Cervical cancer may be more severe and progress faster in women with HIV than in those without the infection, suggesting that the immune status plays an important role in the course of the disease, according to a study presented at the European Society for Medical Oncology (ESMO) Asia 2016 Congress held in Singapore.

The study population consisted of 89 cervical cancer patients aged 25 to 65 years who were HIV-positive (n=49) or HIV-negative (n=40). Data on colposcopy, cytology, morphology, MRI studies, ultrasound of the abdomen and pelvis, and HPV testing were evaluated and compared between the two patient groups.

Majority of the patients (51 percent) in the HIV-positive group had cervical cancer in the T4 stage, whereas 37 and 12 percent in this group were at T2?T3 and T1 stages, respectively. In the HIV-negative group, the corresponding proportion of patients with T4, T2?T3 and T1 stage diseases were 10, 47.5 and 42.5 percent.

All patients had human papillomavirus (HPV) infection, with HPV types 16 and 18 being the most predominant strains. In the HIV-positive group, 80 percent were infected with both HPV 16 and 18 serotypes, 10.2 percent had HPV 16 only, and 9.8 percent had HPV 18 only. In the HIV-negative group, on the other hand, the patients were infected with either HPV 16 or 18 serotype only (62.5 and 37.5 percent, respectively).

Of note, cervical cancer took a more aggressive course in HIV-positive than in HIV-negative patients. Iliac lymph node metastasis occurred in combination with spread to the pelvic organs in 80 percent in the HIV-positive group, while this germination in the adjacent organs was rarely observed in the HIV-negative group (10 percent).

The findings highlight the necessity of screening for cervical cancer upon diagnosis of HIV infection.

Screening in HIV-positive women should be performed every 6 months during the first 2 years, and then annually if the results are negative, said study author Dr Tashmetov Murod from the Tashkent Medical Academy in Uzbekistan.

Discontinuation of screening is possible in women after 70 years old, provided that the cervix is intact and the existence of three or more registered consecutive negative cytological studies within the last 10 years, Murod added.

Furthermore, as the immune status is implicated in the course of cervical cancer, the state of immunity should be monitored in HIV-positive patients, he said.