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Type: Artigo de periódico
Title: Factors Associated With Hpv Persistence After Treatment For High-grade Cervical Intra-epithelial Neoplasia With Large Loop Excision Of The Transformation Zone (lletz).
Author: Sarian, Luís Otávio Zanatta
Derchain, Sophie Françoise Mauricette
Pitta, Denise da Rocha
Morais, Sirlei Siani
Rabelo-Santos, Silvia Helena
Abstract: Human Papillomavirus (HPV) persistence after high-grade cervical intra-epithelial neoplasia (CIN) removal may be associated with residual lesions or risk of disease recurrence. Knowledge regarding the factors associated with HPV persistence following CIN treatment is still limited. The main purpose of this longitudinal study was to assess the association between characteristics of the patients and their cervical lesions with high-risk HPV-type persistence, detected by commercially available Hybrid Capture II (HC II), after CIN 2 and 3 treatment with large loop excision of the transformation zone (LLETZ). For this cohort study, a total of 94 women submitted to LLETZ between March 2001 and September 2002 were included. Only women with at least one follow-up visit at 6 or 12 months and confirmed CIN 2 or 3 in the cone specimen were considered. In each visit women answered to a questionnaire and undertook Pap smear and HC II specimens collection. McNemar's, chi-square and Fisher tests were used for univariate analysis. Generalized Estimating Equations (GEE) were used for multivariate analysis. All calculations were performed within 95% confidence intervals (95% CI). Histological evaluation showed 12 (13%) women with CIN, 2 and 82 (87%) with CIN 3 and conization margins were compromised in 27 (29%) cases. Eighty-seven (92%) women showed positive HC II tests prior to LLETZ. Of women initially HPV negative, none had a positive HC II during follow-up. The proportion of positive HPV tests was reduced from 92% to 20%(P < 0.01) at the first visit and to 22% (P < 0.01) at the second visit after LLETZ. Multivariate analysis showed that smoking and age above 35 years (irrespective of margin status) were strongly associated with positive HPV during follow-up. HPV persistence following LLETZ was associated with smoking and with the interaction between age and conization margins.
Subject: Adolescent
Age Factors
Cervical Intraepithelial Neoplasia
Cervix Uteri
Cohort Studies
Dna, Viral
Follow-up Studies
Longitudinal Studies
Papillomavirus Infections
Treatment Outcome
Tumor Virus Infections
Rights: fechado
Identifier DOI: 10.1016/j.jcv.2004.05.012
Date Issue: 2004
Appears in Collections:Unicamp - Artigos e Outros Documentos

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