Abstract
BACKGROUND.
The objective of this study was to compare the human immunodeficiency virus (HIV) viral load (VL) and CD4 counts in patients infected with HIV with and without cervical cancer. The authors hypothesized that HIVβpositive women with cervical cancer would have a greater risk of immune suppression.
METHODS.
A caseβcontrol study was conducted that included all HIVβpositive patients who were seen at the authors' institution from January 1, 1995 to April 20, 2006 with invasive cervical cancer (cases) and without invasive cervical cancer (controls). Patients were included only if they had a CD4 count recorded <6 months before or <3 months after their diagnosis of invasive cervical cancer (cases) or at their last gynecologic examination (controls). Controls were matched to cases on a 4:1 ratio according to current smoking history. Patients were considered immunocompetent if they had both a CD4 count >200 cells/ΞΌL and a VL <10,000 copies/mL.
RESULTS.
In total, 15 cases and 60 controls were identified. The median CD4 count for cases was 208 cells/ΞΌL (range, 18β1102 cells/ΞΌL) compared with 445 cells/ΞΌL (range, 20β1201 cells/ΞΌL) for controls (P = .03). The median VL was 16,918 copies/mL (range, 50β214,915 copies/mL) for cases compared with 1430 copies/mL (range, 50β571,000 copies/mL) for controls (P = .15). Only 1 of 14 cases (7%) was immunocompetent compared with 35 of 55 controls (64%; odds ratio, 0.04; 95% confidence interval, 0β0.37; P < .001). This significance was maintained after adjusting for other factors (P = .002).
CONCLUSIONS.
Women with HIV who were diagnosed with invasive cervical cancer appeared to have a much greater degree of immunosuppression than women with HIV without invasive cervical cancer. Cancer 2008. Β© 2008 American Cancer Society.