Uterine Cervical Cancer in Women with HIV Infection

This chapter discusses the high prevalence of human papilloma virus (HPV)-associated malignancies in patients with human immunodeficiency virus (HIV), leading to cervical cancer being designated as an acquired immune deficiency syndrome (AIDS)-defining condition. HIV infection is associated with an increased mortality in this group of patients. This is attributed to likely enhanced HPV carcinogenesis in the setting of HIV-related immunosuppression. There continues to be a high prevalence of cervical cancer in the developing world, where low rates of cervical cancer vaccination and Pap smear testing are reported, and this is especially more common in the HIV-infected cohort. There exist no robust guidelines for the treatment of locally advanced cervical cancer in women with HIV, although early initiation of combination antiretroviral therapy (cART) has been recommended and has led to better rates of treatment completion.