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Cervical intraepithelial neoplasia recurrence after conization in HIV‐positive and HIV‐negative women
Author(s) -
Lima Maria Inês,
Tafuri Alexandre,
Araújo Angela C,
de Miranda Lima Luiza,
Melo Victor Hugo
Publication year - 2009
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2008.10.009
Subject(s) - medicine , cervical intraepithelial neoplasia , proportional hazards model , prospective cohort study , cohort , human immunodeficiency virus (hiv) , multivariate analysis , gynecology , biopsy , colposcopy , gastroenterology , cervical cancer , obstetrics , cancer , immunology
Abstract Objectives To evaluate the recurrence rates of cervical intraepithelial neoplasia (CIN) in a cohort of HIV‐infected and noninfected women who underwent the loop electrosurgical excision procedure (LEEP). Methods A prospective cohort study of 94 HIV‐positive and 107 HIV‐negative women, both with CIN, treated with LEEP. The diagnosis of recurrence was established after biopsy. The Kaplan‐Meier method was used for survival analysis and multivariate analyses were carried out using the Cox proportional hazards regression model. Results There was a predominance of low‐grade lesions in HIV‐positive compared with HIV‐negative women ( P < 0.01). Recurrence was more frequent with compromised margins and glandular involvement ( P < 0.01). A multivariate analysis showed that HIV‐infection, glandular involvement, and positive margins were independently associated with recurrence of lesions. Conclusions 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.