Study of Human Papillomavirus Related Genital Pathology Among HIV Positive Women
Study of Human Papillomavirus Related Genital Pathology Among HIV Positive Women
This study is a Multicentre cohort study with inclusion throughout the full duration of the
 study.

 The primary objective is the study of human papillomavirus related genital pathology in HIV
 positive women.

 The secondary objective are:

 1. To study the characteristics of HPV infection and related disease in the context of long
 term HAART and HIV infection ;

 2. To study the characteristics of atypical cells of uncertain significance detected in Pap
 smears, whose prevalence has dramatically increased in the last years;

 3. To describe cervical cancers observed in the cohort

 4. To study the evolution of recurrent high-grade lesions after surgery

 5. To describe the evolution of vaginal lesions developed after hysterectomy for high-grade
 lesions ;

 6. To describe the specific aspects of surgery for the treatment of cervical lesions
 according to the specific localization in the endocervix in HIV-positive women ;

 7. To study the in situ T cell HPV specific response in cervical lesions and the
 relationship between virological and clinical parameters, host immune status and natural
 history of lesions ;

 8. To initiate a prospective study on anal HPV infection and related disease among women
 infected with HIV.

 9. To initiate a study on therapeutic and/or prophylactic HPV vaccines in the context of
 immunosuppression and a high rate of HPV infection ;
Data were be collected into evaluate:

 -  Analysis of prognostic factors (CD4, antiviral therapy) of cervical lesions, using Cox
 models.

 -  Estimation of rates of Incidence of high grade lesions, of recurrence after surgical
 treatments using Kaplan Meier tests.

 -  Logistic regression analysis for the study of factors associated with complete excision
 after surgical treatment.

 -  SIR (standardised incidence rate) evaluation for cervical cancer

 Study procedures are Annual follow-up in case of normal Pap smear, biannual follow-up in case
 of cervical lesions. Surgical management of High grade lesions.
Inclusion Criteria:

 -  women > 18 years old

 -  attending outpatient gynecology consultation

 -  HIV positive

 -  with written informed consent

 -  on social security

 Exclusion Criteria:

 -  unaffiliated to the social healthy security french system