HIV, HPV and cervical cancer in developing countries

Both Cervical cancer and HIV infection are sexually transmitted diseases with no immediate visible symptoms. Cervical cancer originates from a sexually transmitted disease named Human Papilloma virus (HPV) which silently grows in the cervix and later develops to invasive cervical cancer. There is a growing evidence in the medical literature that a difference exists between HIV/AIDS positive and HIV negative women in the incidence and aggressiveness of cervical cancer, and this latter tumor is now regarded as an AIDS defining illness. This is particulary true in the low income developing world. Researchers suggest that as women are living longer due to access to specific anti-retroviral drugs, they are at an increased risk of contracting cervical cancer. While access to antiretroviral therapy is beginning to reduce AIDS mortality worldwide, gynaecologic oncologists warn that women being treated for AIDS could end up dying of cervical cancer unless they have access to appropriate screening and treatment. In fact, HIV positive women commonly show invasive cancer ten years earlier than women who are HIV negative. Moreover, the incidence of the precursor of cervical cancer, i.e. cervical intraepithelial neoplasia (CIN) is 4-5 times higher among HIV-infected than HIV-negative women and girls. In conclusion, there is a need for successful integration of cervical cancer  and HIV/AIDS service especially in low income developing countries. Great efforts should be made to introduce HPV vaccination in young girls and to implement effective secondary prevention and early diagnosis of cervical cancer in HIV positive women.