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

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.