We recommend that all women newly diagnosed with HIV should have cervical surveillance performed by, or in conjunction with, the medical team managing their HIV infection . An initial colposcopy and annual cytology should be performed if resources permit .
We recommend that subsequent colposcopy for cytological abnormality should follow UK national guidelines, and the age range screened should be the same as for HIV-negative women .
We suggest that CIN 2/3 (HSIL) should be managed according to UK national guidelines. Lesions less severe than CIN 2 should probably not be treated according to CIN 2/3 recommendations, as these low-grade lesions represent persistent HPV infection of the cervix rather than pre-malignancy.
Women with HIV and CIN 2/3 treated by excisional procedures have a significantly higher treatment failure rate than HIV negative women. A number of studies show such relapse is less frequent in the presence of HAART or higher CD4 cell counts or undetectable viral load. Multidisciplinary management of such women is thus recommended .
We recommend that women with HIV who have invasive cervical cancer should be managed in the same way as HIV-negative women according to UK national guidelines, again within a multidisciplinary team framework