This review focuses on the recent therapeutic advances that may affect the management of neoplastic anogenital human papillomavirus (HPV)-related lesions in human immunodeficiency virus patients: highly active antiretroviral therapy (HAART) and HPV vaccines. HAART shows limited benefit on the incidence of high grade intraepithelial lesions and cancer in cervix, vulva and anus. On the other hand, it seems to raise discretely the spontaneous regression rates of cervical low grade lesions -cervical intraepithelial neoplasia (CIN) grade I- and condylomas, as well as the regression after treatment of CIN II-III. The benefit of HAART in squamous intraepithelial lesion seems to be modest, mostly due to the improvement of the immune status. The usefulness of DNA-HPV in HIV is not well established. HPV vaccines represent a mid-term new possibility of prevention for these lesions according to the high effectiveness shown in clinical trials, although the lack of data about effectiveness and security in HIV patients restrict its application. Second generation vaccines, still to be developped, might better adapt the specific needs of these patients.
- Cervical cancer