New Delhi: In India, cervical cancer continues to be a major public health concern, ranking as the second most common cancer among women. Persistent infection with high-risk human papillomavirus (HPV) is the primary cause of cervical cancer. However, among women living with human immunodeficiency virus (HIV), the risk of developing cervical cancer increases sharply due to the way HIV undermines the body’s immune defenses.
In an interaction with News9Live, Dr Kasturi Baruah- Cancer Physician- M|O|C Panvel & Vashi, decoded the impact of HIV on the immune system. As per the expert, the impact is profound enough to raise cervical cancer risk.
HIV targets and destroys CD4+ T-lymphocytes, cells that are central to the body’s immune response against viral infections such as HPV. As CD4 counts decline, the immune system becomes less capable of clearing HPV infections, allowing them to persist and progress unchecked. Studies have shown that women living with HIV are about six times more likely to develop cervical cancer than HIV-negative women because of this diminished immune surveillance.
In women with normal immune function, HPV infections are often transient and cleared by the immune system over time. But in immunocompromised women—such as those with untreated or advanced HIV—HPV persists longer, and precancerous changes evolve more quickly into cervical intraepithelial neoplasia (CIN) and invasive cancer. In fact, while cervical cancer may take 15–20 years to develop in women with healthy immunity, it can progress in as little as 5–10 years in women with weakened immune systems due to HIV.
India is home to the third-largest population of people living with HIV/AIDS, with women accounting for a significant portion of this group. HIV-positive women in India demonstrate two to five times higher rates of HPV-related cervical abnormalities compared with their HIV-negative counterparts.
“Understanding the molecular interplay between HIV and HPV is critical,” says a senior MOC oncologist. “HIV doesn’t just weaken immunity—it accelerates HPV persistence and cellular changes that lead to cancer. This underscores the need for integrated HIV and cervical cancer screening programs.”
Addressing this dual burden requires routine HPV and cervical screening (e.g., Pap smears), HPV vaccination, and early HIV diagnosis and treatment. For women living with HIV, more frequent follow-up and cervical surveillance are essential to catch precancerous changes early and prevent the development of invasive cervical cancer. With targeted public health strategies, India can significantly reduce the disproportionate impact of cervical cancer among immunocompromised women.