Factors Associated With Recurrence of Cervical Intraepithelial Neoplasia 2+ After Treatment Among HIV-Infected Women in Western Kenya

Huchko, Megan J. MD, MPH*; Leslie, Hannah MPH; Maloba, May RN; Bukusi, Elizabeth A. MBChB, MMed, MPH, PhD‡,§; Cohen, Craig R. MD, MPH*

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000130
Brief Report: Clinical Science
Abstract

Abstract: HIV-infected women are at increased risk for recurrence of cervical dysplasia after treatment. Short-term recurrence rates may reflect treatment efficacy and therefore impact screening protocols and follow-up planning. We conducted a prospective study of 297 HIV-infected women undergoing loop electrosurgical excision procedure for cervical intraepithelial neoplasia 2+ (CIN2+) in an HIV clinic in Kisumu, Kenya. By 6 months after the procedure, 20 (7.1%) of women had recurrent CIN2+. Recurrence was significantly associated with CD4+ nadir but not with highly active antiretroviral therapy use. Longer-term follow-up of this cohort will illustrate the potential impact of highly active antiretroviral therapy and immune status on CIN2/3 disease recurrence.

Author Information

*Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA;

Department of Epidemiology, University of California, Berkeley, CA;

Kenya Medical Research Institute, Nairobi, Kenya; and

§.

Correspondence to: Megan J. Huchko, MD, MPH, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 50 Beale Street, Ste 1200, San Francisco, CA 94105 (e-mail: meganhuchko@ucsf.edu).

Salary of M.J.H. is supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant KL2 TR000143. The remaining authors have no funding or conflicts of interest to disclose.

Received November 12, 2013

Accepted January 06, 2014

© 2014 by Lippincott Williams & Wilkins