Skip Navigation LinksHome > January 2011 - Volume 15 - Issue 1 > A Comparison of Loop Electrosurgical Excision Procedures Bet...
Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e3181eb3115
Original Articles

A Comparison of Loop Electrosurgical Excision Procedures Between Human Immunodeficiency Virus-Seropositive and -Seronegative Women

Cejtin, Helen E. MD; Malapati, Radha MD; Chaparala, Sushma MD

Collapse Box

Abstract

Objective. The purpose of this study was to compare preoperative and postoperative factors between human immunodeficiency virus (HIV)-seropositive and -seronegative women having a loop electrosurgical excision procedure (LEEP). Our hypothesis is that cervical intraepithelial neoplasia (CIN) presents differently in immunocompromised women.

Materials and Methods. A database of LEEPs performed from October 2004 to November 2009 at John H. Stroger Jr. Hospital, Cook County, Illinois, was created. Patients were considered to have persistent/recurrent disease if they had a cytological diagnosis of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion, or worse with no histology or a histological diagnosis of CIN 1 or worse at any time after their LEEP. χ2 Analysis was performed to evaluate differences between HIV-seropositive and -seronegative women.

Results. There were 886 LEEPs performed during the study period, 92 among HIV-seropositive and 794 among HIV-seronegative women. Overall, 64.7% had any cytology or histology performed after their procedure, and seropositive women were more likely to follow up (p = .004). Preoperative cytological and cervical histological diagnoses were not different between seropositive and negative women; however, a preoperative endocervical curettage, which was positive, was more common among seropositive women (p < .0001). Human immunodeficiency virus-seropositive women were more likely to have CIN on LEEP histology (p = .04), and more likely to have positive margins (p < .0001) and recurrent/persistent disease (p < .0001).

Conclusions. The spectrum of cervical disease was very different between HIV-seropositive and -negative women having LEEPs in our study. Practitioners managing HIV-infected women should be aware of these differences and counsel and follow up appropriately.

©2011The American Society for Colposcopy and Cervical Pathology

Login

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.