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HIV and Cervical Dysplasia

Cervical dysplasia is an abnormal change in cells of your cervix . It needs to be monitored by a health care provider, because it could progress to cervical cancer if left untreated (dysplasia itself is not cancer). Regularly scheduled Pap smears are an important detection tool, because many women do not experience any symptoms of dysplasia. Smoking and a weakened immune system can make you more vulnerable to developing cervical dysplasia.

Causes

Cervical dysplasia is usually linked to a sexually transmitted infection called HPV (Human Papillomavirus). There are lots of types of HPV that can produce different reactions in the body, including cervical dysplasia. HPV is a very common sexually transmitted infection that can take years to show signs in the body, so even if you haven’t been sexually active in a long time, it’s important to have Pap smears. Women who have sex with women can transmit HPV to their partners, so lesbians shouldn’t pass on a Pap either.

Diagnosis and Treatment

Cervical dysplasia is first detected through Pap smears. If you have a Pap smear that is abnormal, your doctor may recommend you have a colposcopy, a procedure using a special microscope to examine the abnormal cervical cells more closely. During a colposcopy, a bit of tissue can be removed and sent to a lab for examination. This is called a cervical biopsy.

Dysplasia is categorized based on how much it has developed, and treatment will vary depending on the size and severity of the affected area. The goal is to be the least invasive but the most effective in removing the problematic cells:

  • Cryosurgery: Liquid nitrogen is applied to the area to freeze the cells, which then die
  • Laser treatment: A laser light beam removes abnormal tissue
  • Loop electrosurgical excision procedure (LEEP) uses a fine wire charged with an electrical current to remove the tissue
  • Cone biopsy: A cone-shaped cut removes the abnormal tissue

If cervical cancer is diagnosed from the tissue sample removed during the cervical biopsy, further treatment may be necessary.

Untreated, dysplasia may lead to cervical cancer, which can progress faster in women with HIV than in women without the virus. Women with lower CD4 counts are more vulnerable to dysplasia. HIV treatment may decrease the risk of developing cervical dysplasia in women with HIV because it reduces viral load and increases CD4+ counts, thereby strengthening the immune system. HAART may also improve cervical dysplasia by causing abnormal cells to shrink and disappear.

Prevention

Keep your risks of cervical dysplasia as low as possible. You can:

  • Practice safer sex
  • Get regular Pap tests in order to diagnose and treat infections early (talk to your care provider about the best schedule for you)
  • Quit smoking
  • Talk with your doctor about whether HIV treatment would be a good choice for you

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