Type-specific persistence or regression of human papillomavirus genotypes in women with cervical intraepithelial neoplasia 1: A prospective cohort study

Abstract

Objective To evaluate the type-specific human papillomavirus (HPV) persistence or regression in women with or less than lowgradecervical intraepithelial neoplasia (CIN). Methods This prospective cohort study included patients with or less than cytological low-grade squamous intraepithelial lesion(or histologically CIN 1 when biopsy was performed) combined with HPV infection. The cohort was collected from July2006 to November 2011 at Korea University Guro Hospital. Follow-up was performed with liquid-based Papanicolaou test,hybrid capture 2 test, AnyplexTM II HPV 28 Detection, colposcopic biopsy if necessary every 4 months. All patients wereprospectively observed without treatment. Results One hundred and thirty-seven patients were enrolled. Of these, 21 patients whose minimum follow-up periods wereless than 8 months were excluded. Finally, one hundred sixteen patients were included and followed-up. Medianfollow-up period was 16 months. In case of high-risk HPVs, HPV 53 was the most prevalent type, followed by HPV 52,68, 66, and 16. HPV 16 took 10.6 months to regress spontaneously, which was the longest period among the 10 mostprevalent high-risk HPV genotypes. In case of spontaneous regression, HPV clearance was always accompanied by lesionclearance. A total of 13 patients showed disease progression either cytologically or histologically. Two cases of CIN 3were confirmed by colposcopy-directed biopsy during follow-up, which were subsequently managed by conization. Conclusion HPV 16 is the most persistent HPV genotypes. Studies with longer term follow-up and larger sample size are neededto demonstrate whether persistence of HPV 16 is directly correlated with progression of low-grade lesions.