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. 2023 Nov 1;32(6):525-532.
doi: 10.1097/CEJ.0000000000000822. Epub 2023 Jul 3.

Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Giorgio Bogani  1 , Francesco Sopracordevole  2 , Andrea Ciavattini  3 , Enrico Vizza  4 , Paolo Vercellini  5 , Andrea Giannini  1 , Fabio Ghezzi  6 , Giovanni Scambia  7 , Francesco Raspagliesi  8 , Violante Di Donato  1 ; Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV); The Investigators of the Italian HPV study group (iHPV study group)
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Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia

Giorgio Bogani et al. Eur J Cancer Prev. .

Abstract

Objective: To evaluate how the duration of human papillomavirus (HPV) persistence influences the risk of developing recurrent high-grade cervical dysplasia (CIN2+).

Methods: Data of patients with persistent HPV infection (at least at 6 months) after primary conization were extracted from a multi-institutional Italian database, retrospectively. Kaplan-Meier and Cox proportional hazards models were used to evaluate associations between duration of HPV persistence with the 5-year risk of developing recurrent CIN2+.

Results: Overall, 545 patients met the inclusion criteria. Positive margins were detected in 160 (29.3%) patients. Overall, 247 (45.3%) and 123 (22.6%) patients had a documented infection from HPV16/18, and other high-risk HPV types. 187 (34.3%), 73 (13.4%), and 40 (7.3%) were diagnosed with persistent HPV infection at 12, 18, and 24 months, respectively. Patients with HPV persistence at 6 months experienced a risk of recurrence of 7.46%. Twelve-month HPV persistence strongly correlates with the risk of developing the recurrent disease (risk of recurrence: 13.1%). While, having HPV persistence >12 months did not correlate with an increased risk of recurrence (hazard ratio: 1.34 (95% confidence interval: 0.78-2.32); P = 0.336, log-rank test).

Conclusion: HPV persistence is one of the most important factors predicting the risk of CIN2+ recurrence. The risk of CIN2+ recurrence increased with the increase of HPV persistence for up to 1 year. The persistence of HPV after the first year does not appear as a risk factor.

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References

    1. Bogani G, Tagliabue E, Ferla S, Martinelli F, Ditto A, Chiappa V, et al. (2019). Nomogram-based prediction of cervical dysplasia persistence/recurrence. Eur J Cancer Prev 28:435–440.
    1. Bogani G, Di Donato V, Sopracordevole F, Ciavattini A, Ghelardi A, Lopez S, et al. 2020a). Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser Conization: a 5-year follow-up study. Gynecol Oncol 159:636–641.
    1. Bogani G, Raspagliesi F, Sopracordevole F, Ciavattini A, Ghelardi A, Simoncini T, et al. 2020b). Assessing the long-term role of vaccination against HPV after loop electrosurgical excision procedure (LEEP): a propensity-score matched comparison. Vaccines (Basel) 8:717.
    1. Bogani G, Raspagliesi F, di Donato V, Brusadelli C, Guerrisi R, Pinelli C, et al. 2021a). Spotlight on the role of human papillomavirus vaccines. Gynecol Oncol 160:346–350.
    1. Bogani G, Sopracordevole F, Di Donato V, Ciavattini A, Ghelardi A, Lopez S, et al. 2021b). High-risk HPV-positive and -negative high-grade cervical dysplasia: analysis of 5-year outcomes. Gynecol Oncol 161:173–178.

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