HAART has a beneficial effect for women with HIV with Cervical Intraepithelial Neoplasia (CIN)

I Heard and colleagues from Paris reported at the 8th Retrovirus Conference (Feb 2001) on the impact of HAART on CIN. This is a prospective study (started in 1993) of CIN in HIV+ women with semestrial follow-up (I assume this means twice a year) including colposcopy, PAP smears, and biopsy. All women with biopsy-proven CIN were included in this sub-study. Regression (improvement) of CIN was defined as reversal to normal or change from high-grade to low-grade biopsy proven CIN.

168 women were included: 80 with high-grade CIN and 88 with low-grade CIN. The median CD4 at inclusion was 250. 86 women were treated with PI and 10 with NNRTI in combination with NRTIs. Women were followed for an average of 18 months.

Regression was seen in 67 women (40%): from low grade CIN to normal in 30 women; from high-grade CIN to low grade CIN in 31; from high-grade to normal in 6. Progression to high-grade was seen in 20 women with low grade CIN. The regression rate at 12 months was estimated to be 23% for high-grade, and 15% for low grade. In women receiving PI or NNRTI, regression was twice as high compared to women not receiving HAART (hazard ratio 2.09). Heard said further studies are being conducted to evaluate the impact of HAART on cervical HPV infections.