Factors affecting the clearance of high-risk human papillomavirus infection and the progression of cervical intraepithelial neoplasia

J Int Med Res. 2012;40(2):486-96. doi: 10.1177/147323001204000210.

Abstract

Objective: This study aimed to identify factors that predict clearance of high-risk human papillomavirus (HPV) infection and progression to cervical intraepithelial neoplasia (CIN) 2 or higher, in women with normal cervical histology or CIN 1.

Methods: A retrospective analysis was performed on 817 high-risk HPV-infected women with histologically verified CIN 1 or normal cervical histology. Patients were followed-up for a maximum of 24 months. Cervical HPV DNA tests were performed at every visit.

Results: At the end of followup, 648/817 (79.3%) patients were free from HPV infection and 66/817 patients (8.1%) progressed to CIN 2 or higher. Age, parity, cytology and viral load at diagnosis were significantly and inversely associated with HPV clearance. Cytology, viral load and presence of CIN 1 lesions were significantly associated with lesion progression.

Conclusions: Cytology and high-risk HPV viral load may be useful markers for the likelihood of high-risk HPV clearance and lesion progression. Histological status, parity and marital status may also be useful factors to consider when predicting progression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cervix Uteri / pathology
  • Cervix Uteri / virology
  • DNA, Viral / blood
  • Disease Progression
  • Female
  • Humans
  • Middle Aged
  • Papillomaviridae / genetics
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / virology*
  • Retrospective Studies
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / virology*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / virology*
  • Vaginal Smears
  • Viral Load
  • Young Adult

Substances

  • DNA, Viral