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Spectrum of HPV types before and after treatment of cervical intraepithelial neoplasia grade 2 and 3

Lindroth, Ylva LU ; Bjelkenkrantz, Kaj and Forslund, Ola LU (2017) In Journal of Clinical Virology 97. p.38-43
Abstract

Background To monitor residual disease after treatment of high grade cervical intraepithelial neoplasia (CIN), cytology together with human papillomavirus (HPV) testing are commonly performed. Objectives To analyse the spectrum of HPV types before and after treatment. Study design This register-based study included 446 women treated for CIN2 or 3, where cytology samples had been HPV-tested before and after treatment by the use of the MGP-PCR Luminex HPV L1-DNA-assay identifying 39 HPV types, including 12 high risk (HR) HPV types. Results Before and after treatment, 706 and 248 HPV isolates were detected of 36 and 34 different HPV types, respectively. Among all the HR HPV isolates, type-specific persistency was observed among 14%... (More)

Background To monitor residual disease after treatment of high grade cervical intraepithelial neoplasia (CIN), cytology together with human papillomavirus (HPV) testing are commonly performed. Objectives To analyse the spectrum of HPV types before and after treatment. Study design This register-based study included 446 women treated for CIN2 or 3, where cytology samples had been HPV-tested before and after treatment by the use of the MGP-PCR Luminex HPV L1-DNA-assay identifying 39 HPV types, including 12 high risk (HR) HPV types. Results Before and after treatment, 706 and 248 HPV isolates were detected of 36 and 34 different HPV types, respectively. Among all the HR HPV isolates, type-specific persistency was observed among 14% (76/542) after treatment, compared to 34% (31/92) of low-risk (LR) HPV isolates (p < 0.001). Among the potential high risk (PHR) HPV isolates, 8.3% (6/72) persisted. Totally, 99% (440/446) and 40% (179/446) of the women were HPV-positive before and after treatment, respectively. At least one of the 12 HR HPV types was present in 91% (404/446) and 24% (109/446) of the women before and after treatment, respectively (p < 0.0001). HR HPV types were present both before and after treatment among 23% (102/446) of the women, and 16% (71/446) manifested at least one persistent HR HPV type. The sensitivity, specificity and negative predictive value of HR HPV testing for detection of residual high grade squamous intraepithelial lesion (HSIL) was based on the first cytology after treatment, and was 91.7% (95% CI: 61.5%–99.8%), 84.1% (95% CI: 80.0%–87.7%) and 99.7% (95% CI: 98.2%–100.0%), respectively. Conclusions About one out six treated women (16%) manifested at least one persistent HR HPV type, that was associated with recurrent or residual HSIL disease (odds ratio 58.1, 95% CI 7.4–457) (p = 0.0001). Testing for HR HPV demonstrated high sensitivity (92%) for residual HSIL. The higher persistency rate of LR HPV types suggests that they are more likely to be outside the treated area.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
CIN, HPV-types, Treatment
in
Journal of Clinical Virology
volume
97
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85032451926
  • pmid:29100063
  • wos:000415927900008
ISSN
1386-6532
DOI
10.1016/j.jcv.2017.10.014
language
English
LU publication?
yes
id
da8b7727-e897-45ec-8128-8f16d103d592
date added to LUP
2017-11-12 15:37:03
date last changed
2018-02-07 15:04:05
@article{da8b7727-e897-45ec-8128-8f16d103d592,
  abstract     = {<p>Background To monitor residual disease after treatment of high grade cervical intraepithelial neoplasia (CIN), cytology together with human papillomavirus (HPV) testing are commonly performed. Objectives To analyse the spectrum of HPV types before and after treatment. Study design This register-based study included 446 women treated for CIN2 or 3, where cytology samples had been HPV-tested before and after treatment by the use of the MGP-PCR Luminex HPV L1-DNA-assay identifying 39 HPV types, including 12 high risk (HR) HPV types. Results Before and after treatment, 706 and 248 HPV isolates were detected of 36 and 34 different HPV types, respectively. Among all the HR HPV isolates, type-specific persistency was observed among 14% (76/542) after treatment, compared to 34% (31/92) of low-risk (LR) HPV isolates (p &lt; 0.001). Among the potential high risk (PHR) HPV isolates, 8.3% (6/72) persisted. Totally, 99% (440/446) and 40% (179/446) of the women were HPV-positive before and after treatment, respectively. At least one of the 12 HR HPV types was present in 91% (404/446) and 24% (109/446) of the women before and after treatment, respectively (p &lt; 0.0001). HR HPV types were present both before and after treatment among 23% (102/446) of the women, and 16% (71/446) manifested at least one persistent HR HPV type. The sensitivity, specificity and negative predictive value of HR HPV testing for detection of residual high grade squamous intraepithelial lesion (HSIL) was based on the first cytology after treatment, and was 91.7% (95% CI: 61.5%–99.8%), 84.1% (95% CI: 80.0%–87.7%) and 99.7% (95% CI: 98.2%–100.0%), respectively. Conclusions About one out six treated women (16%) manifested at least one persistent HR HPV type, that was associated with recurrent or residual HSIL disease (odds ratio 58.1, 95% CI 7.4–457) (p = 0.0001). Testing for HR HPV demonstrated high sensitivity (92%) for residual HSIL. The higher persistency rate of LR HPV types suggests that they are more likely to be outside the treated area.</p>},
  author       = {Lindroth, Ylva and Bjelkenkrantz, Kaj and Forslund, Ola},
  issn         = {1386-6532},
  keyword      = {CIN,HPV-types,Treatment},
  language     = {eng},
  month        = {12},
  pages        = {38--43},
  publisher    = {Elsevier},
  series       = {Journal of Clinical Virology},
  title        = {Spectrum of HPV types before and after treatment of cervical intraepithelial neoplasia grade 2 and 3},
  url          = {http://dx.doi.org/10.1016/j.jcv.2017.10.014},
  volume       = {97},
  year         = {2017},
}