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Recurrence rate of cervical dysplasia high in HIV-positive women
Last Updated: 2002-06-11 14:39:58 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Women who are HIV-positive are more likely to have a recurrence of cervical dysplasia, regardless of treatment modality, compared with their HIV-negative counterparts, researchers report.
Drs. Darren R. Tate and Ralph J. Anderson from John Peter Smith Hospital, Fort Worth, Texas, studied 43 HIV-positive women and 103 HIV-negative women. The subjects underwent standard cryotherapy, laser ablation, or loop electrosurgical excision procedure for cervical dysplasia. Women who had failed these therapies underwent cold knife conization or hysterectomy.
The patients were followed for at least 24 months, according to the report in the May issue of the American Journal of Obstetrics and Gynecology.
For all treatment modalities, recurrence of cervical dysplasia was higher among the HIV-positive women (77.3%) compared with HIV-negative women (19.4%, p=0.019), Drs. Tate and Anderson found.
Among HIV-positive women, recurrence rates were also higher among women with CD4 cell counts of <200 cells per microliter compared with women with higher CD4 counts (55% versus 26%), they report. "Relative risk for recurrence after standard therapy with negative margins was calculated at 17.5," Drs. Tate and Anderson note.
Although the recurrence rate among HIV-positive women was lower after hysterectomy compared with other treatments, recurrence was still high (three of six women), the researchers add.
""Recurrent disease was found in a high percentage of women who were HIV-positive, despite reported negative margins after loop electrosurgery excision procedure, cold knife conization or hysterectomy," Drs. Tate and Anderson conclude.
"Patients with recurrent disease were more likely to have a compromised immune status as evidenced by low CD4 counts," they add.
Am J Obstet Gynecol 2002;186:880-882.

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