Treatment failure and recurrence of cervical intraepithelial neoplasia in HIV-infected women

Evaluation of: Reimers LL, Sotardi S, Daniel D et al.: Outcomes after an excisional procedure for cervical intraepithelial neoplasia in HIV-infected women. Gynecol. Oncol. 119, 92-97 (2010). In a retrospective cohort study of 136 HIV-infected women who had a loop electrosurgical excision procedure (LEEP) or cone procedure for cervical intraepithelial neoplasia (CIN), Reimers et al. show that treatment failure and recurrence of CIN was common. Most recurrent CIN lesions, and those detected at treatment failure, were high-grade lesions. Both treatment failure and subsequent recurrence of CIN were found to be high in women with poorly controlled HIV, after LEEP, and those with positive cervical tissue margins following treatment. Based on these data the authors suggest that cervical conization may be superior to LEEP in the treatment of CIN in HIV-infected women.