The effect of human immunodeficiency virus on the clinical course and treatment of gestational trophoblastic disease

Objectives: The objective of the study was to describe the HIV-positive patients with gestational trophoblastic disease and to determine whether it is safe to adopt a shorter surveillance strategy in these patients. Methods: This was a retrospective descriptive study carried out at the Gynaecologic Oncology unit at Tygerberg Hospital. All cases of Gestational trophoblastic disease registered and managed at this unit over a 4-year period from 1st January 2017 to 31st December 2020 were included in the study. Results: Ninety one women were diagnosed with GTD. Fourteen patients were excluded from the analysis. The mean age of the patients was 31.6 years. All patients had a known HIV status, eleven (14.2%) were HIV-positive and sixty-six (85.7%) were HIV-negative. The presenting features did not differ between HIV-positive and negative patients. Histologically, fifteen patients (19.5%) had partial moles and 60 patients (77.8%) had complete moles. There was no difference in type of gestational trophoblastic disease between HIV-positive and HIV-negative patients (p=0.343). At 56 days after evacuation of the molar pregnancy, none of the HIV positive patients’ BhCG level was <5mIU/ml. There was a significant difference in the mean time to BhCG< 5mIU/ml between HIV positive and negative women (p=0.009). PTN occurred in 16.9 % (13) of the 77 included women and 9.1% had choriocarcinoma. All persistent disease resolved after chemotherapy. Conclusion: A shorter BhCG follow up time of 6 months post evacuation of a complete molar pregnancy can be adopted in HIV-positive patients. In our study, however, none of the HIV-positive patients met the criteria of BhCG < 5 within 56 days for this shorter follow up to be beneficial. There were not enough HIV-positive patients with partial moles for meaningful analysis. It is essential that all patients be advised to adhere to BhCG follow up, especially in HIV-positive women where the follow up may be lengthy.

Grantor dc:publisher

Stellenbosch : Stellenbosch University

Year dc:date.issued

2025

Author dc:creator

• Burns, Lucinda Carmen

Advisor dc:contributor.advisor

• Butt, Jennifer

Repository record dc:identifier.uri

https://scholar.sun.ac.za/handle/10019.1/132093

OAI identifier oai:identifier

oai:scholar.sun.ac.za:10019.1/132093