Risk factors for <scp>HPV</scp> persistence and cytology anomalies at follow‐up after treatment for cervical dysplasia

Rizzuto, Ivana; Nalam, Mythili; Jiang, Jason; Linder, Anders; Rufford, Barnaby

doi:10.1002/ijgo.12431

Cited by 13 publications

(6 citation statements)

References 22 publications

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“…In multivariate analysis, the hrHPV persistence rates were not affected by the status of resection margin ( P =0.528), however a positive resection margin was associated with a 1.94-fold higher risk of hrHPV persistence ( P <0.05) in univariate analysis. As several previous studies have pointed out [ 13 , 20 , 28 , 29 ], a positive resection margin is the most significant risk factor for predicting hrHPV persistence and residual/recurrent CIN-2/3. However, a negative resection margin does not always indicate complete excision due to the possibility of multifocal lesions.…”

Section: Discussionmentioning

confidence: 91%

Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment

et al. 2020

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Objective This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment. Methods Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses. Results Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load ( P <0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment ( P <0.01; OR, 2.732), and multiple hrHPV infections ( P <0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types ( P <0.05). Menopause ( P <0.001; OR, 3.969), preoperative and postoperative hrHPV load ( P <0.05; OR, 2.430; P <0.05; OR, 5.351), and infection with multiple hrHPV types ( P <0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment. Conclusion HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.

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Section: Discussionmentioning

confidence: 91%

Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment

et al. 2020

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“…A US-based study among young women reported that smoking was protective against persistent HPV infection, but researchers were unsure whether it was because of a biological or a confounding effect 21 . In another UKbased study, no association between smoking and persistent HR-HPV infection was found, partly on account of the short 6-month follow-up 9 .…”

Section: Discussionmentioning

confidence: 89%

“…As a well-known risk factor for the progression of cervical lesions with HPV infection, smoking was supposed to promote a persistent infection. However, the association has never been clearly evaluated, and some previous studies have found negative 21 or null 9,[15][16][17][18]22 associations between current smoking and HPV persistent infection. The inconsistency of these studies may be due to different definitions of HPV persistence or clearance, sample sizes, followup intervals and durations and so on.…”

Section: Discussionmentioning

confidence: 99%

“…Smoking was linked to persistent HPV infection in a study of Romanian women (OR=2.320, p=0.033) 8 . Another study in Britain found no significant connection between smoking and the probability of HR-HPV persistence after six months (risk ratio, RR=1.12; p=0.516) 9 . Nevertheless, similar research was rarely conducted in women with a normal pathological cervical biopsy.…”

Section: Introductionmentioning

confidence: 93%

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Impact of smoking exposure on human papillomavirus clearance among Chinese women: A follow-up propensity score matching study

Ma*¹,

Li*²,

Wu³

et al. 2023

Tob. Induc. Dis.

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INTRODUCTION Smoking has been proven to increase the risk of cervical cancer, but it is still controversial whether smoking reduces women’s ability to clear human papillomavirus (HPV) infection. This study investigated the association between smoking behaviors during follow-up and clearance of HPV infection in women with HPV-positive and pathologically normal uterine cervix in China, using a propensity score matching (PSM) analysis. METHODS The present prospective study included data from women examined in the Gynecology Department of Shanghai General Hospital from January 2018 to June 2020. Twenty patients who smoked throughout follow-up were selected and matched with 60 patients using the 1:3 PSM method on age, marital status, and whether infected with high-risk HPV (HR-HPV). At each visit, smoking and sexual behaviors were collected. The Kaplan–Meier method and a Cox proportional hazard regression model were used to evaluate the probability of clearing HPV infection within a 2-year follow-up. RESULTS A total of 80 patients were included in the study, all of whom were infected with at least one HR-HPV type at baseline. Current smokers had a lower likelihood of clearing the HPV infection than current non-smokers, after adjusting for a history of sexually transmitted diseases (STD), HPV infection status, and sexual behaviors during follow-up (AHR=0.478; 95% CI: 0.239–0.958, p=0.037). Additionally, longer duration, higher frequency and larger doses of smoking correlated with the lower clearance possibility of HPV infection (p for trend=0.029, 0.022 and 0.026, respectively). CONCLUSIONS This study showed that the use of tobacco throughout follow-up could increase the risk of a persistent HPV infection, this risk being higher for smokers with heavier tobacco consumption. Our results should alert HPV-positive women to reiterate the advice to cut-back on or stop smoking.

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“…The most common types of HPV are viral types 16 and 18 [1]. Persistent high-risk (HR) HPV infections are significantly related to the progression of CIN2-3 and are thought to progress to cervical cancer [2]. Conservative therapy with a loop electrosurgical excision procedure (LEEP) has been performed to diagnose or treat CIN2-3 [3].…”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus genotyping is a reliable prognostic marker of recurrence for high- grade cervical intraepithelial neoplasia (CIN2-3) with positive margins after loop electrosurgical excision procedure

2020

EJGO

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Risk factors for HPV persistence and cytology anomalies at follow‐up after treatment for cervical dysplasia

Abstract: Clinical factors, including age, smoking, treatment history, and status of surgical margins, could help to determine the risk of dysplasia recurrence and facilitate patient follow-up based on risk stratification.

Cited by 13 publications

References 22 publications

Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment

Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment

Impact of smoking exposure on human papillomavirus clearance among Chinese women: A follow-up propensity score matching study

Human papillomavirus genotyping is a reliable prognostic marker of recurrence for high- grade cervical intraepithelial neoplasia (CIN2-3) with positive margins after loop electrosurgical excision procedure

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