How to Cite
Abstract
Introduction. According to the WHO, 17,221 new cases of cervical cancer (CC) were registered in the Russian Federation in 2022. The number of people living with HIV in the Russian Federation reached 1,692,795 by the end of 2023. Immunodeficiency associated with an impaired antiviral response in HIV may potentially complicate specialized treatment for CC due to potential drug interactions or the specific immunological status of the patients.
Aim. To identify the most common adverse events (AE) during chemotherapy for malignant epithelial tumors of the cervix in women living with HIV and to characterize their course.
Materials and Methods. The study included 97 patients living with HIV (HIV+) in the main group and 82 patients without HIV (HIV-) with CC in the control group. HIV status was confirmed via immunoblotting. All patients in both groups received the standard carboplatin-paclitaxel (TCarb) regimen and were comparable according to ECOG performance status.
Results. During chemotherapy (CT), HIV+ patients experienced significantly higher rates of hematological complications compared to controls (p < 0.01). Thrombocytopenia occurred in 65.9% (n=64) of HIV+ patients (grade 3-4: 15.5%, n=10) vs. 37.8% (n=31) of controls (grade 3-4: 6.4%, n=5). Leukopenia occurred in 50.5% (n=49) of HIV+ patients (grade 3-4: 10.2%, n=5) vs. 28% (n=23) of controls (no grade 3-4 events). A non-significant trend towards more severe anemia was also noted in the HIV+ group (35.1%, n=34; grade 3-4: 14.7%) versus controls (26.8%, n=22; grade 3-4: 1.4%). The severity of hematological complications correlated inversely with T-helper cell levels (r = -0.52, p < 0.05). Non-hematological adverse events were more frequent in HIV+ patients (91.2% vs. 78.7%), but their spectrum was comparable between groups (p > 0.05).
Conclusion. The adverse event profile during chemotherapy in HIV+ CC patients is distinct, characterized by a higher prevalence and severity of thrombocytopenia, leukopenia, and more common anemia. The severity of these hematological toxicities correlates with lower T-helper and T-suppressor cell counts. Treatment efficacy is associated with adherence to antiretroviral therapy.
References
Покровский В.В., Ермак Т.Н., Беляева В.В., et al. ВИЧ-инфекция и СПИД. Национальное руководство. Москва: ГЭОТАР-Медиа. 2020: 608. [Pokrovsky V.V., Ermak T.N., Belyaeva V.V., et al. HIV infection and AIDS. National guidelines. Moscow: GEOTAR-Media. 2020: 608 (In Rus)].
Покровский В.В. ВИЧ-инфекция и СПИД. Изд. 2-е, перераб. и доп. Москва: ГЭОТАР-Медиа. 2010: 192. [Pokrovsky V.V. HIV infection and AIDS. 2nd ed., revised and enlarged. Moscow: GEOTAR-Media. 2010: 192. (in Rus)].
Рассохин В.В., Некрасова А.В., Беляков Н.А. Злокачественные опухоли при ВИЧ-инфекции. Локализация, профилактика, лечение. Часть 2. ВИЧ инф. и иммуносупрессии. 2017; 9(2): 16-26.-DOI: https://doi.org/10.22328/2077-9828-2017-9-2-16-26. [Rassokhin V.V., Nekrasova A.V., Belyakov N.A. Malignant tumors in HIV infection. Localization, prevention, treatment. Part 2. HIV Infection and Immunosuppressive Disorders. 2017; 9(2): 16-26.-DOI: https://doi.org/10.22328/2077-9828-2017-9-2-16-26 (In Rus)].
Берлев И.В., Урманчеева А.Ф. Рак шейки матки. Санкт-Петербург: Эко-Вектор. 2018: 212. [Berlev I.V., Urmancheeva A.F. Cervical cancer. St. Petersburg: Eko-Vektor. 2018: 212 (In Rus)].
Рассохин В.В., Некрасова А.В., Михайлова Н.Б. Злокачественные опухоли при ВИЧ-инфекции. Эпидемиология, патогенез, формы опухолей. Часть 1. ВИЧ инф. и иммуносупрессии. 2017; 9(1): 7-21.-DOI: https://doi.org/10.22328/2077-9828-2017-9-1-7-21. [Rassokhin V.V., Nekrasova A.V., Mikhailova N.B. Malignant tumors in HIV infection. Epidemiology, pathogenesis, forms of tumors. Part 1. HIV Infection and Immunosuppressive Disorders. 2017; 9(1): 7-21.-DOI: https://doi.org/10.22328/2077-9828-2017-9-1-7-21 (In Rus)].
Bonnet F., Lewden C., May T., et al. Malignancy-related causes of death in human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy. Cancer. 2004; 101(2): 317-324.-DOI: https://doi.org/10.1002/cncr.20354.
Беляков Н.А., Рассохин В.В., Степанова Е.В., et al. Персонализированный подход к лечению пациента с ВИЧ-инфекцией. ВИЧ инф. и иммуносупрессии. 2020; 12(3): 7-34.-DOI: https://doi.org/10.22328/2077-9828-2020-12-3-7-34. [Belyakov N.A., Rassokhin V.V., Stepanova E.V., et al. Personalized approach to the treatment of a patient with HIV infection. HIV Infection and Immunosuppressive Disorders. 2020; 12(3): 7-34.-DOI: https://doi.org/10.22328/2077-9828-2020-12-3-7-34 (In Rus)].
Ambler K.L., Vickars L.M., Leger C.S., et al. Clinical features, treatment, and outcome of HIV-associated immune thrombocytopenia in the HAART era. Adv Hematol. 2012; 2012: 910954.-DOI: https://doi.org/10.1155/2012/910954.
Ananworanich J., Phanuphak N., Nuesch R., et al. Recurrent thrombocytopenia associated with structured treatment interruption in patients with human immunodeficiency virus infection. Clin Infect Dis. 2003; 37(5): 723-725.-DOI: https://doi.org/10.1086/377270.
Vannappagari V., Nkhoma E.T., Atashili J., et al. Prevalence, severity, and duration of thrombocytopenia among HIV patients in the era of highly active antiretroviral therapy. Platelets. 2011; 22(8): 611-618.-DOI: https://doi.org/10.3109/09537104.2011.577255.
Ambrosioni J., Levi L., Alagaratnam J., et al. Major revision version 12.0 of the European AIDS Clinical Society guidelines 2023. HIV Med. 2023; 24(11): 1126-1136.-DOI: https://doi.org/10.1111/hiv.13542.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2026