We suggest that CIN 2/3 (HSIL) should be managed according to UK national guidelines. Lesions less severe than CIN 2 should probably not be treated according to CIN 2/3 recommendations, as these low-grade lesions represent persistent HPV infection of the cervix rather than pre-malignancy (level of evidence Gefitinib nmr 2B). Women with HIV and CIN 2/3 treated by excisional procedures have a significantly higher treatment failure rate than HIV-negative women. A number of studies show such relapse is less frequent in the presence of HAART or higher CD4

cell counts or undetectable viral load. Multidisciplinary management of such women is thus recommended (GPP). We recommend that women with AZD9291 mw HIV who have invasive cervical cancer should be managed in the same way as HIV-negative women according to UK national guidelines, again within a multidisciplinary team framework (level of evidence 1B). 9 Anal cancer 9.5 Summary of guidance We recommend the examination under anaesthetic (EUA) of the anal canal and rectum with biopsy in all suspected cases (level of evidence 1D). We recommend that staging for anal cancer following EUA and biopsy includes computerized tomography (CT) of the chest, abdomen and pelvis and MRI of the pelvis in order to assess regional lymph nodes and tumour extension [2] (level of evidence 1B). We recommend that the management of HIV patients

with anal cancer is in specialized centres where there is MDT experience in order to ensure optimal outcomes [2] (level of evidence 1C). We suggest that centres caring for these patients should be able to provide high-resolution anoscopy (HRA) services

(level of evidence 2D). We recommend CRT with 5-fluorouracil and mitomycin C (level of evidence 1A). We recommend that all people living with HIV who are to be treated with CRT should start HAART (level Thiamine-diphosphate kinase of evidence 1C) and opportunistic infection prophylaxis (level of evidence 1D). We suggest that salvage surgery may be appropriate for people living with HIV who experience loco-regional disease persistence or relapse following CRT (level of evidence 2D). We suggest that best supportive care may be more appropriate for patients with metastatic disease or local relapse following salvage surgery (level of evidence 2D). We suggest a similar approach in people living with HIV (level of evidence 2D) and advocate surveillance for AIN by HRA (level of evidence 2D). 10 Hodgkin Lymphoma (HL) 10.4.1 Recommendations We recommend for early-favourable HL: ABVD x2–4 + IFRT 20–30 Gy (level of evidence 1B). We recommend for early-unfavourable HL: ABVD x4 + IFRT 30 Gy (level of evidence 1B). We recommend for advanced-stage HL: ABVD x6–8 +/− RT (level of evidence 1B). 10.5.1 Recommendations We recommend patients should receive HAART during chemotherapy (level of evidence 1A).