Recurrence of cervical intraepithelial lesions after thermo-coagulation in HIV-positive and HIV-negative Nigerian women

BMC Women's Health

Research Article

Jessica P. Brown¹  Clayton Brown¹  Emmanuel A. Oga²  Clement Adebamowo³  Achara Peter⁴  Kayode Obende⁵  Michael Odutola⁶  Patrick Dakum⁶  Victor Adekanmbi⁶  Eileen Dareng⁷  Ayodele Stephen Adewole⁸  Olayinka Olaniyan⁹  Richard Offiong^1,10 

[1] Department of Epidemiology and Public Health, University of Maryland School of Medicine, 21201, Baltimore, MD, USA;Department of Epidemiology and Public Health, University of Maryland School of Medicine, 21201, Baltimore, MD, USA;Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria;Department of Epidemiology and Public Health, University of Maryland School of Medicine, 21201, Baltimore, MD, USA;Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria;University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD, USA;Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA;Federal Medical Centre, Keffi, Nigeria;Garki Hospital, Abuja, Nigeria;Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria;Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria;Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK;Mother and Child Hospital, Ondo, Nigeria;National Hospital, Abuja, Nigeria;University of Abuja Teaching Hospital, Gwagwalada, Nigeria;

关键词: Cervical Intraepithelial Neoplasia (CIN);    Cervical cancer;    Visual inspection;    Acetic acid;    Lugol’s Iodine;    Recurrence;    HIV;    Thermo-coagulation;    Cold coagulation;    Ablation;    Cervical Intraepithelial lesions;    See-and-treat and Nigeria;   

DOI  :  10.1186/s12905-016-0304-8

 received in 2015-07-04, accepted in 2016-05-04,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe burden of cervical cancer remains huge globally, more so in sub-Saharan Africa. Effectiveness of screening, rates of recurrence following treatment and factors driving these in Africans have not been sufficiently studied. The purpose of this study therefore was to investigate factors associated with recurrence of cervical intraepithelial lesions following thermo-coagulation in HIV-positive and HIV-negative Nigerian women using Visual Inspection with Acetic Acid (VIA) or Lugol’s Iodine (VILI) for diagnosis.MethodsA retrospective cohort study was conducted, recruiting participants from the cervical cancer “see and treat” program of IHVN. Data from 6 sites collected over a 4-year period was used. Inclusion criteria were: age ≥18 years, baseline HIV status known, VIA or VILI positive and thermo-coagulation done. Logistic regression was performed to examine the proportion of women with recurrence and to examine factors associated with recurrence.ResultsOut of 177 women included in study, 67.8 % (120/177) were HIV-positive and 32.2 % (57/177) were HIV-negative. Recurrence occurred in 16.4 % (29/177) of participants; this was 18.3 % (22/120) in HIV-positive women compared to 12.3 % (7/57) in HIV-negative women but this difference was not statistically significant (p-value 0.31). Women aged ≥30 years were much less likely to develop recurrence, adjusted OR = 0.34 (95 % CI = 0.13, 0.92). Among HIV-positive women, CD4 count <200cells/mm3 was associated with recurrence, adjusted OR = 5.47 (95 % CI = 1.24, 24.18).ConclusionRecurrence of VIA or VILI positive lesions after thermo-coagulation occurs in a significant proportion of women. HIV-positive women with low CD4 counts are at increased risk of recurrent lesions and may be related to immunosuppression.

【 授权许可】

CC BY   
© Oga et al. 2016