chapter  Chapter 13
20 Pages

Cervical Neoplasia, Human Papilloma Virus and Psychoneuroimmunology

WithMichael H. Antoni, Karl Goodkin

Cervical carcinoma is the fifth most common cancer in the world and the second major cause of cancer-related death in women, preceded only by breast cancer. Cervical neoplasias are part of the list of such malignancies which identify those HIV-1 infected individuals as having acquired immune deficiency syndrome (AIDS) and as candidates for imminent progression to other AIDS-related conditions due to the documented immunosuppression and human papillomavirus infections (HPV) which are probable criteria for the manifestation of Cervical intraepithelial neoplasia (CIN). Most work suggests that HPV infection alone may be insufficient to induce dysplastic changes in an immunocompetent host. Cofactors such as cigarette smoking and coinfection with herpesviruses and other pathogens that may contribute to immunosuppression are possibly sufficient. Since adequate immune system challenge is apparent in CIN, some depression of cellular immune functioning via insufficient production of cytokines may be necessary to create the conditions for immunological escape allowing CIN promotion.