Vaginal Intraepithelial Neoplasia: Clinical Presentation, Management, and Outcomes in Relation to HIV Infection Status. Bradbury, M., Xercavins, N., García-Jiménez, Á., Pérez-Benavente, A., Franco-Camps, S., Cabrera, S., Sánchez-Iglesias, J. L., De La Torre, J., Díaz-Feijoo, B., Gil-Moreno, A., & Centeno-Mediavilla, C. 23(1):7–12.
doi  abstract   bibtex   
OBJECTIVES: The data available on vaginal intraepithelial neoplasia (VAIN) and infection by HIV are scarce. We therefore aimed to review the clinical presentation, management, and survival outcomes of VAIN in this group of women. MATERIALS AND METHODS: This is an observational cohort study of women diagnosed with VAIN for a 23-year period. Clinical characteristics and outcomes were analyzed according to women's HIV infection status. Disease-free and progression-free survival were compared between groups. RESULTS: Twenty-two of 87 women were HIV positive (25.3%) compared with the HIV-negative group, HIV-positive women were younger (median age = 39 vs 57 years, p \textless .001) and more frequently smokers (p \textless .001). They also presented with multifocal and multicentric disease more often (p = .004 and p = .033, respectively) in relation to infection by human papillomavirus. All HIV-positive women were receiving antiretroviral treatment. The median time from the diagnosis of HIV to the development of VAIN was 14 years (range = 1-22 years). There were no significant differences in survival outcomes between groups. CONCLUSIONS: HIV-positive women are at an increased risk of developing VAIN and frequently present at a younger age with multifocal and multicentric disease. Vaginal intraepithelial neoplasia lesions can develop many years after the initial diagnosis of HIV infection reason why prolonged surveillance is essential to enable prompt diagnosis and treatment.
@article{bradbury_vaginal_2019,
	title = {Vaginal Intraepithelial Neoplasia: Clinical Presentation, Management, and Outcomes in Relation to {HIV} Infection Status},
	volume = {23},
	issn = {1526-0976},
	doi = {10.1097/LGT.0000000000000431},
	shorttitle = {Vaginal Intraepithelial Neoplasia},
	abstract = {{OBJECTIVES}: The data available on vaginal intraepithelial neoplasia ({VAIN}) and infection by {HIV} are scarce. We therefore aimed to review the clinical presentation, management, and survival outcomes of {VAIN} in this group of women.
{MATERIALS} {AND} {METHODS}: This is an observational cohort study of women diagnosed with {VAIN} for a 23-year period. Clinical characteristics and outcomes were analyzed according to women's {HIV} infection status. Disease-free and progression-free survival were compared between groups.
{RESULTS}: Twenty-two of 87 women were {HIV} positive (25.3\%) compared with the {HIV}-negative group, {HIV}-positive women were younger (median age = 39 vs 57 years, p {\textless} .001) and more frequently smokers (p {\textless} .001). They also presented with multifocal and multicentric disease more often (p = .004 and p = .033, respectively) in relation to infection by human papillomavirus. All {HIV}-positive women were receiving antiretroviral treatment. The median time from the diagnosis of {HIV} to the development of {VAIN} was 14 years (range = 1-22 years). There were no significant differences in survival outcomes between groups.
{CONCLUSIONS}: {HIV}-positive women are at an increased risk of developing {VAIN} and frequently present at a younger age with multifocal and multicentric disease. Vaginal intraepithelial neoplasia lesions can develop many years after the initial diagnosis of {HIV} infection reason why prolonged surveillance is essential to enable prompt diagnosis and treatment.},
	pages = {7--12},
	number = {1},
	journaltitle = {Journal of Lower Genital Tract Disease},
	shortjournal = {J Low Genit Tract Dis},
	author = {Bradbury, Melissa and Xercavins, Natalia and García-Jiménez, Ángel and Pérez-Benavente, Asunción and Franco-Camps, Silvia and Cabrera, Silvia and Sánchez-Iglesias, José Luis and De La Torre, Javier and Díaz-Feijoo, Berta and Gil-Moreno, Antonio and Centeno-Mediavilla, Cristina},
	date = {2019-01},
	pmid = {30161052},
	keywords = {Humans, Female, Adult, Aged, Aged, 80 and over, Middle Aged, Carcinoma in Situ, Cohort Studies, Disease Management, {HIV} Infections, Survival Analysis, Treatment Outcome, Vaginal Neoplasms},
}
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