HPV and HIV Coinfection
HPV and HIV Coinfection
Whether HAART will have a beneficial impact on HPV-induced cancer remains a matter of debate. A decrease in HPV-induced lesions might be achieved after several years of efficient HAART, probably in patients in whom HAART has been initiated earlier in the course of the HIV disease. However, in the significant proportion of patients diagnosed with advanced HIV diseases, the benefit of HAART on HPV disease might be overcome by a more advanced HPV disease that has been evolving for several years and for which immune reconstitution comes too late. Meanwhile, we should elucidate the possible negative impact of PI and improve cancer screening coverage in both men and women. Prophylactic vaccination by the quadrivalent vaccine, which has proved to be safe and immunogenic, should be proposed and evaluated in HIV patients until data on the bivalent and nine-valent vaccines are available. Therapeutic vaccines will probably be improved and might particularly benefit HIV-infected patients by reducing the need for recurrent or extensive excisional procedures for anogenital cancers.
Future Perspective
Whether HAART will have a beneficial impact on HPV-induced cancer remains a matter of debate. A decrease in HPV-induced lesions might be achieved after several years of efficient HAART, probably in patients in whom HAART has been initiated earlier in the course of the HIV disease. However, in the significant proportion of patients diagnosed with advanced HIV diseases, the benefit of HAART on HPV disease might be overcome by a more advanced HPV disease that has been evolving for several years and for which immune reconstitution comes too late. Meanwhile, we should elucidate the possible negative impact of PI and improve cancer screening coverage in both men and women. Prophylactic vaccination by the quadrivalent vaccine, which has proved to be safe and immunogenic, should be proposed and evaluated in HIV patients until data on the bivalent and nine-valent vaccines are available. Therapeutic vaccines will probably be improved and might particularly benefit HIV-infected patients by reducing the need for recurrent or extensive excisional procedures for anogenital cancers.
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