{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:50:06Z","timestamp":1763643006078},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GH002036","GH002001"],"award-info":[{"award-number":["GH002036","GH002001"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the utility of detecting endocervical cervical intraepithelial neoplasia (CIN) 2+ with endocervical curettage (ECC) and treating with loop electrosurgical excision procedure (LEEP) plus top hat (+TH) among women with HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cytology was followed by coloscopy\u2010directed biopsy if participants had HSIL or ASC\u2010H and biopsy plus ECC if there were glandular cells present. CIN2\/3 on ECC and\/or inadequate colposcopy (ENL) was treated with LEEP+TH, while CIN2\/3 on ectocervix (ECL) received LEEP alone. Recurrent CIN2+ were compared over a 2\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 5330 participants, 160 underwent ECC, 98 were CIN2\/3 on ECC, and 77 received LEEP+TH. ECC detected 15 (9%) more women with CIN2\/3 than biopsy alone. Women were more likely to have ENL if they were older (\u226545 vs &lt;35\u00a0years) (adjusted relative risk [aRR] 2.14; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009) and on antiretroviral treatment longer (\u22652 vs &lt;2\u00a0years) (aRR 3.97; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Over the 2\u2010year follow\u2010up, 35 (29%) ENL had recurrent CIN2+ after TH compared to 19 (24%) ECL after LEEP (hazard ratio 1.32; 95% confidence interval 0.75\u20132.31; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.338).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among HIV\u2010infected women, adding ECC did not increase detection of pre\u2010cancerous disease significantly and treatment with LEEP+TH for ENL was comparable to treatment with LEEP for ECL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13466","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T07:48:10Z","timestamp":1604476090000},"page":"118-124","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Loop electrosurgical excision procedure (LEEP) plus top hat for HIV\u2010infected women with endocervical intraepithelial neoplasia in Kenya"],"prefix":"10.1002","volume":"152","author":[{"given":"Michael H.","family":"Chung","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care Ghent University Ghent Belgium"},{"name":"Department of Medicine Emory University Atlanta GA USA"},{"name":"Department of Global Health University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"De Vuyst","sequence":"additional","affiliation":[{"name":"Prevention and Implementation Group International Agency for Research on Cancer (IARC\u2010WHO) Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon A.","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hillary M.","family":"Topazian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of North Carolina Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahin","family":"Sayed","sequence":"additional","affiliation":[{"name":"Department of Pathology Aga Khan University Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahir","family":"Moloo","sequence":"additional","affiliation":[{"name":"Department of Pathology Aga Khan University Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Cagle","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evans","family":"Nyongesa\u2010Malava","sequence":"additional","affiliation":[{"name":"Department of Surgery Coptic Hospital Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley","family":"Luchters","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Ghent University Ghent Belgium"},{"name":"Department of Population Health Aga Khan University Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marleen","family":"Temmerman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; 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