Effect of HAART Treatment in a Cohort of Women in Mozambique Affected by Human Papilloma Virus (HPV) Infection and Human Immunodeficiency Virus (HIV)

A strong association between Human Papilloma Virus (HPV) and the development of pre-invasive and invasive lesions of the uterine cervix has been established. Rates of cervical cancer and its precursor are significantly higher in women with Human Immunodeficiency Virus (HIV) and/or AIDS than in the general population. The aim of this study is to investigate the mid and long–term impact of Highly Active Antiretroviral Therapy (HAART) treatment in a cohort of woman with HPV and HIV in Mozambique. The study was conducted in the context of the DREAM Programme in Mozambique, in collaboration with the Department of Gynaecology and Department of Pathology of the Central Hospital of Maputo. This is a prospective observational study including HIV negative women and HIV positive women who had either started or had not started HAART. Three hundred and nineteen ( 319) women were enrolled: 236 HIV positive and 83 HIV negative; The risk of HPV infection was significantly higher among HIV infected women (RR=1.8; CL 1.3 -2.4). Severe lesions (CIN2/CIN3) correlated significantly with CD4 cell counts. The risk of CIN 2/3 lesions increase in patients with less than 200 CD4 cells was very high (X2=14.362; p=0.02) Our data confirm the potential role of HAART in protecting against cervical cancer in HIV positive patients. The immune reconstitution mediated by HAART enables an increase in CD4 cell counts and decreases the risk of developing of cervical cancer.