[Treatment and after-care of HIV patients with cervix dysplasia].
We have been observing an increased prevalence of cervical intraepithelial neoplasia in HIV-infected women in our department of obstetrics and gynaecology. 10 HIV-infected patients with cervical intraepithelial neoplasia were treated by CO2-laser - 6 were subjected to laser excision conisation, and 4 patients to laser vaporisation. After laser vaporisation and laser excision conisation, no postoperative complications were observed. Intraoperative bleeding was rarely seen. The preoperative examination of the CD4-cell count had no influence on the choice of the applied method of laser treatment, laser vaporisation or laser excision conisation. But all the 4 patients with a CD4-cell count < or = 200/microliters experienced recurrence of disease shortly after the first laser treatment. Only one out of five patients with CD4-cell counts between 200-499/microliters had a recurrence of disease after laser treatment. All in all, a recurrence of disease was seen in five out of ten HIV-infected patients with cervical intraepithelial neoplasia. The recurrence rate is possibly increased because HIV-infected women have multifocal cervical, vulval and vaginal dysplasia more frequently than HIV-negative patients. In our study, we observed multifocal cervical, vulval and vaginal dysplasia in four HIV-infected patients. Therefore, an accurate short-term follow-up with colposcopy and cytological smears should be carried out after the treatment of HIV-infected patients with cervical intraepithelial neoplasia.
Küppers
V
V
Frauenklinik, Heinrich-Heine-Universität Düsseldorf.
Eckardstein
S
S
Koldovsky
U
U
Somville
T
T
Bender
H G
HG
D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D014626:Vaginal Smears
Behandlung und Nachsorge von HIV-Patientinnen mit einer Zervixdysplasie.