Cellular immunodeficiency enhances the progression of human papillomavirus‐associated cervical lesions

Most cases of low‐grade cervical intraepithelial neoplasia (CIN) associated with oncogenic human papillomavirus (HPV) types regress spontaneously within years. Unknown co‐factors seem to be necessary for a progression to malignancy. To determine the possible role of cellular immunodeficiency as such a co‐factor in the genesis of genital neoplasia, 48 HIV‐infected women and 52 allograft recipients were examined periodically during a 3‐year period. Colposcopy, cytology and HPV‐DNA typing (Vira Type) were performed at each visit. Each cervical lesion was matched prospectively with 2 lesions from immunocompetent controls. In all, 29/100 patients suffered from cervical neoplasms, including 2 advanced cervical cancers and 9 CIN3 lesions. Correlation between grade of lesion and HPV DNA 16/18 was significant. Low‐grade lesions among patients progressed more often than among controls and recurrent lesions after destructive treatment were seen more frequently among patients than among controls. All patients with CD4‐lymphocyte counts of