Title : The recurrence of cervical precancerous lesion among HIV positive and negative Ethiopian women after cryotherapy: A retrospective cohort study

Abstract:

Background: Early testing and treatment is among the successful strategies for the prevention and control of cervical precancerous and invasive cancer, and a paramount for women with HIV. In Ethiopia, visual inspection with acetic acid for screening and cryotherapy treatment is commonly practiced, though the recurrence of the precancerous lesion after treatment has not been well documented.

Objective: This study was aimed to estimate the association of HIV status and the recurrence of cervical precancerous lesion after cryotherapy among Ethiopian women.

Methods: We conducted a retrospective cohort study from January to April 2021. The time to the incidence of recurrence was compared between HIV positive and HIV negative women. Cox regression models were used to adjust the analyses for potential confounders, and only women treated with cryotherapy after a positive Visual Inspection with Acetic acid (VIA) screening test were included.

Results: A total of 140 eligible patient cards were included in the analysis with the median follow-up of 15.5 months. The overall recurrence rate was 15.7% (22/140), with a greater proportion among HIV negative women, 19.0% (4/21) than HIV positive 15.1% (18/119). Prolonged use of corticosteroid and higher age were the major significant predictors of a higher likelihood of recurrence. The recurrence of screening positive lesion was higher among women aged above 39 years (hazard ratio (HR) of 11.94 (95% CI, 1.07-133.04; P = .04), and women with prolonged use of corticosteroid (HR = 7.82, 95% CI = 1.04-58.75; P = .046) than their counterparts.

Conclusion: The recurrence of cervical precancerous lesion after cryotherapy was higher than the expert panel report by WHO with a higher proportion among women of old age and prolonged corticosteroid use. Cryotherapy showed a satisfying performance against the recurrence of cervical disease diagnosed through VIA. To substantiate, our findings, further prospective cohort study is also recommended.

Keywords: visual inspection with acetic acid, cryotherapy, recurrence, women, Ethiopia

Biography:

Agajie Likie Bogale is a PhD holder in Tropical and Infectious Diseases obtained from Addis Ababa University (AAU) in July 2023. He obtained his MSc and BSc degree in Medical Lab Science from the same University, AAU in 2014 and 2009, respectively. He invited to the USA for a short-term training and research visit in 2022. He participated and presented his research work, including the international conferences of the 35^TH International Papillomavirus Conference & Basic Clinical and Public Health Scientific Workshops (IPVC 2023)) | Washington DC, and in other African countries.  He has published more than 20 research articles.