Cervical intraepithelial neoplasia recurrence after conization in HIV‐positive and HIV‐negative women

Abstract

Recurrence rate of CIN in HIV-positive women was higher than in HIV-negative women. The factors associated with recurrence were HIV infection, glandular involvement, and positive margins.

Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women

“…24 A Brazilian study demonstrated that immunosuppressed women had a higher risk of lesion recurrence compared to women with a CD4 T-lymphocyte count > 200 cells/mm 3 . 25 In our study, there was significant association between HIV-related immunodeficiency measured by CD4 T-lymphocyte count, and the presence of CIN. This association remained statistically relevant even after controlling for HPV detection.…”

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

“… positive surgical margins with LEEP or cervical conization (present in >40% of HIV+ women) (Boardman et al 1999;Gilles et al 2005;Lima et al 2009).  glandular involvement (Lima et al 2009).…”

“… glandular involvement (Lima et al 2009).  greater immunosuppression (Holcomb et al 1999;Shah et al 2008)  lack of suppressive ART (Robinson et al 2001).…”

See-and-Treat Approaches to Cervical Cancer Prevention for HIV-Infected Women

“…In this study, persistent CIN was noted in 46% of HIV-positive women and 33% of HIV-negative women 6 months after their initial treatment by cryotherapy, LEEP, knife conization, laser ablation, or laser conization [38]. More recently, Lima and colleagues [39] reported on a cohort of 98 HIV-positive and 120 HIV-negative Brazilian women. In their study, recurrence rates of CIN were 33% among HIV-positive women and 8.4% among HIV-negative women completing 24 months of follow-up after LEEP ( P <0.01) [39].…”

“…More recently, Lima and colleagues [39] reported on a cohort of 98 HIV-positive and 120 HIV-negative Brazilian women. In their study, recurrence rates of CIN were 33% among HIV-positive women and 8.4% among HIV-negative women completing 24 months of follow-up after LEEP ( P <0.01) [39]. Treatment failure may also be associated with immunosuppression [40, 41], endocervical disease [40], positive margins, and HPV infection [42].…”