Preventing cervical cancer among HIV-positive women

Cervical cancer, caused by human papilloma virus (HPV), is a leading cause of cancer-related death among women in low-resource settings. Some areas with the high cervical cancer prevalence, such as sub-Saharan Africa, also have high HIV prevalence. Among HIV-positive women, a weakened immune system and inability to clear HPV may lead to an increased risk of cervical cancer; studies have found a 2- to 22-fold increase in the incidence of invasive cervical cancer among women living with HIV compared with the general population.

The high risk of cervical cancer among HIV-positive women underscores the urgent need for effective cervical cancer prevention programs tailored to their needs. To help develop such programs, researchers with the UCSF Bixby Center worked with a group of HIV-positive women with cervical cancer in Western Kenya. The researchers saw the women six and twelve months following a treatment to clear abnormal cervical cells. The treatment effectively reduced the risk of cancer for up to one year, with only 13% of women experiencing a return of cervical cancer. However, among the women who did experience a return of the disease, the researchers observed a high proportion of invasive cancer.

Because of the risk of developing invasive cancer after treatment, HIV-positive women should receive continued and close follow-up care for cervical cancer. However, the standard of care in low-resource settings means that many cases of invasive cervical cancer could be missed. For instance, without collecting specimen samples of cervical tissue, cases of invasive disease may be missed, especially among HIV-positive women. The researchers call for a continued investigation of the most cost-effective and feasible programs to prevent and treat cervical cancer worldwide.