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Cervical neoplasia often recurs in women with HIV infection
  NEW YORK (Reuters Health) - Following surgery for cervical intraepithelial neoplasia (CIN), there is considerable recurrence of the condition in HIV-positive women, researchers in France report.
Dr. Isabelle Heard of Hopital Europeen Georges Pompidou, Paris and colleagues note that there is a high rate of success for surgical treatment in immunocompetent women with CIN. However, studies conducted before the advent of highly active antiretroviral therapy (HAART) indicated that this was not the case in women with HIV infection.
To gain more current information, the researchers followed 120 HIV-positive women who had undergone surgery for CIN. The findings are published in the August 1st issue of the Journal of Acquired Immunodeficiency Syndromes.
Over 166 patient-years of follow-up, the rate of recurrence of any CIN was 22.3 per 100 patients. Over 279 patient-years of follow-up, the rate of high-grade CIN was 8.6 per 100 patient-years.
The rate of recurrence of CIN at 36 months was 53.9%. The use of HAART was associated with a threefold lower risk of the recurrence of any lesion.
The researchers note that CD4 cell counts below 200 cells per microliter and a positive margin were predictors of recurrence.
Summing-up, Dr. Heard told Reuters Health that cervical disease is common in HIV-infected women and "the expectation is that surgery associated with HAART may delay the occurrence of cervical cancer. We strongly suggest that HIV-positive women need careful cervical cancer screening."
J Acquir Immune Defic Syndr 2005;39:412-418.
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