AIDS: the recurrence rate of cervical intraepithelial neoplasia of the uterus is higher among HIV-positive women

The recurrence rate of cervical intraepithelial neoplasia of the uterus after surgery is higher among HIV-positive women to the AIDS virus (HIV +), reaching 22.3 per 100 patient-years, shows a French study.

Previous studies have objectified an increased risk of cervical intraepithelial neoplasia of the uterus (NIC), or cervical intraepithelial neoplasia in HIV-+ women, a precursor form of invasive cancer of the cervix, but French researchers show that Once they are also more prone to recurrence after surgical treatment.

The team coordinated by Isabelle Heard, Unit of Clinical Immunology, Georges Pompidou European Hospital in Paris, followed 121 HIV + patients operated for a NIC, subject to cytology, histology and colposcopy.

The recurrence rate was 22.3 per 100 patient-years for all types of injuries and 8.6 per 100 patient-years for high-grade lesions for 166 and 279 patient-years of follow-up, respectively.

Among the risk factors, positive surgical margins are associated with a relative risk of 3.5 for recurrent lesions (all types) and a relative risk of 9 for high-grade lesions.

A low CD4 count below 200 cells/mm3, is also correlated with a greater risk of recurrent lesions of all grades (RR: 9.4) but not at the risk of recurrence of high-grade lesions.

In contrast, the highly active antiretroviral therapy (HAART) has a protective effect, both for all lesions and for high-grade lesions.

So while the surgery is very effective in HIV-negative patients, it seems to only prevent the progression of lesions to form a cancer in HIV + patients, the authors conclude.

"These findings show that relapses are common among HIV + women, even in the era of HAART, and emphasize the need for regular follow-up after surgery," say the authors