HPV Clereance after therapeutic conization
Marta Garcia Yuste (ES), Ana Muñoz (ES), María Santana (ES), Isabel Moreno (ES)
[GARCIA YUSTE] HOSPITAL RIO HORTERA, [Muñoz] Hospital Rio Hortega , [Santana] Hospital Rio Hortega, [Moreno] Hospital Rio Hortega
CONTEXT The clearance rate of human papillomavirus (HPV) after conization is generally high, although some HPV infections persist. It is considered that there is clearance when HPV is present prior to conization, and has been negativized at 6 months post-treatment. OBJETIVE To analyze the follow-up results after conization. METHODS We retrospectively analyzed 42 patients (mean age 45 years, range 31 to 67 years) with CIN 2/3 or persistent CIN 1 who underwent loop electrosurgical excision procedure (LEEP) PATIENTS Women were evaluated in the cervical pathology department of our hospital because of pathological cytology and / or HPV test with a positive result. They were diagnosed by cervical biopsy as persistent CIN 1 or CIN2 / 3 and they were operated on. We submitted them to a therapeutical conization. RESULTS A total of 142 patients were referred to our hospital with result on PAP smear test or HPV testing positive. We excluded from the study 100 patients because they didn’t have susceptibles of biopsy lesions or LEEP. The remaining 42 patients were tested for DNA HPV at 6, 12, and 18 months after LEEP. All remaining patients were positive for HR-HPV before LEEP. After 6 months of conization, only the 19% of those women had persistent HPV. After LEEP, type 16 was found to be with the highest persistence rate. We analyze age, Pap smear, HPV load, lesion grade in biopsy, and resection margin status. CONCLUSIONS HPV infection is not completely eradicated by LEEP in patients with HSIL lesion on PAP smear. Type 16 was associated with significantly increased risk of persistence compared with the other high risk types. A clereance of the infection reaches 81% of the cases after 6 months of follow-up.