Comparison of high-grade human papillomavirus-induced cervical lesions between human immunodeficiency virus-positive and human immunodeficiency virus-negative women

Abstract

OBJECTIVE: The aim of this study was to compare the evolution of high-grade human papillomavirus-induced cervical lesions between human immunodeficiency virus-positive and human immunodeficiency virus-negative women. METHODS: Human immunodeficiency virus-positive and human immunodeficiency virus-negative women were enrolled in a retrospective cohort study after undergoing large-loop excision of the transformation zone between January 2008 and December 2017 as participants in the high-grade cervical lesion screening program. The evolution of human papillomavirus lesions induced in human immunodeficiency virus-infected women was evaluated in comparison with the general population. The following potentially confounding variables were examined: age at treatment and at the end of follow-up, histologic grade of treated intraepithelial disease, compromised margins, adequacy of colposcopy during follow-up, and recurrence of histopathologic diagnosis of high-grade squamous intraepithelial lesion. RESULTS: Of the 195 women, 51 were human immunodeficiency virus-positive (26.2%) and 144 were human immunodeficiency virus-negative (73.8%). Age of menarche (11.8±1.5) and sexarche (14.5±2.2) were earlier in human immunodeficiency virus-positive women (p=0.021 and 0.006, respectively). Parity (2.35±109) and number of pregnancies (2.86±1.47) were higher in human immunodeficiency virus-positive women (p=0.027 and 0.018, respectively). The prevalence of incomplete schooling was lower in human immunodeficiency virus-positive women (47.1 vs. 19.8%, p=0.002). Smoking was more common in human immunodeficiency virus-positive women (58.8 vs. 31.9%, p=0.001). Compromised surgical margins were found in 33.3% of human immunodeficiency virus-positive and 16.7% of human immunodeficiency virus-negative women (p<0.001). The risk of recurrence was 37.3% in human immunodeficiency virus-positive and 13.9% in human immunodeficiency virus-negative women (p<0.001). Cumulative survival over months was shortened in human immunodeficiency virus-positive women (p<0.001). CONCLUSION: human immunodeficiency virus-positive women in this cohort had a significantly higher risk of recurrence than human immunodeficiency virus-negative women in addition to shorter overall survival.