Recurrent cervical intraepithelial neoplasia (CIN) in human immunodeficiency virus (HIV) seropositive women (Meeting abstract).

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Recurrent cervical intraepithelial neoplasia (CIN) in human immunodeficiency virus (HIV) seropositive women (Meeting abstract).

24th Annual Meeting of the Society of Gynecologic Oncologists. February 7-10, 1993, Palm Desert, CA, A31 1993. Unique Identifier : AIDSLINE ICDB/94698472
Maiman M; Fruchter R; Serur E; Levine P; SUNY-Health Science Center at Brooklyn, Brooklyn, NY 11203

Abstract: To determine the effect of HIV infection on patterns of recurrence of CIN, 184 patients of known HIV serostatus were followed after standard ablative therapy. The clinical course of 45 HIV positive (+) women was compared with 139 HIV negative (-) women. Patients were treated with cryotherapy, laser vaporization or cone biopsy as per standard indications. All had at least one follow-up Pap smear. CIN severity, modality of treatment and age were similar in the two groups. Follow-up ranged from 6 to 36 mo. Of 45 HIV+ women, 17 (38%) developed biopsy-proven recurrent CIN compared to 11 (8%) of 139 HIV- women (p less than 0.05) . Using the product-limit method to evaluate recurrence over time (data shown in a graph), a significant difference between the two groups was demonstrated (p less than 0.001). The mean CD4 count in HIV+ patients who recurred was 239/mm3 compared to 365/mm3 in HIV+ patients who remained free of CIN. Only 18% of HIV+ patients with CD4 counts over 500/mm3 recurred, compared to 45% of those with CD4 counts under 500. In HIV-, but not in HIV+ patients, recurrence was related to increasing grade of CIN. We conclude that recurrence rates of CIN after standard treatment in HIV+ women are high, and that recurrence is related to immune status in this high-risk group. Unique therapeutic strategies that address these treatment failures should be developed in HIV-seropositive women.

Keywords: Cervix Neoplasms/*COMPLICATIONS/PATHOLOGY/SURGERY Female Human HIV Seropositivity/*COMPLICATIONS Laser Coagulation *Neoplasm Recurrence, Local ABSTRACT
940730
M9470929

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