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High‐risk HPV positivity is a long‐term risk factor for recurrence after cervical excision procedure in women living with HIV
Objective To evaluate the risk factors for recurrence of high‐grade disease after cervical excision in women living with HIV (WLWH), with a specific interest in the role of high‐risk (HR‐) HPV positivity. Methods Multicentric retrospective study conducted on WLWH who underwent cervical excision betw...
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| Published in: | International journal of gynecology and obstetrics 2021-12, Vol.155 (3), p.442-449 |
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| Main Authors: | , , , , , , , , , , , , , |
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| container_end_page | 449 |
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| container_title | International journal of gynecology and obstetrics |
| container_volume | 155 |
| creator | Agarossi, Alberto Delli Carpini, Giovanni Sopracordevole, Francesco Serri, Matteo Giannella, Luca Gardella, Barbara Maestri, Marta Del Fabro, Anna Sansone, Matilde Fallani, Maria Grazia Pieralli, Annalisa Fasolo, Maria Michela Mazzali, Cristina Ciavattini, Andrea |
| description | Objective
To evaluate the risk factors for recurrence of high‐grade disease after cervical excision in women living with HIV (WLWH), with a specific interest in the role of high‐risk (HR‐) HPV positivity.
Methods
Multicentric retrospective study conducted on WLWH who underwent cervical excision between January 1987 and June 2017 in six Italian institutions. The rate of high‐grade recurrence was determined. Risk factors for recurrence and HR‐HPV positivity were determined with the Log‐rank test and Cox proportional hazards regression models.
Results
A total of 271 WLWH were included in the final analysis. A high‐grade recurrence was found in 58 (21.4%) patients. Age 41 years or more at inclusion and HR‐HPV positivity during follow up were independently associated with a higher risk of disease recurrence with relative risks of 4.15 (95% confidence interval [CI] 2.01–8.58, P |
| doi_str_mv | 10.1002/ijgo.13674 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8596685</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2501852946</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4204-fd4249d6ad2e4007a4d40298aa5a6de5e9402b49fb82a539feb0f09fd2d53e013</originalsourceid><addsrcrecordid>eNp9kctuEzEUhi1ERdPChgdAXiKkaX2bizdIqIImVaWygG4txz6euMyMgz2TkF15A56RJ8Ft2go2LKwj6__0nSP9CL2m5IQSwk79TRtOKK9q8QzNaFPLgotaPkezHJKiZpIdoqOUbgghtKb0BTrkvGaUMz5DP-e-Xf2-_RV9-obnn6_xOiQ_-o0fd9gnrHEXhjbnI8Qe30NOmzFE7PKLYKYYYTCAtcsENhA33ugOww_jkw8DXsdgwE4RsB_wNvQw4C7bhxZv_bjC88X1S3TgdJfg1cM8Rl8_ffxyNi8ur84XZx8uCyMYEYWzgglpK20ZCEJqLawgTDZal7qyUILM36WQbtkwXXLpYEkckc4yW3IglB-j93vvelr2YA0MY9SdWkff67hTQXv1bzL4lWrDRjWlrKqmzIK3D4IYvk-QRtX7ZKDr9ABhSoqVhDYlk6LK6Ls9amJIKYJ7WkOJuutM3XWm7jvL8Ju_D3tCH0vKAN0DW9_B7j8qtbg4v9pL_wDMTKbw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2501852946</pqid></control><display><type>article</type><title>High‐risk HPV positivity is a long‐term risk factor for recurrence after cervical excision procedure in women living with HIV</title><source>Wiley</source><creator>Agarossi, Alberto ; Delli Carpini, Giovanni ; Sopracordevole, Francesco ; Serri, Matteo ; Giannella, Luca ; Gardella, Barbara ; Maestri, Marta ; Del Fabro, Anna ; Sansone, Matilde ; Fallani, Maria Grazia ; Pieralli, Annalisa ; Fasolo, Maria Michela ; Mazzali, Cristina ; Ciavattini, Andrea</creator><creatorcontrib>Agarossi, Alberto ; Delli Carpini, Giovanni ; Sopracordevole, Francesco ; Serri, Matteo ; Giannella, Luca ; Gardella, Barbara ; Maestri, Marta ; Del Fabro, Anna ; Sansone, Matilde ; Fallani, Maria Grazia ; Pieralli, Annalisa ; Fasolo, Maria Michela ; Mazzali, Cristina ; Ciavattini, Andrea</creatorcontrib><description>Objective
To evaluate the risk factors for recurrence of high‐grade disease after cervical excision in women living with HIV (WLWH), with a specific interest in the role of high‐risk (HR‐) HPV positivity.
Methods
Multicentric retrospective study conducted on WLWH who underwent cervical excision between January 1987 and June 2017 in six Italian institutions. The rate of high‐grade recurrence was determined. Risk factors for recurrence and HR‐HPV positivity were determined with the Log‐rank test and Cox proportional hazards regression models.
Results
A total of 271 WLWH were included in the final analysis. A high‐grade recurrence was found in 58 (21.4%) patients. Age 41 years or more at inclusion and HR‐HPV positivity during follow up were independently associated with a higher risk of disease recurrence with relative risks of 4.15 (95% confidence interval [CI] 2.01–8.58, P < 0.001) and 5.18 (95% CI 2.12–12.67, P < 0.01), respectively. Age 41 years or more (relative risk 1.75, 95% CI 1.01–3.04, P = 0.047) resulted as a risk factor for HR‐HPV positivity during follow up.
Conclusion
HR‐HPV positivity is a risk factor for recurrence after cervical excision in WLWH. Women older than 41 years may benefit from a long‐term yearly follow up. Future studies regarding HPV vaccination after treatment in WLWH may be useful, considering the protective role of the higher probability of HPV negativity in vaccinated women.
Synopsis
High‐risk‐HPV positivity during long‐term follow up is a risk factor for high‐grade disease recurrence after cervical excisional treatment in women living with HIV.</description><identifier>ISSN: 0020-7292</identifier><identifier>EISSN: 1879-3479</identifier><identifier>DOI: 10.1002/ijgo.13674</identifier><identifier>PMID: 33721323</identifier><language>eng</language><publisher>United States: John Wiley and Sons Inc</publisher><subject>Adult ; cervical excisional procedure ; cervical intraepithelial neoplasia ; Clinical ; conization ; Female ; HIV ; HIV Infections ; Humans ; Neoplasm Recurrence, Local - epidemiology ; Papillomaviridae ; Papillomavirus Infections ; recurrence ; Retrospective Studies ; Risk Factors ; Uterine Cervical Dysplasia ; Uterine Cervical Neoplasms - surgery</subject><ispartof>International journal of gynecology and obstetrics, 2021-12, Vol.155 (3), p.442-449</ispartof><rights>2021 International Federation of Gynecology and Obstetrics</rights><rights>2021 International Federation of Gynecology and Obstetrics.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4204-fd4249d6ad2e4007a4d40298aa5a6de5e9402b49fb82a539feb0f09fd2d53e013</citedby><cites>FETCH-LOGICAL-c4204-fd4249d6ad2e4007a4d40298aa5a6de5e9402b49fb82a539feb0f09fd2d53e013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33721323$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Agarossi, Alberto</creatorcontrib><creatorcontrib>Delli Carpini, Giovanni</creatorcontrib><creatorcontrib>Sopracordevole, Francesco</creatorcontrib><creatorcontrib>Serri, Matteo</creatorcontrib><creatorcontrib>Giannella, Luca</creatorcontrib><creatorcontrib>Gardella, Barbara</creatorcontrib><creatorcontrib>Maestri, Marta</creatorcontrib><creatorcontrib>Del Fabro, Anna</creatorcontrib><creatorcontrib>Sansone, Matilde</creatorcontrib><creatorcontrib>Fallani, Maria Grazia</creatorcontrib><creatorcontrib>Pieralli, Annalisa</creatorcontrib><creatorcontrib>Fasolo, Maria Michela</creatorcontrib><creatorcontrib>Mazzali, Cristina</creatorcontrib><creatorcontrib>Ciavattini, Andrea</creatorcontrib><title>High‐risk HPV positivity is a long‐term risk factor for recurrence after cervical excision procedure in women living with HIV</title><title>International journal of gynecology and obstetrics</title><addtitle>Int J Gynaecol Obstet</addtitle><description>Objective
To evaluate the risk factors for recurrence of high‐grade disease after cervical excision in women living with HIV (WLWH), with a specific interest in the role of high‐risk (HR‐) HPV positivity.
Methods
Multicentric retrospective study conducted on WLWH who underwent cervical excision between January 1987 and June 2017 in six Italian institutions. The rate of high‐grade recurrence was determined. Risk factors for recurrence and HR‐HPV positivity were determined with the Log‐rank test and Cox proportional hazards regression models.
Results
A total of 271 WLWH were included in the final analysis. A high‐grade recurrence was found in 58 (21.4%) patients. Age 41 years or more at inclusion and HR‐HPV positivity during follow up were independently associated with a higher risk of disease recurrence with relative risks of 4.15 (95% confidence interval [CI] 2.01–8.58, P < 0.001) and 5.18 (95% CI 2.12–12.67, P < 0.01), respectively. Age 41 years or more (relative risk 1.75, 95% CI 1.01–3.04, P = 0.047) resulted as a risk factor for HR‐HPV positivity during follow up.
Conclusion
HR‐HPV positivity is a risk factor for recurrence after cervical excision in WLWH. Women older than 41 years may benefit from a long‐term yearly follow up. Future studies regarding HPV vaccination after treatment in WLWH may be useful, considering the protective role of the higher probability of HPV negativity in vaccinated women.
Synopsis
High‐risk‐HPV positivity during long‐term follow up is a risk factor for high‐grade disease recurrence after cervical excisional treatment in women living with HIV.</description><subject>Adult</subject><subject>cervical excisional procedure</subject><subject>cervical intraepithelial neoplasia</subject><subject>Clinical</subject><subject>conization</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections</subject><subject>Humans</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Papillomaviridae</subject><subject>Papillomavirus Infections</subject><subject>recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Uterine Cervical Dysplasia</subject><subject>Uterine Cervical Neoplasms - surgery</subject><issn>0020-7292</issn><issn>1879-3479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp9kctuEzEUhi1ERdPChgdAXiKkaX2bizdIqIImVaWygG4txz6euMyMgz2TkF15A56RJ8Ft2go2LKwj6__0nSP9CL2m5IQSwk79TRtOKK9q8QzNaFPLgotaPkezHJKiZpIdoqOUbgghtKb0BTrkvGaUMz5DP-e-Xf2-_RV9-obnn6_xOiQ_-o0fd9gnrHEXhjbnI8Qe30NOmzFE7PKLYKYYYTCAtcsENhA33ugOww_jkw8DXsdgwE4RsB_wNvQw4C7bhxZv_bjC88X1S3TgdJfg1cM8Rl8_ffxyNi8ur84XZx8uCyMYEYWzgglpK20ZCEJqLawgTDZal7qyUILM36WQbtkwXXLpYEkckc4yW3IglB-j93vvelr2YA0MY9SdWkff67hTQXv1bzL4lWrDRjWlrKqmzIK3D4IYvk-QRtX7ZKDr9ABhSoqVhDYlk6LK6Ls9amJIKYJ7WkOJuutM3XWm7jvL8Ju_D3tCH0vKAN0DW9_B7j8qtbg4v9pL_wDMTKbw</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Agarossi, Alberto</creator><creator>Delli Carpini, Giovanni</creator><creator>Sopracordevole, Francesco</creator><creator>Serri, Matteo</creator><creator>Giannella, Luca</creator><creator>Gardella, Barbara</creator><creator>Maestri, Marta</creator><creator>Del Fabro, Anna</creator><creator>Sansone, Matilde</creator><creator>Fallani, Maria Grazia</creator><creator>Pieralli, Annalisa</creator><creator>Fasolo, Maria Michela</creator><creator>Mazzali, Cristina</creator><creator>Ciavattini, Andrea</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202112</creationdate><title>High‐risk HPV positivity is a long‐term risk factor for recurrence after cervical excision procedure in women living with HIV</title><author>Agarossi, Alberto ; Delli Carpini, Giovanni ; Sopracordevole, Francesco ; Serri, Matteo ; Giannella, Luca ; Gardella, Barbara ; Maestri, Marta ; Del Fabro, Anna ; Sansone, Matilde ; Fallani, Maria Grazia ; Pieralli, Annalisa ; Fasolo, Maria Michela ; Mazzali, Cristina ; Ciavattini, Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4204-fd4249d6ad2e4007a4d40298aa5a6de5e9402b49fb82a539feb0f09fd2d53e013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>cervical excisional procedure</topic><topic>cervical intraepithelial neoplasia</topic><topic>Clinical</topic><topic>conization</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections</topic><topic>Humans</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Papillomaviridae</topic><topic>Papillomavirus Infections</topic><topic>recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Uterine Cervical Dysplasia</topic><topic>Uterine Cervical Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Agarossi, Alberto</creatorcontrib><creatorcontrib>Delli Carpini, Giovanni</creatorcontrib><creatorcontrib>Sopracordevole, Francesco</creatorcontrib><creatorcontrib>Serri, Matteo</creatorcontrib><creatorcontrib>Giannella, Luca</creatorcontrib><creatorcontrib>Gardella, Barbara</creatorcontrib><creatorcontrib>Maestri, Marta</creatorcontrib><creatorcontrib>Del Fabro, Anna</creatorcontrib><creatorcontrib>Sansone, Matilde</creatorcontrib><creatorcontrib>Fallani, Maria Grazia</creatorcontrib><creatorcontrib>Pieralli, Annalisa</creatorcontrib><creatorcontrib>Fasolo, Maria Michela</creatorcontrib><creatorcontrib>Mazzali, Cristina</creatorcontrib><creatorcontrib>Ciavattini, Andrea</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley-Blackwell Open Access Backfiles</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Agarossi, Alberto</au><au>Delli Carpini, Giovanni</au><au>Sopracordevole, Francesco</au><au>Serri, Matteo</au><au>Giannella, Luca</au><au>Gardella, Barbara</au><au>Maestri, Marta</au><au>Del Fabro, Anna</au><au>Sansone, Matilde</au><au>Fallani, Maria Grazia</au><au>Pieralli, Annalisa</au><au>Fasolo, Maria Michela</au><au>Mazzali, Cristina</au><au>Ciavattini, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High‐risk HPV positivity is a long‐term risk factor for recurrence after cervical excision procedure in women living with HIV</atitle><jtitle>International journal of gynecology and obstetrics</jtitle><addtitle>Int J Gynaecol Obstet</addtitle><date>2021-12</date><risdate>2021</risdate><volume>155</volume><issue>3</issue><spage>442</spage><epage>449</epage><pages>442-449</pages><issn>0020-7292</issn><eissn>1879-3479</eissn><abstract>Objective
To evaluate the risk factors for recurrence of high‐grade disease after cervical excision in women living with HIV (WLWH), with a specific interest in the role of high‐risk (HR‐) HPV positivity.
Methods
Multicentric retrospective study conducted on WLWH who underwent cervical excision between January 1987 and June 2017 in six Italian institutions. The rate of high‐grade recurrence was determined. Risk factors for recurrence and HR‐HPV positivity were determined with the Log‐rank test and Cox proportional hazards regression models.
Results
A total of 271 WLWH were included in the final analysis. A high‐grade recurrence was found in 58 (21.4%) patients. Age 41 years or more at inclusion and HR‐HPV positivity during follow up were independently associated with a higher risk of disease recurrence with relative risks of 4.15 (95% confidence interval [CI] 2.01–8.58, P < 0.001) and 5.18 (95% CI 2.12–12.67, P < 0.01), respectively. Age 41 years or more (relative risk 1.75, 95% CI 1.01–3.04, P = 0.047) resulted as a risk factor for HR‐HPV positivity during follow up.
Conclusion
HR‐HPV positivity is a risk factor for recurrence after cervical excision in WLWH. Women older than 41 years may benefit from a long‐term yearly follow up. Future studies regarding HPV vaccination after treatment in WLWH may be useful, considering the protective role of the higher probability of HPV negativity in vaccinated women.
Synopsis
High‐risk‐HPV positivity during long‐term follow up is a risk factor for high‐grade disease recurrence after cervical excisional treatment in women living with HIV.</abstract><cop>United States</cop><pub>John Wiley and Sons Inc</pub><pmid>33721323</pmid><doi>10.1002/ijgo.13674</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0020-7292 |
| ispartof | International journal of gynecology and obstetrics, 2021-12, Vol.155 (3), p.442-449 |
| issn | 0020-7292 1879-3479 |
| language | eng |
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| source | Wiley |
| subjects | Adult cervical excisional procedure cervical intraepithelial neoplasia Clinical conization Female HIV HIV Infections Humans Neoplasm Recurrence, Local - epidemiology Papillomaviridae Papillomavirus Infections recurrence Retrospective Studies Risk Factors Uterine Cervical Dysplasia Uterine Cervical Neoplasms - surgery |
| title | High‐risk HPV positivity is a long‐term risk factor for recurrence after cervical excision procedure in women living with HIV |
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