Recrudescence of cervical dysplasia among women who are infected with the human immunodeficiency virus: a case-control analysis.

Abstract

The purpose of this study was to compare the recurrence rates of cervical dysplasia after ablation therapy and hysterectomy for women who are positive for the human immunodeficiency virus and for women who are negative for the human immunodeficiency virus. Forty-three women who were positive for the human immunodeficiency virus were compared with 103 patients who were negative for the human immunodeficiency virus after cryotherapy, laser ablation, loop electrosurgical excision procedure, conization, and hysterectomy for cervical dysplasia. All patients were followed up for at least 24 months. Patients with preexisting cervical cancer or with positive margins after treatment were excluded. Recurrence was higher in the HIV positive group for all modalities (73% vs 27%; P =.019). Higher recurrence rates were seen with CD4 counts <200 cells/mm3 (55% vs 26%). Hysterectomy fared better than standard therapy (50% vs 86%), but recurrences were significant.