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This review focuses on the recent therapeutic advances that may affect the management of neoplastic anogenital human papillomavirus (HPV)-related lesions in human immunodeficiency virus patients: highly active antiretroviral therapy (HAART) and HPV vaccines. HAART shows limited benefit on the incidence of high grade intraepithelial lesions and cancer in cervix, vulva and anus. On the other hand, it seems to raise discretely the spontaneous regression rates of cervical low grade lesions -cervical intraepithelial neoplasia (CIN) grade I- and condylomas, as well as the regression after treatment of CIN II-III. The benefit of HAART in squamous intraepithelial lesion seems to be modest, mostly due to the improvement of the immune status. The usefulness of DNA-HPV in HIV is not well established. HPV vaccines represent a mid-term new possibility of prevention for these lesions according to the high effectiveness shown in clinical trials, although the lack of data about effectiveness and security in HIV patients restrict its application. Second generation vaccines, still to be developed, might better adapt the specific needs of these patients.

Background and Objective: Our goal was to investigate the feasibility of identifying the sentinel lymph node (SLN) in patients undergoing surgery for cervical and vulvar carcinomas. We also evaluated the advantages that such procedure can offer in this kind of tumors., Patients and Method: We detected the sentinel lymph node through preoperative lymphoscintigraphy (Technetium-99m colloid) and intraoperative visualization with blue dye by a hand-held or laparoscopic gamma-probe in 7 patients with invasive cervical carcinoma (clinical stage Ib1) and in 6 patients with vulvar carcinoma (clinical stages Ib and II) ., Results: At least one sentinel lymph node was identified in each patient. SNL was more commonly found in patients with invasive cervical carcinoma. We observed neoplastic infiltration in 3 nodes, all of them corresponding to cases of vulvar carcinoma., Conclusions: Sentinel lymph node identification is a feasible technique in the management of vulvar and cervical carcinomas. Our preliminary data show that SLN in gynecological carcinomas have similar uses as in other anatomical sites, identifying women in whom lymph node dissection can be avoided.