Oga, Emmanuel A., Brown, Jessica P., Brown, Clayton, Dareng, Eileen, Adekanmbi, Victor, Odutola, Michael, Olaniyan, Olayinka, Offiong, Richard, Obende, Kayode, Adewole, Ayodele Stephen, Peter, Achara, Dakum, Patrick and Adebamowo, Clement (2016) Recurrence of cervical intraepithelial lesions after thermo-coagulation in HIV-positive and HIV-negative Nigerian women. BMC Women's Health, 16 (1). doi:10.1186/s12905-016-0304-8 ISSN 1472-6874.

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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.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Cervix uteri -- Cancer -- Treatment -- Nigeria, HIV-positive women -- Diseases -- Relapse, Acetic acid
Journal or Publication Title:	BMC Women's Health
Publisher:	BioMed Central Ltd.
ISSN:	1472-6874
Official Date:	11 May 2016
Dates:	Date Event 11 May 2016 Published 4 May 2016 Accepted 4 July 2015 Submitted
Volume:	16
Number:	1
DOI:	10.1186/s12905-016-0304-8
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	17 May 2016
Date of first compliant Open Access:	17 May 2016
Funder:	National Cancer Institute (U.S.) (NCI), National Institutes of Health (U.S.) (NIH)

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