Human papillomavirus prevalence, persistence and cervical dysplasia in females with cystic fibrosis

• Published in: Journal of cystic fibrosis 2023-05, Vol.22 (3), p.505-514
• Main Authors: Rousset-Jablonski, C., Mekki, Y., Denis, A., Reynaud, Q., Nove-Josserand, R., Durupt, S., Touzet, S., Perceval, M., Ray-Coquard, I., Golfier, F., Durieu, I.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cystic Fibrosis - complications; Cystic Fibrosis - diagnosis; Cystic Fibrosis - epidemiology; Early Detection of Cancer; Female; Human Papillomavirus Viruses; Humans; Middle Aged; Papillomavirus Infections - diagnosis; Papillomavirus Infections - epidemiology; Prevalence; Prospective Studies; Statistics; Uterine Cervical Dysplasia - diagnosis; Uterine Cervical Dysplasia - epidemiology; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - prevention & control; Young Adult
• ISSN: 1569-1993; 1873-5010
• DOI: 10.1016/j.jcf.2022.11.005

•Transplanted CF females are at higher risk of HR-HPV infection than non-CF females.•Transplanted CF females have high frequencies of abnormal cervical cytology.•HR-HPV prevalence in non-transplanted CF females seems similar to non -CF females.•Non-transplanted CF females have high frequencies of abnormal cervical cytology.•Cervical cancer screening and prevention should be promoted among females with CF. A higher risk of human papillomavirus (HPV)-related cervical intra-epithelial neoplasia (CIN) is suspected among females with cystic fibrosis (CF). We conducted a single center prospective cohort study among females attending the Lyon adult CF center. We performed a cervical cytology (Hologic Thinprep®) and HPV testing with genotyping (Clinical Arrays Papillomavirus; Genomica, enabling 35 genotype detection, 20 of which are high-risk (HR-HPV)) at inclusion. We followed all females with positive HPV tests at 6, 12 and 24 months to evaluate HPV persistence, and performed a colposcopy in cases of abnormal cytology. We included eighty-five participants, 18 (21%) of whom were lung-transplanted. The mean age at inclusion was 31.9 (range 18-59) years. The prevalence of HPV (all types) was 31.8%. HR-HPV was found in 25.9% of the whole cohort, 44.4% of transplanted patients, and 20.1% of nontransplanted patients. Genotype-specific HR-HPV persistence at 12 months was 43.5% among transplanted and 34.6% among nontransplanted patients. Overall, 17.6% (15/85) of females had an abnormal cytology: 44.4% (8/18) among transplanted and 10.4% (7/67) among nontransplanted patients. CIN was identified in 12 (14.1%) patients (6 low-grade, 6 high-grade). High-grade CIN developed in 4 nontransplanted patients. Transplanted females had high HR-HPV, abnormal cervical cytology and CIN prevalence rates compared to large published cohorts in the general non-CF population. Although HR-HPV prevalence and persistence were globally not significantly different in nontransplanted females compared to the general population, we reported high frequencies of abnormal cytology and CIN. Cervical cancer screening and prevention should be promoted among females with CF.