Cervical disease in postmenopausal HIV-1-infected women

• Published in: Journal de gynecologie, obstetrique et biologie de la reproduction Vol. 39; no. 6; p. 466
• Main Authors: Ceccaldi, P-F, Ferreira, C, Coussy, F, Mechler, C, Meier, F, Crenn-Hebert, C, Mandelbrot, L
• Format: Journal Article
• Language: French
• Published: France 01.10.2010
• Subjects: Adult; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - etiology; Carcinoma, Squamous Cell - surgery; Disease Progression; Female; France - epidemiology; HIV Infections - epidemiology; HIV-1 - isolation & purification; Humans; Incidence; Menopause; Middle Aged; Retrospective Studies; Uterine Cervical Dysplasia - epidemiology; Uterine Cervical Dysplasia - etiology; Uterine Cervical Dysplasia - surgery; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - etiology; Uterine Cervical Neoplasms - surgery; France
• DOI: 10.1016/j.jgyn.2010.06.009

An increasing number of HIV-1-infected women reaches the age of menopause. This infection is associated with a higher incidence of cervical squamous intraepithelial lesions (low-grade or LSIL, high grade or HSIL). The aim of our study was to describe the cervical disease in these patients during menopause. Retrospective study, identifying all Pap smears and colposcopy in HIV-1-infected postmenopausal women between 1995 and 2008, in our hospital. Eighteen postmenopausal women, aged of 54 years (43-63), have HIV-1 infection since 7.5 years (2-25). Fifty-one pathological exams were reviewed in which 27 (50.98%) abnormal, including four (7.84%) ASC-US, 15 (29.41%) LSIL lesions, and seven (13.73%) HSIL. Ten patients had surgery (laser, conisation, hysterectomy) during the period. The evolution of cervical lesions was: stability in 40.48%, regression in 35.71% and progression in 23.81%. The median time to develop an HSIL at menopause was 5 years. In our study, postmenopausal HIV-1-infected women have most frequently LSIL and persistent. Monitoring of these postmenopausal women should be continued, the attitude to realise an initial HPV typing and confirmation of an abnormal annually Pap smear with colposcopic exam should be confirmed by larger study.