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Archives of Gynecology and Obstetrics

, Volume 284, Issue 1, pp 191–197 | Cite as

Factors associated with recurrence of cervical intraepithelial neoplasia after conization in HIV-infected and noninfected women

  • Claudia Teixeira Lodi
  • Márcia Antoniazi Michelin
  • Maria Inês Lima
  • Nara Chartuni Teixeira
  • Sheila Jorge Adad
  • Eddie Fernando Murta
  • Victor Hugo Melo
Gynecologic Oncology

Abstract

Purpose

To identify risk factors associated with recurrence of cervical intraepithelial neoplasia (CIN) following loop electrosurgical excision procedures in women with and without human immunodeficiency virus (HIV).

Methods

A total of 33 patients with recurrent CIN and 105 without recurrence were contrasted using a nested case–control design. The patients were enrolled between 1999 and 2004. Recurrence diagnosis was established after conization, and tissues were fixed in formalin and embedded in paraffin. Polymerase chain reaction was used to detect the human papillomavirus genome (HPV DNA) types 6, 11, 16, 18, 31, 33, and 35. Statistical analysis was performed using χ2 test with Yates correction and the Fisher’s exact test for comparison of categorical variables. Multivariate analysis was carried out using logistic regression models.

Results

Human immunodeficiency virus infection (p = 0.001), glandular involvement (p = 0.000), and compromised margins (p = 0.02) were significantly associated with CIN recurrence. HPV DNA was positive in 57.6% of patients with CIN recurrence. High-risk HPV subtypes were detected in most cases but were not associated with recurrence (p = 0.27). In multivariate analysis, HIV infection and glandular involvement were independently associated with CIN recurrence.

Conclusions

Human immunodeficiency virus infection and glandular involvement are associated with CIN recurrence.

Keywords

Cervical intraepithelial neoplasia Human immunodeficiency virus Loop electrosurgical excision procedure Recurrence Human papillomavirus 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Claudia Teixeira Lodi
    • 1
  • Márcia Antoniazi Michelin
    • 2
  • Maria Inês Lima
    • 3
  • Nara Chartuni Teixeira
    • 4
  • Sheila Jorge Adad
    • 2
  • Eddie Fernando Murta
    • 2
  • Victor Hugo Melo
    • 5
  1. 1.Medical Science School of Minas GeraisBelo HorizonteBrazil
  2. 2.Instituto de Pesquisa em Oncologia (Research Institute of Oncology)Federal University of Triangulo MineiroUberabaBrazil
  3. 3.Serviço de Referencia em Patologia Cervical (Reference Service in Cervical Pathology)PAM Sagrada FamíliaBelo HorizonteBrazil
  4. 4.Prefeitura Municipal (Municipal Government)Belo HorizonteBrazil
  5. 5.School of MedicineFederal University of Minas GeraisBelo HorizonteBrazil

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