Cervical intraepithelial neoplasia in human immunodeficiency virus-positive patients

Cervical intraepithelial neoplasia (CIN) is common in patients positive for human immunodeficiency virus (HIV). The questions are whether the manageme nt of CIN in these patients should be different from that of HIV-negative w omen, whether there an any prognostic factors to indicate the course of GIN , and whether the latter is influenced by antiretroviral therapy. A total o f 267 HIV-seropositive women were counseled and examined in our colposcopic clinic. Of that number, 53 patients died during the observation period; 74 % of these patients were immunosuppressed (CD4 count < 200 cells/mm(3)), an d 45% were given diagnoses of GIN. The incidence of CIN was significantly h igher in patients with CD4 less than 200 cells/mm3. Neither the route of HI V infection nor the HPV status nor smoking habits correlated with GIN. CIN relapse was histologically confirmed in 28% of patients who underwent compl ete surgical removal. Immune status plays an important role in HIV-positive women not only with respect to survival but with respect to CIN.