HPV testing in HIV-positive women may help reduce frequent cervical cancer screening

July 22, 2012

A new study by researchers at Albert Einstein College of Medicine of Yeshiva University suggests that HIV-positive women may be able to use new methods that can help to safely reduce the frequency of screening in some women, similar to practices accepted in the general population. The findings will be published in the July 25 issue of the Journal of the American Medical Association (JAMA), a theme issue on HIV/AIDS.

A new study by researchers at Albert Einstein College of Medicine of Yeshiva University suggests that HIV-positive women may be able to use new methods that can help to safely reduce the frequency of screening in some women, similar to practices accepted in the general population. The findings will be published in the July 25 issue of the (JAMA), a theme issue on HIV/AIDS.

Howard Strickler, M.D., M.P.H. professor of epidemiology and population health at Einstein and senior author of the study, presented the findings today at a JAMA media briefing at the International AIDS Conference.

Marla Keller, M.D., discusses her new research that indicates HPV testing in HIV-positive women may help reduce the frequent Pap tests, used to screen for cervical cancer, that are now recommended. Dr. Keller is associate professor of medicine and of obstetrics & gynecology and women’s health at Albert Einstein College of Medicine and attending physician, medicine at Montefiore Medical Center, the University Hospital for Einstein Credit: Albert Einstein College of Medicine

As of 2009, 1.2 million people age 13 and older were living with HIV in the United States, according to the Centers for Disease Control and PreventionWomen accounted for about one-quarter of those infected.

In March 2012, the United States Preventive Services Task Force revised its screening guidelines for HIV-negative women aged 30 or older to once every five years from once every three years provided they have a normal test and a negative test for (HPV), the virus mainly responsible for cervical cancer. The detects precancerous or in the cervical lining and the detects cancer-associated types of the virus.

But those guidelines did not update screening recommendations for HIV-positive women. Current recommendations for HIV-positive women are to have two Pap tests, at six-month intervals, in the first year following diagnosis of HIV and, if normal, on an annual basis from then on. HPV testing is not currently recommended for HIV-positive women.

The current study looked at whether cervical could be reduced in HIV-positive women who have a normal Pap test and a negative test for HPV. The Einstein researchers reasoned that for women with a normal Pap test and no evidence of cervical HPV infection, the risk of cervical precancer or cancer is likely to be very low for several years regardless of HIV status.

“It is widely thought that before cervical precancer or cervical cancer can develop, there must be persistent infection by a cancer-associated HPV, as well as the accumulation of additional genetic changes over time,” said Dr. Strickler.

The study analyzed data on 420 HIV-positive and 279 HIV-negative women who were enrolled in the Women’s Interagency HIV Study (WIHS), the largest prospective study of HIV-positive women in the US. (Montefiore Medical Center, the University Hospital for Einstein, is one of the six clinical sites for WIHS.) At enrollment, each woman had a normal Pap test and tested negative for the cancer-related HPV types. The women’s rates of cervical precancer and cancer were measured after three- and five-years of follow-up.

At both the three- and five-year screening intervals, the incidence of cervical precancer was found to be similar in both HIV-positive and HIV-negative women. No cases of cervical cancer were detected in either group.

“Overall, few cases of cervical precancer would have gone undiagnosed if the HIV-positive women did not have any additional Pap tests during the five years following enrollment — no more than in the HIV-negative group,” said lead author Marla Keller, M.D., associate professor of medicine and of obstetrics & gynecology and women’s health at Einstein and attending physician, medicine at Montefiore. “Thus, these data raise the possibility that HPV and Pap co-testing could be used to reduce the burden of frequent Pap tests and, by extension, unnecessary biopsies in HIV-positive who are in long-term clinical follow-up.”

Explore further: Health groups issue cervical cancer screening guidelines

More information: JAMA. 2012;308[4]:362-369.

Related Stories

Health groups issue cervical cancer screening guidelines

March 14, 2012
The American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) have released new guidelines for the prevention and early detection ...

HIV raises anal cancer risk in women, study says

April 16, 2012
(HealthDay) -- Women with HIV are at increased risk for anal cancer, a new study finds.

Most anal lesions don't cause cancer in men, research shows

March 23, 2012
(HealthDay) -- Anal human papillomavirus (HPV) infection and precancerous lesions are common among gay and bisexual men, but most of these cases will not progress to anal cancer, a new analysis of earlier research shows.

Screening for HPV persistence and cervical cancer risk

September 6, 2011
Women over the age of thirty who test positive for HPV (Human Papillomavirus) should be re-tested two years later as part of cervical cancer screening, according to a study published online TK in the Journal of the National ...

Recommended for you

Study suggests a way to stop HIV in its tracks

December 1, 2017
When HIV-1 infects an immune cell, the virus travels to the nucleus so quickly there's not enough time to set off the cell's alarm system.

Discovery puts the brakes on HIV's ability to infect

November 30, 2017
Viewed with a microscope, the virus faintly resembles a pineapple—the universal symbol of welcome. But HIV, the virus that causes AIDS, is anything but that. It has claimed the lives of more than 35 million people so far.

Rising levels of HIV drug resistance

November 30, 2017
HIV drug resistance is approaching and exceeding 10% in people living with HIV who are about to initiate or reinitiate first-line antiretroviral therapy, according to the largest meta-analysis to date on HIV drug resistance, ...

Male circumcision and antiviral drugs appear to sharply reduce HIV infection rate

November 29, 2017
A steep drop in the local incidence of new HIV infections accompanied the rollout of a U.S.-funded anti-HIV program in a large East-African population, according to a study led by researchers at Johns Hopkins Bloomberg School ...

Combination HIV prevention reduces new infections by 42 percent in Ugandan district

November 29, 2017
A study published today in the New England Journal of Medicine provides real-world evidence that implementing a combination of proven HIV prevention measures across communities can substantially reduce new HIV infections ...

Research on HIV viral load urges updates to WHO therapy guidelines

November 24, 2017
A large cohort study in South Africa has revealed that that low-level viraemia (LLV) in HIV-positive patients who are receiving antiretroviral treatment (ART) is an important risk factor for treatment failure.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.