Cervicovaginal and vulvar papillomavirus lesions: epidemiology in HIV seropositive women. A preliminary study on a continuous series

In a series of 29 HIV-seropositive women (mean age 27.4 years; 75.9 per cent acquired HIV by intravenous drug abuse) observed over a 2 years' period, we were able to determine the main epidemiological characteristics of cervico-vaginal and vulvar lesions caused by human papillomavirus (HPV). More than 58 per cent of cervico-vaginal smears showed cytological evidence of HPV infection (koilocytosis), and 6 cervical biopsies showed histological abnormalities (from CIN I to invasive carcinoma). Condyloma acuminata was found in 38 per cent of the cases, always associated with cervical HPV lesions. Systematic colposcopy of the whole female genital tract frequently detected multifocal HPV infection. HIV-seropositive women constitute a high-risk group for cervico-vaginal and vulvar HPV infection. They clearly need close supervision with frequent cervical smears and, preferably, colposcopy and biopsy for early detection and eradication of genital dysplasias and viral lesions.