BACKGROUND: Female renal transplant recipients (RTR) are at high risk of human papillomavirus (HPV)-related anogenital premalignancies and cancer. The aim of this study was to estimate the incidence of cervical intraepithelial lesions (IL) and HPV infection, and their associated factors, in Mexican RTR. METHODS: This is a prospective cohort study conducted between January 2011 and December 2017. Demographic, clinical and gynecological data were collected using a previously designed questionnaire. Gynecological examination, cervical cytology and detection of high- and low-risk HPV DNA were undertaken prior to and after the renal transplant (RT). Colposcopically-guided biopsies were obtained from patients who presented high grade squamous intraepithelial lesions (HSIL) during the follow-up period. Diagnoses were established according to the Bethesda system. RESULTS: Among 130 RTR, 62 were eligible for our study. The overall incidence of IL was 17.7% (95% CI; 8-27%), (11/62 patients), at 25.6 ± 10.7 months post-RT. Nine out of the eleven affected patients had low-grade squamous intraepithelial lesions (81.8%) and only 2 had HSIL (18.2%). The incidence of HPV infection, determined in a subgroup of 30 RTR, was 53.3% (95% CI; 35-71%), (16 out of 30 patients), at 18.3 ± 8.9 months post-RT. High-risk HPV genotypes were present in 62.5% of HPV positive cases (10/16). In eleven patients (36.6%) HPV infection was not associated to IL. CONCLUSIONS: HPV infection and cervical IL are common in the early post-transplant period. Our findings support the need of screening for cervical cancer to detect precancerous changes in RTR and the need of strengthening the knowledge of medical personnel on this issue. This article is protected by copyright. All rights reserved.
BACKGROUND: Female renal transplant recipients (RTR) are at high risk of human papillomavirus (HPV)-related anogenital premalignancies and cancer. The aim of this study was to estimate the incidence of cervical intraepithelial lesions (IL) and HPV infection, and their associated factors, in Mexican RTR. METHODS: This is a prospective cohort study conducted between January 2011 and December 2017. Demographic, clinical and gynecological data were collected using a previously designed questionnaire. Gynecological examination, cervical cytology and detection of high- and low-risk HPV DNA were undertaken prior to and after the renal transplant (RT). Colposcopically-guided biopsies were obtained from patients who presented high grade squamous intraepithelial lesions (HSIL) during the follow-up period. Diagnoses were established according to the Bethesda system. RESULTS: Among 130 RTR, 62 were eligible for our study. The overall incidence of IL was 17.7% (95% CI; 8-27%), (11/62 patients), at 25.6 ± 10.7 months post-RT. Nine out of the eleven affected patients had low-grade squamous intraepithelial lesions (81.8%) and only 2 had HSIL (18.2%). The incidence of HPV infection, determined in a subgroup of 30 RTR, was 53.3% (95% CI; 35-71%), (16 out of 30 patients), at 18.3 ± 8.9 months post-RT. High-risk HPV genotypes were present in 62.5% of HPV positive cases (10/16). In eleven patients (36.6%) HPV infection was not associated to IL. CONCLUSIONS:HPV infection and cervical IL are common in the early post-transplant period. Our findings support the need of screening for cervical cancer to detect precancerous changes in RTR and the need of strengthening the knowledge of medical personnel on this issue. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
cervical intraepithelial lesions; human papilloma virus; renal transplant
Authors: Aleksandra Wielgos; Bronisława Pietrzak; Barbara Suchonska; Mariusz Sikora; Lidia Rudnicka; Miroslaw Wielgos Journal: Int J Environ Res Public Health Date: 2022-03-16 Impact factor: 3.390