II. Associated Conditions: Invasive Cervical Cancer (AIDS defining disease)
- Progressive Immunodeficiency enhances HPV replication
- HPV infection is very common in HIV
- HPV Implicated in Cervical Cancer and anal carcinoma
- Monitor high risk patient with Pap Smear every 6 months
- Women with Cervical Dysplasia
- CD4 Cell Count <200
III. Associated Conditions: Infectious Vaginitis
-
Vulvovaginal Candidiasis
- Occurs in 20-30% HIV infected women if CD4 Count >500
- Recurrent Candidiasis in young women suggests HIV
-
Trichomonas
- Extremely prevalent
- Unrelated to CD4 Counts
- May be refractory to Metronidazole
IV. Prevention
- HPV Vaccine for appropriate age groups
-
Cervical Cancer Screening
- HIV is associated with increased risk of HPV
- Obtain Pap Smear at initial HIV diagnoses
- Repeat Pap Smear yearly for at least 3 years
- If normal may repeat every 3 years
- Co-testing with Pap Smear AND HPV testing may be performed after age 30 years
- Continue obtaining Pap Smears life long in HIV Infection