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Warts lesions of the lower genital tract of women affected by HPV are often characterised by a strong tendency to relapse. This behaviour is undoubtedly influenced by the conditions of the immune system. Prevalence of disease is increased in the 80's due to the spreading of the HIV all over the world. Relapse is probably related to the persistence of the viral genoma in the perilesional area pretreated or to the reinfections by partners HPV positive. The AIDS epidemic continues to spread throughout the world with a frightening power. WHO estimates that 13 million people, including 1 million children who acquired virus perinatally, had been infected by the end of 1994 and that the number may increase by threefold at the end of the century. As heterosexual transmission becomes the primary mode of HIV transmission in western developed countries, the proportion of women of all ages contracting the disease increase steadily. Those at greatest risk are women in their reproductive years, and AIDS is becoming the leading cause of death among the women aged 25-34 in some U.S. urban areas. As more evidence accumulates about HIV infection, new clinical conditions and syndromes emerge. Although relevant data are mosfly anedocted, it seems that certain gynecological problems are more prevalent in HIV-seropositive women. Although a direct effect of HIV infection cannot be ruled out, alterations in the local immune response of the genital tract cause by HIV infection, as well as viral interaction with other infectious agents or known risk factors, probably account for the higher prevalence, recurrence and progression rates of certain gynecological neoplasms. One such phenomenon is the established high rate of HPV and cervical neoplasia reported in HIV-infected women. The mechanism by which immunosuppression increases the incidence of neoplasia is still unclear. The possibility that immunosuppression predisposes to viral infection with HPV or HSV-2 and to subsequent development of neoplastic conditions has been suggested. Animal experiments have shown that immunosuppressive therapy facilitates infection and potentiates the effect of oncogenic viruses. Halpert showed that the rate of HPV infection in immunosuppressed women was nine times and the raste of cervical neoplasia 16 times the rate found in the general population. Siiman reported evidence of HPV infection in all 20 immunosuppressed women with lower genital neoplasia in his study: he furthre demonstrated that HPV infection and neoplasia in these patients rapidly extended to adjacent areas, tended to recur, resisted therapy and frequently progressed to invasive cancer.
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