title: Factors associated with recurrence of cervical intraepithelial neoplasia after conization in HIV-infected and noninfected women.
abstract: OBJECTIVE
  To identify risk factors associated with recurrence of cervical intraepithelial neoplasia (CIN) following loop electrosurgical excision procedures in women with and without human immunodeficiency virus (HIV).
  
  
  METHODS
  A total of 33 patients with recurrent CIN and 105 without recurrence were contrasted using a nested case-control design. The patients were enrolled between 1999 and 2004. Recurrence diagnosis was established after conization, and tissues were fixed in formalin and embedded in paraffin. Polymerase chain reaction was used to detect the human papillomavirus genome (HPV DNA) types 6, 11, 16, 18, 31, 33, and 35. Statistical analysis was performed using χ² test with Yates correction and the Fisher's exact test for comparison of categorical variables. Multivariate analysis was carried out using logistic regression models.
  
  
  RESULTS
  Human immunodeficiency virus infection (p = 0.001), glandular involvement (p = 0.000), and compromised margins (p = 0.02) were significantly associated with CIN recurrence. HPV DNA was positive in 57.6% of patients with CIN recurrence. High-risk HPV subtypes were detected in most cases but were not associated with recurrence (p = 0.27). In multivariate analysis, HIV infection and glandular involvement were independently associated with CIN recurrence.
  
  
  CONCLUSIONS
  Human immunodeficiency virus infection and glandular involvement are associated with CIN recurrence.
authors.affiliation: Medical Science School of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Claudia Teixeira
authors.initials: CT
authors.lastname: Lodi
authors.forename: Márcia Antoniazi
authors.initials: MA
authors.lastname: Michelin
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Lima
authors.forename: Nara Chartuni
authors.initials: NC
authors.lastname: Teixeira
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad
authors.forename: Eddie Fernando
authors.initials: EF
authors.lastname: Murta
authors.forename: Victor Hugo
authors.initials: VH
authors.lastname: Melo
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000472:pathogenicity*; D016022:Case-Control Studies; D019092:Conization; D004598:Electrosurgery; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000821:virology*; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000601:surgery / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000601:surgery / Q000821:virology*