par Gilles, Christine 
;Manigart, Yannick ;Konopnicki, Deborah ;Barlow, Patricia ;Rozenberg, Serge
Référence Gynecologic oncology, 96, 1, page (112-118)
Publication Publié, 2005-01
;Manigart, Yannick ;Konopnicki, Deborah ;Barlow, Patricia ;Rozenberg, Serge Référence Gynecologic oncology, 96, 1, page (112-118)
Publication Publié, 2005-01
Article révisé par les pairs
| Résumé : | To assess whether adequate strategies are used for the management of cervical intraepithelial neoplasia (CIN) in HIV-positive patients. Setting: Retrospective study in a HIV reference university hospital. Sixty-eight HIV-infected patients who had undergone a cervical biopsy between January 1995 and March 2002 were matched for CIN and age with HIV-negative patients. Outcome: Assess mean of treatment strategy. Assess mean of treatment failure by immediate follow-up PAP smear and recurrence rate by long-term follow-up smears. Both groups of patients received similar treatments for their cervical anomalies. HIV-positive women were two times more likely to have involved margins after conisation than HIV-negative women (P < 0.01). Globally, two thirds of HIV-negative patients had a first follow-up PAP smear that was normal, while this was the case in only one third of HIV-positive women. These proportions were also significantly different after conisation (P < 0.01). The same differences were also observed after sustained follow-up. HIV-infected women who showed a recurrence of dysplasia were more likely to have failed antiviral therapy (9/44) than those without any recurrence (7/12) (P < 0.01). Higher rates of recurrence were observed among HIV-infected women, indicating that CIN management is more difficult and may require adapted guidelines in HIV-positive patients. In HIV-infected patients, an association was found between the absence of recurrence and a viral response to antiviral therapy. © 2004 Elsevier Inc. All rights reserved. |
