Predictors of Persistent Cervical Abnormalities After Treatment in HIV-Positive Women
Author Information
Author(s): Adam Yasmin, van Gelderen Cyril J, de Bruyn Guy, McIntyre James A, Turton Diane A, Martinson Neil A
Primary Institution: Chris Hani Baragwanath Hospital, University of the Witwatersrand
Hypothesis
The presence of HIV infection and disease at excision margins increases the risk of persistent cytological abnormalities after treatment for cervical intraepithelial neoplasia.
Conclusion
The study found a high risk of persistent cytological abnormalities after treatment, especially in patients with incomplete excision and those who are immunocompromised.
Supporting Evidence
- 49% of women had persistent cytological abnormalities after treatment.
- HIV infection and disease at excision margins were significant predictors of persistence.
- Women with a CD4 count of ≥ 500 cells/mm3 had a lower risk of persistent abnormalities.
Takeaway
This study shows that many women still have abnormal cervical tests after treatment, especially if they have HIV or if the disease was not completely removed.
Methodology
Women with high-grade cervical lesions were treated with LLETZ and followed up with Pap smears to assess for persistent abnormalities.
Potential Biases
Potential bias due to reliance on self-reported HIV status and loss to follow-up.
Limitations
The study relied on self-reported HIV status, which may lead to misclassification, and did not account for all potential confounding factors.
Participant Demographics
Women referred to a colposcopy clinic in Soweto, South Africa, with a high prevalence of HIV.
Statistical Information
P-Value
p<0.0001
Confidence Interval
OR = 10.7, CI = 3.0–37.4
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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