Predictors of persistent cytologic abnormalities after treatment of cervical intraepithelial neoplasia in Soweto, South Africa: a cohort study in a HIV high prevalence population

Abstract

Background: In the presence of both HIV infection and cervical intraepithelial neoplasia (CIN), the risk of cancer development despite treatment may be greater. We investigated clinical predictors of persistent cytological abnormalities in women who had had a large loop excision of the transformation zone (LLETZ).

Progression and regression of premalignant cervical lesions in HIV-infected women from Soweto: a prospective cohort

“…In HIV infected women however, higher rates of HPV infection [7,8,9,10], more rapid and more frequent progression [11], with poorer treatment outcomes [11,12,13] compared to HIV-seronegative have been reported. South African women have very high rates of invasive cervical cancer; in 1997 Black South Africa women had a lifetime risk of 1 in 23 for invasive cervical cancer [14].…”

Cervical intra-epithelial neoplasia in HIV-positive women after excision of transformation zone – does the grade change?

“…5 Studies show that the recurrence of CIN after treatment was between 20% and 65% in HIV-infected women. 6,7 We aimed to assess whether the cervical disease that occurs in HIV-infected women after treatment is of a different grade of disease compared with the histology results at presentation.…”

Low‐grade squamous intraepithelial lesions among women with HIV

“…In the present study, women who used ART were 43% less likely to have CIN2 or higher than those who did not use ART. The severity of HIV infection (as reflected by CD4 cell count) has also been shown to be associated with increasing severity of cervical dysplasia …”

“…The presence of disease at the margins after excision of the transformation zone is an important predictor of recurrent cervical cancer precursor lesions . Recurrence of such lesions is high among women with HIV, either with or without complete excision.…”