Article Text
Abstract
Introduction/Background HPV persistence after conization represent one of the most important risk factors for disease recurrence. However, no data regarding the impact of duration of HPV persistence are still available. Here, we aim to evaluate the how duration of HPV persistence influence the risk of developing recurrent high-grade cervical dysplasia (CIN2+).
Methodology 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 HR-HPV types. 187 (34.3%), 73 (13.4%), and 40 (7.3%) were diagnosed with persistent HPV infection at 12-, 18-, and 24-month, respectively. Patients with HPV persistence at 6-month 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 (HR: 1.34 (95%CI: 0.78, 2.32); p=0.336, log-rank test).
Conclusion HPV persistence is one of the most important factor predicting the risk of CIN2+ recurrence. The risk of CIN2+ recurrence increased by the increase of HPV persistence up to one year. The persistence of HPV after the first year does not appear as a risk factor