuar la práctica de la detección sistemática del cáncer cervical y el tratamiento de las lesiones cervicales de alto grado en las pacientes HIV positivas, aun entre las mujeres que han respondido adecuadamente a la TARGA.

Palabras clave
Papilomavirus humano, virus de la inmunodeficiencia humana, cáncer de cuello uterino, terapia antirretroviral de gran actividad, neoplasia cervical intraepitelial


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CERVICAL NEOPLASIA AND THE HIV-INFECTED PATIENT

Abstract
The purpose of this review is to summarize studies of cervical human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) in HIV-infected women. In addition, this review discusses management of the abnormal Pap smear and treatment recommendations for cervical dysplasia in the HIV-infected patient. Cervical HPV infection and CIN are clearly increased in HIV-positive women when compared with risk-matched HIV-negative women. Any abnormal Pap smear should be further investigated with a colposcopic evaluation. Treatment is recommended for CIN2-3. However, recurrence rates after treatment are very high. The impact of highly active antiretroviral therapy (HAART) on the incidence of HPV infection, cervical dysplasia, and recurrence rate after treatment is not yet clear. Current data suggest that cervical cancer screening and treatment of high-grade cervical lesions in HIV-positive women should continue, even in women who have responded well to HAART.

Key words
Human papillomavirus, human immunodeficiency virus, cervical cancer, highly active antiretroviral therapy, cervical intraepithelial neoplasia


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Artículos originales > Expertos del Mundo >
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Especialidades
Principal: Infectología, Obstetricia y Ginecología
Relacionadas: Anatomía Patológica, Atención Primaria, Diagnóstico por Laboratorio, Medicina Familiar, Medicina Interna, Oncología, Salud Pública



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Stier, Elizabeth
Bibliografía del artículo
  1. Gallagher B, Wang Z, Schymura MJ, et al. Cancer incidence in New York State acquired immunodeficiency syndrome patients. Am J Epidemiol. 2001 Sep 15;154(6):544-56.
  2. National Center for HIV, STD and TB Prevention: Basic Statistics [database online]. Atlanta, Ga: Centers for Disease Control and Prevention; 2002. Updated September 27, 2002.
  3. Sun XW, Kuhn L, Ellerbrock TV et al. Human Papillomavirus infection in women infected with the human immunodeficiency virus N Engl J Med 1997; 337:1343-9.
  4. Ellerbrock TV, Chiasson MA, Bush TJ, et al. Incidence of cervical squamous intraepithelial lesions in HIV-infected women. JAMA. 2000 Feb 23;283(8):1031-7.
  5. Jamieson DJ, Duerr A, Burk R, et al. Characterization of genital human Papillomavirus infection in women who have or who are at risk of having HIV infection. Am J Obstet Gynecol. 2002 Jan;186(1):21-7.
  6. Ahdieh L, Klein RS, Burk R, et al. Prevalence, incidence, and type-specific persistence of human Papillomavirus in human immunodeficiency virus (HIV)-positive and HIV-negative women. J Infect Dis. 2001 Sep 15;184(6):682-90.
  7. Duerr A, Kieke B, Warren D, et al. Human Papillomavirus-associated cervical cytologic abnormalities among women with or at risk of infection with human immunodeficiency virus. Am J Obstet Gynecol. 2001 Mar;184(4):584-90.
  8. Palefsky JM, Minkoff H, Kalish LA, et al. Cervicovaginal human Papillomavirus infection in human immunodeficiency virus-1 (HIV)-positive and high-risk HIV-negative women. J Natl Cancer Inst. 1999 Feb 3;91(3):226-36.
  9. Massad LS, Ahdieh L, Benning L, et al. Evolution of cervical abnormalities among women with HIV-1: evidence from surveillance cytology in the women's interagency HIV study. J Acquir Immune Defic Syndr. 2001 Aug 15;27(5):432-42.
  10. Heard I, Tassie JM, Schmitz V, et al. Increased risk of cervical disease among human immunodeficiency virus-infected women with severe immunosuppression and high human Papillomavirus load(1). Obstet Gynecol. 2000 Sep;96(3):403-9.
  11. Delmas MC, Larsen C, van Benthem B, et al. Cervical squamous intraepithelial lesions in HIV-infected women: prevalence, incidence and regression. European Study Group on Natural History of HIV Infection in Women. AIDS. 2000 Aug 18;14(12):1775-84.
  12. Davis AT, Chakraborty H, Flowers L, et al. Cervical dysplasia in women infected with the human immunodeficiency virus (HIV): a correlation with HIV viral load and CD4+ count. Gynecol Oncol. 2001 Mar;80(3):350-4.
  13. Volkow P, Rubi S, Lizano M, et al. High prevalence of oncogenic human Papillomavirus in the genital tract of women with human immunodeficiency virus. Gynecol Oncol. 2001 Jul;82(1):27-31.
  14. US Public Health Service (USPHS) and Infectious Diseases Society of America (IDSA). 2001 USPHS/IDSA Guidelines for the Prevention of Opportunistic Infections in Persons Infected with Human Immunodeficiency Virus.
  15. Stein MD, Cunningham WE, Nakazono T, et al. Screening for cervical cancer in HIV-infected women receiving care in the United States. J Acquir Immune Defic Syndr. 2001 Aug 15;27(5):463-6.
  16. Swierczynski SL, Lewis-Chambers S, Anderson JR, et al. Impact of liquid-based gynecologic cytology on an HIV-positive population. Acta Cytol. 2004;48(2):165-72.
  17. Wright Jr TC, Cox JT, Massad LS, et al. 2001 ASCCP-sponsored consensus conference 2001: consensus guidelines for the management of women with cervical cytological abnormalities. JAMA 2002;287:2120-9.
  18. Holcomb K, Abulafia O, Matthews RP, et al. The significance of ASCUS cytology in HIV-positive women. Gynecol Oncol. 1999 Oct;75(1):118-21.
  19. Cejtin HE, Komaroff E, Massad LS, et al. Adherence to colposcopy among women with HIV infection. J Acquir Immune Defic Syndr. 1999 Nov 1;22(3):247-52.
  20. Frisch M, Biggar RJ, Goedert JJ. Human Papillomavirus-associated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome. J Natl Cancer Inst. 2000 Sep 20;92(18):1500-10.
  21. Robinson WR, Andersen J, Darragh TM, et al. Isotretinoin for low-grade cervical dysplasia in human immunodeficiency virus-infected women. Obstet Gynecol. 2002 May;99(5 Pt 1):777-84.
  22. Fruchter RG, Maiman M, Sedlis A, et al. Multiple recurrences of cervical intraepithelial neoplasia in women with the human immunodeficiency virus. Obstet Gynecol. 1996 Mar;87(3):338-44.
  23. Tate DR, Anderson RJ. Recrudescence of cervical dysplasia among women who are infected with the human immunodeficiency virus: a case-control analysis. Am J Obstet Gynecol. 2002 May;186(5):880-2.
  24. Holcomb K, Matthews RP, Chapman JE, et al. The efficacy of cervical conization in the treatment of cervical intraepithelial neoplasia in HIV-positive women. Gynecol Oncol. 1999 Sep;74(3):428-31.
  25. Maiman M, Watts DH, Andersen J, et al. Vaginal 5-fluorouracil for high-grade cervical dysplasia in human immunodeficiency virus infection: a randomized trial. Obstet Gynecol. 1999 Dec;94(6):954-61.
  26. Diaz-Arrastia C, Arany I, Robazetti SC, et al. Clinical and molecular responses in high-grade intraepithelial neoplasia treated with topical imiquimod 5%. Clin Cancer Res. 2001 Oct;7(10):3031-3.
  27. Palella FJ Jr, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998 Mar 26;338(13):853-60.
  28. Heard I, Tassie JM, Kazatchkine MD, et al. Highly active antiretroviral therapy enhances regression of cervical intraepithelial neoplasia in HIV-seropositive women. AIDS. 2002 Sep 6;16(13):1799-802.
  29. Minkoff H, Ahdieh L, Massad LS, et al. The effect of highly active antiretroviral therapy on cervical cytologic changes associated with oncogenic HPV among HIV-infected women. AIDS. 2001 Nov 9;15(16):2157-64.
  30. Ahdieh-Grant L, Li R, Levine AM, et al. Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women. J Natl Cancer Inst 2004;96:1070-6.
  31. Schuman P, Ohmit SE, Klein RS, et al. Longitudinal study of cervical squamous intraepithelial lesions in human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women. J Infect Dis. 2003;188(1):128-36.
  32. Lillo FB, Ferrari D, Veglia F, et al. Human papillomavirus infection and associated cervical disease in human immunodeficiency virus-infected women: effect of highly active antiretroviral therapy. J Infect Dis. 2001;184(5):547-51.
  33. Del Mistro A, Bertorelle R, Franzetti M, et al. Antiretroviral therapy and the clinical evolution of human papillomavirus-associated genital lesions in HIV-positive women. Clin Infect Dis. 2004;38(5):737-42.
  34. Robinson WR, Hamilton CA, Michaels SH, et al. Effect of excisional therapy and highly active antiretroviral therapy on cervical intraepithelial neoplasia in women infected with human immunodeficiency virus. Am J Obstet Gynecol. 2001 Mar;184(4):538-43.
  35. Steller M. Cervical cancer vaccines: progress and prospects. J Soc Gynecol Investig. 2002 Sep-Oct;9(5):254.
 
 
 
 
 
 
 
 
 
 
 
 
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