The impact of focality and centricity on vulvar intraepithelial neoplasia on disease progression in HIV+ patients: a 10-year retrospective study

Ayakannu, Thangesweran, Murugesu, Sughashini, Taylor, Anthony H., Sokhal, Priya, Ratnasekera, Limandhee, Wilhelm-Benartzi, Charlotte S.M. ORCID: https://orcid.org/0000-0003-4927-6158, Lyons, Deirdre and Chatterjee, Jayanta 2019. The impact of focality and centricity on vulvar intraepithelial neoplasia on disease progression in HIV+ patients: a 10-year retrospective study. Dermatology 235 (4) , pp. 327-333. 10.1159/000500469

Preview

PDF - Accepted Post-Print Version Download (351kB) | Preview

Abstract

Background: The impact of lesion focality and centricity in relation to patient outcome and disease recurrence of vulvar intraepithelial neoplasia (VIN) is an understudied area of research, especially in immunocompromised women. The prevalence and incidence of VIN have increased steadily since the 1980s because of the co-existence of human papillomavirus (HPV) and human immunodeficiency virus (HIV). In this study, we retrospectively examined the records of VIN patients to determine the effect of lesion focality and centricity with respect to the interval to disease recurrence. Materials and Methods: All women diagnosed with VIN and managed between January 2002 and December 2011 were included (n = 90) and followed up until December 2017. Symptoms at the time of presentation, including HIV positivity (n = 75), were collated, including the influences of multifocality and multicentricity on time to disease recurrence. Results: Multicentricity caused a more rapid recurrence of disease than unicentricity (p = 0.006), whereas multifocality increased the risk of recurrence more than unifocality (p < 0.0001). Viral load in the HIV+ patients was not associated with time to disease recurrence, but the reduced number of CD4+ lymphocytes present in HIV+ patients was. Treatment modalities had no effect on disease recurrence. Conclusion: Both focality and centricity have effects on interval to recurrence and final patient outcome, with multifocal disease having a poorer prognosis. Centricity and focality should be recorded at the time of diagnosis and act as a warning for disease recurrence. HIV+ VIN patients with multifocal disease and/or known immunosuppression (low CD4+ lymphocyte counts) should be regarded as “high-risk” patients and treated accordingly.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Karger Publishers
ISSN:	1018-8665
Date of First Compliant Deposit:	12 August 2019
Date of Acceptance:	15 April 2019
Last Modified:	07 Jan 2024 17:14
URI:	https://orca.cardiff.ac.uk/id/eprint/124776

Citation Data

Cited 1 time in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item