Brief Report: Recurrence of Anal High-Grade Squamous Intraepithelial Lesions Among Women Living With HIV. (1st May 2020)

• Record Type: Journal Article
• Authors: Stier, Elizabeth A.; Abbasi, Wafaa; Agyemang, Amma F.; Valle Álvarez, Eduardo Amílkar; Chiao, Elizabeth Y.; Deshmukh, Ashish A.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 84:Number 1(2020)
• Publication Date: 2020-05-01
• Subjects: HIV -- anal HSIL -- women living with HIV; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000002304
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: Women living with HIV (WLHIV) have a high risk of developing invasive anal cancer. Anal cancer may be prevented with early detection and treatment of anal histologic high-grade squamous intraepithelial lesions (HSIL). However, there are limited data on the efficacy of anal HSIL treatment in WLHIV. Study design: We conducted a retrospective study of WLHIV treated for anal HSIL under high-resolution anoscopy (HRA) guidance from January 1, 2007 to December 31, 2017 with at least one post-treatment visit at an urban tertiary care hospital. Results: Forty-five WLHIV women with at least 1 follow-up evaluation after treatment for anal HSIL were identified. The median age was 46 years (range 35–66 years), 63% were African American, 27% were Hispanic/Latino, and 53% were current smokers. The mean absolute CD4 + T-cell count was 516 cells/mm 3 ; 50% and 24% of the cohort had a history of cervical or vulvar HSIL respectively. The cumulative probability of anal HSIL recurrence was 29% at 12 months, 52% at 24 months, and 79% at 36 months post-treatment. Conclusion: Most WLHIV treated for anal HSIL recurred within 3 years, suggesting need for continued surveillance after treatment. Our data contribute to the information needed to develop effective anal cancer prevention guidelines in WLHIV.