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BMC Women's Health
Published in: BMC Women's Health 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Emmanuel A. Oga, Jessica P. Brown, Clayton Brown, Eileen Dareng, Victor Adekanmbi, Michael Odutola, Olayinka Olaniyan, Richard Offiong, Kayode Obende, Ayodele Stephen Adewole, Achara Peter, Patrick Dakum, Clement Adebamowo

Published in: BMC Women's Health | Issue 1/2016

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Abstract

Background

The 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.

Methods

A 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.

Results

Out 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).

Conclusion

Recurrence 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.
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Metadata
Title
Recurrence of cervical intraepithelial lesions after thermo-coagulation in HIV-positive and HIV-negative Nigerian women
Authors
Emmanuel A. Oga
Jessica P. Brown
Clayton Brown
Eileen Dareng
Victor Adekanmbi
Michael Odutola
Olayinka Olaniyan
Richard Offiong
Kayode Obende
Ayodele Stephen Adewole
Achara Peter
Patrick Dakum
Clement Adebamowo
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2016
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-016-0304-8

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