Prevention of cervical cancer in women with HIV
Prevention of cervical cancer in women with HIV
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DOI：
10.1097/coh.0b013e328319bcbe
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发表时间：
2009-01-01
影响因子：
4.1
通讯作者：
Heard, Isabelle
中科院分区：
文献类型：
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作者：
Heard, Isabelle
由人乳头瘤病毒（HPV）引起的宫颈癌是唯一一种几乎可以通过定期筛查预防的癌症。在高资源国家，如同在低资源和中等资源国家一样，受艾滋病流行病打击的妇女感染HPV和相关疾病，包括宫颈癌的发病率很高。宫颈癌筛查通过检测普通人群中的癌前病变，有助于显著降低宫颈癌发病率，但在HIV感染的情况下，宫颈癌的发病率是否有效仍存在争议。最近的发现在过去的十年中，HIV感染妇女宫颈癌的风险仍然很高且稳定，接受抗病毒治疗的妇女中，随着CD4细胞计数的提高，发病率并没有降低。目前正在评估提高宫颈癌筛查灵敏度和特异性的最佳方法。在一般人群中认可的初级筛查中使用HPV DNA检测在免疫功能低下的女性中可能不那么特异，因此可能在筛查中不那么有效。HPV疫苗，最近可用的，没有治疗效果，因此可能不是非常有用的预防宫颈癌的人口高度感染的多重和持续性HPV.SummaryCervical癌预防仍然是一个重要的目标，在HIV感染的妇女和具体的指导方针是必要的，这个不断增加的人口。
Purpose of reviewCervical cancer, caused by the human papillomavirus (HPV), is the only cancer that is almost preventable through regular screening. In high-resource, as in low-resource and middle-resource countries, women hit by the AIDS epidemic have a high prevalence of infection with HPV and related disease, including cervical cancer. The question whether cervical screening, which helped to reduce dramatically cervical cancer rates through the detection of precancerous lesions in the general population, is as efficient in the setting of HIV is still debated.Recent findingsThe risk for cervical cancer remained high and stable during the last decade in HIV-infected women, and incidence did not decrease with improving CD4 cell counts in women receiving antiviral therapy. Optimal methods to improve both the sensitivity and the specificity of cervical cancer screening are currently evaluated. The use of HPV DNA tests in primary screening endorsed in the general population may be less specific in immunocompromised women and might thus not be as efficient on screening. HPV vaccines, recently available, have no therapeutic effect and might thus not be very useful in preventing cervical cancer in a population highly infected with multiple and persistent HPV.SummaryCervical cancer prevention remains an important goal in HIV-infected women and specific guidelines are warranted for this increasing population.