Me studies have suggested that women living with HIV/ AIDS have

Me studies have suggested that women living with HIV/ AIDS have increased frequency and incidence of single and multiple infections caused by human papillomavirus (HPV) [3]; the natural history of infection becomes altered, thereby leading to an increased risk of developing BI-78D3 site Cervical cancer (CC) and contributing towards this type of cancer being the most frequently diagnosed in HIV-positive women [4]. This relationship may be due to: higher HPV exposure in Peptide M HIV-infected women, increased frequency of main risk factors involved in CC development or therole of HIV-related immunosuppression in favoring carcinogenesis [5]. The immunosuppression can be attenuated through using antiretroviral therapy which favors balanced counts of CD4 lymphocytes, however, this therapy has not been consistently implicated in the reduction of HPV-related diseases [6]. The CC incidence in the Colombian 23727046 general population is 36.4 cases/year/100,000 women [7]; the disease onset occurs approximately between 7 and 12 years after initial HPV infection [8]. These clinical features are altered in women infected simultaneously with HPV and HIV where a short-term clinical outcome usually occurs, involving lesions developing more aggressively, slower HPV infection regression rates and poorer responses to treatment [9]; such factors mean that pre-cancerous lesions could reach 60 (evolving in less than 3 years) [10]. Cervical cytology is the most widely used strategy for reducing the cervical cancer burden around the world [11]. However, this screening test has reduced impact in HIV-infected women, as this group has a greater probability of becoming infected with HPV and developing cervical lesions [12], which has led to cytologicalHPV in HIV-Infected Women Paired Samplesscreening guidelines being rewritten, now including a test every six months during the first year followed by a yearly check-up scheme if no lesions are observed [13]. Nevertheless, cytology coverage in this group of women is poor and insufficient [10], therefore, monitoring programs that allow the constant screening in extended time periods is thus suggested, considering the high risk associated with this group of women. In view of the above, the use of complementary techniques to the Papanicolau test could represent a useful tool in detecting women at risk. Some of these methods are non-invasive, such as self-sampling, as when they are used in screening programs they could provide advantages related to increased acceptance regarding sample-taking, adherence and following-up women, especially those having some form of immunological compromise [14,15]. Specimen tampons, vaginal swabs and urine samples have been studied as self-sampling methods; such sampling methods are also used for detecting other sexually-transmitted pathogens affecting the cervical area [9,16], urine samples being the easiest to obtain and having had the greatest acceptance in the population. However, they do have some limitations, including low cellular load and they are not taken directly from the HPV infection site; this could mean that the results obtained from this type of sample might not reflect the real clinical state of an infection [14]. In spite of their limitations, using urine samples as a test for detecting HPV-DNA presence could facilitate frequent sampletaking due to their practicality and greater acceptance among women. This could be useful in studies involving a large number of samples and a pelvic examination is also.Me studies have suggested that women living with HIV/ AIDS have increased frequency and incidence of single and multiple infections caused by human papillomavirus (HPV) [3]; the natural history of infection becomes altered, thereby leading to an increased risk of developing cervical cancer (CC) and contributing towards this type of cancer being the most frequently diagnosed in HIV-positive women [4]. This relationship may be due to: higher HPV exposure in HIV-infected women, increased frequency of main risk factors involved in CC development or therole of HIV-related immunosuppression in favoring carcinogenesis [5]. The immunosuppression can be attenuated through using antiretroviral therapy which favors balanced counts of CD4 lymphocytes, however, this therapy has not been consistently implicated in the reduction of HPV-related diseases [6]. The CC incidence in the Colombian 23727046 general population is 36.4 cases/year/100,000 women [7]; the disease onset occurs approximately between 7 and 12 years after initial HPV infection [8]. These clinical features are altered in women infected simultaneously with HPV and HIV where a short-term clinical outcome usually occurs, involving lesions developing more aggressively, slower HPV infection regression rates and poorer responses to treatment [9]; such factors mean that pre-cancerous lesions could reach 60 (evolving in less than 3 years) [10]. Cervical cytology is the most widely used strategy for reducing the cervical cancer burden around the world [11]. However, this screening test has reduced impact in HIV-infected women, as this group has a greater probability of becoming infected with HPV and developing cervical lesions [12], which has led to cytologicalHPV in HIV-Infected Women Paired Samplesscreening guidelines being rewritten, now including a test every six months during the first year followed by a yearly check-up scheme if no lesions are observed [13]. Nevertheless, cytology coverage in this group of women is poor and insufficient [10], therefore, monitoring programs that allow the constant screening in extended time periods is thus suggested, considering the high risk associated with this group of women. In view of the above, the use of complementary techniques to the Papanicolau test could represent a useful tool in detecting women at risk. Some of these methods are non-invasive, such as self-sampling, as when they are used in screening programs they could provide advantages related to increased acceptance regarding sample-taking, adherence and following-up women, especially those having some form of immunological compromise [14,15]. Specimen tampons, vaginal swabs and urine samples have been studied as self-sampling methods; such sampling methods are also used for detecting other sexually-transmitted pathogens affecting the cervical area [9,16], urine samples being the easiest to obtain and having had the greatest acceptance in the population. However, they do have some limitations, including low cellular load and they are not taken directly from the HPV infection site; this could mean that the results obtained from this type of sample might not reflect the real clinical state of an infection [14]. In spite of their limitations, using urine samples as a test for detecting HPV-DNA presence could facilitate frequent sampletaking due to their practicality and greater acceptance among women. This could be useful in studies involving a large number of samples and a pelvic examination is also.

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