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P180 Vulval pathology in HIV positive women attending a tertiary vulval dermatology clinic over a 5-year period
  1. O Dosekun,
  2. P Farrugia,
  3. F Lewis,
  4. G Sethi
  1. Guy's and St. Thomas' NHS Foundation Trust, London, UK

Abstract

Background Studies have suggested that HIV infected women are at increased risk of developing invasive vulval carcinoma and recurrent herpes simplex type 2 (HSV-2) reactivation.

Objective To describe the spectrum of HIV associated vulval disease in women attending a tertiary dermatology referral centre in a busy urban setting.

Methods A retrospective case note review of all HIV positive women seen in the vulval dermatology clinic from January 2007 to January 2012.

Results 11 women were identified (see abstract P180 table 1). 9 (81%) were black Africans. The mean age at vulval disease diagnosis was 37 years. Most (81%) were already known to be HIV infected and on combined antiretroviral therapy (cART). There were six cases of undifferentiated vulval intra-epithelial neoplasia (uVIN) (43%) with two cases being diagnosed prior to an HIV diagnosis. The three cases of HSV-2 occurred in women with near-complete immune restoration on cART. Six women remain under regular dermatology follow-up, a median of 20 months since diagnosis.

Abstract P180 Table 1

HIV positive women seen in vulval dermatology clinic 2007 to 2012

Conclusion There were no cases of invasive vulval carcinoma. HSV-2 may cause atypical disease even in the context of near-complete immune reconstitution on cART. Most women with vulval disease were already under HIV care, on cART and had a CD4 cell count above 200 cells/μl.

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