A Six-Year Gynecological Follow-Up of Immunosuppressed Women with a High-Risk Human Papillomavirus Infection

• Published in: International journal of environmental research and public health 2022-03, Vol.19 (6), p.3531
• Main Authors: Wielgos, Aleksandra, Pietrzak, Bronisława, Suchonska, Barbara, Sikora, Mariusz, Rudnicka, Lidia, Wielgos, Miroslaw
• Format: Article
• Language: English
• Subjects: Anogenital; Biopsy; Cellular biology; Cervical cancer; Cervix; Chronic conditions; Clinics; Colposcopy; Cytology; Dysplasia; Enrollments; Female; Follow-Up Studies; Gynecology; Health risks; Human papillomavirus; Humans; Immunosuppressive agents; Infections; Invasiveness; Lesions; Medical screening; Obstetrics; Outpatient care facilities; Papillomaviridae; Papillomavirus Infections - diagnosis; Participation; Patients; Risk; Systemic lupus erythematosus; Transplants & implants; Uterine Cervical Dysplasia - diagnosis; Uterine Cervical Dysplasia - epidemiology; Uterine Cervical Neoplasms - diagnosis; Vagina; Vaginal Smears; Womens health
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph19063531

Immunocompromised women are at an increased risk of developing malignancies, especially those that are viral-induced, such as invasive cervical cancer caused by the human papillomavirus (HPV). The aim of the study was to describe gynecological follow-up of women undergoing chronic immunosuppressive therapy for various reasons (e.g., kidney/liver transplant, systemic lupus erythematosus), diagnosed with a high-risk HPV (hrHPV) infection based on a self-sampling test. Twenty-six hrHPV-positive women were invited to take part in a gynecological follow-up, including a visual assessment of the anogenital region, two-handed gynecological examination, and cervical cytology as well as a colposcopy and cervical biopsy when necessary. Four women declined taking part in the study. Over six years of observation, low-grade squamous intraepithelial lesions (LSIL) were detected at least once in 7/22 women (31.8%), and a cervical intraepithelial lesion 1 (CIN 1) histopathologic result was obtained five times in 3/22 women. No cases of high-grade squamous intraepithelial lesions, CIN 2/3, or invasive cervical cancers were observed. Loop electrosurgical excision procedure (LEEP) was performed in three patients. As immunocompromised women are prone to persistent hrHPV infections, they should be under strict gynecological supervision because only vigilant surveillance enables fast detection and treatment of early dysplasia and, therefore, provides a chance for the reduction of the cervical cancer burden.