Treatment of Cervical Cancer in Women with HIV Infection
Clinical Scenario
This protocol addresses the management of cervical cancer in the specific context of concurrent HIV infection — a combination that requires coordinated oncology and infectious disease care to optimise both cancer outcomes and immune function.
HIV Infection — Key Consideration
Women with cervical cancer who are living with HIV require baseline assessment of immune status and viral control before and during cancer treatment. A pre-treatment CD4 count and viral load measurement are essential to guide the overall management strategy.
Treatment Approach (Overview)
Management in this setting involves initiating and maintaining highly active antiretroviral therapy alongside oncology-directed treatment, following established international guidelines. Attention to prophylaxis for opportunistic infections is integral to the plan. Additional systemic options may be considered in certain cases.
The complete structured regimen — including sequencing, agent selection, and specific recommendations — is available in the full protocol.
Treatment Goals
Control of viral load in response to antiretroviral therapy
Improvement of immunological status (CD4 count)
References
DOI: 10.1016/j.ijgc.2025.102747
Women who test positive for HIV should have a baseline pre-treatment CD4 count (normal range 500 - 1,600 cells per cubic millimeter of blood [cells/mm3]) to assess their immune status and viral load (normal range is below 10,000 copies per milliliter of blood) to assess response to highly active anti-retroviral therapy.
Highly active anti-retroviral therapy should be started at the diagnosis of HIV infection and should continue during cervical cancer treatment to improve the immunological status of patients, control viral load, and reduce HIV-associated morbidities.
Treatment should follow the principles included in the ESGO-ESTRO-ESP guidelines and resource-stratified guidelines.
Prophylaxis for opportunistic infections, such as pneumocystis pneumonia, should be given, and great attention should be paid to other opportunistic infections, such as candidiasis, tuberculosis, hepatitis, or herpes, as they can complicate treatment.
Targeted therapies like bevacizumab may be an option, although data on use in women living with HIV are still limited.
View source ↗