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Lesson of the month: Natural history and clearance of HPV after treatment of precancerous cervical lesions

(2008) HISTOPATHOLOGY. 52(3). p.381-386
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Abstract
Aims: To assess the clearance rate of human papillomavirus (HPV) after out-patient treatment of cervical intraepithelial neoplasia (CIN). Methods and results: A total of 122 Nicaraguan women with HPV DNA-positive and histologically confirmed CIN lesions were included in the study. Fifty-five patients with CIN1 and 67 with CIN2-3 were treated by cryotherapy and loop electrosurgical excision procedure (LEEP), respectively. Follow-up visits were scheduled at 6 weeks, 6 months, 1 year and 2 years. Investigations included cytology, HPV DNA testing and colposcopy/biopsy if needed. The clearance rate of HPV was calculated by multivariate logistic regression. Immediately after treatment, a pronounced decrease in presence of HPV was observed in both groups, with a significantly higher clearance in the LEEP group than in the cryotherapy group (P = 0.019). Subsequently, clearance continued over time and was similar between the cryotherapy group and the LEEP group (P = 0.73). Approximately the same detection rates were obtained for persistence of all HPV types and for high-risk types separately: 43.9, 37.6, 29.9 and 17.7% in the cryotherapy group and 24.9, 20.3, 15.3 and 8.4% in the LEEP group at 6 weeks, 6 months, 1 year and 2 years, respectively. Conclusions: Out-patient treatment of precancerous lesions of the cervix usually results in clearance of HPV. Both LEEP and cryotherapy are highly effective methods of eradicating HPV. HPV DNA testing may have added value in the follow-up of patients.
Keywords
clearance, precancerous cervical lesion, human papillomavirus

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Chicago
Aerssens, Annelies, Patricia Claeys, A Garcia, Yolande Sturtewagen, R Velasquez, Davy Vanden Broeck, Stijn Vansteelandt, Marleen Temmerman, and CA Cuvelier. 2008. “Lesson of the Month: Natural History and Clearance of HPV After Treatment of Precancerous Cervical Lesions.” Histopathology 52 (3): 381–386.
APA
Aerssens, A., Claeys, P., Garcia, A., Sturtewagen, Y., Velasquez, R., Vanden Broeck, D., Vansteelandt, S., et al. (2008). Lesson of the month: Natural history and clearance of HPV after treatment of precancerous cervical lesions. HISTOPATHOLOGY, 52(3), 381–386.
Vancouver
1.
Aerssens A, Claeys P, Garcia A, Sturtewagen Y, Velasquez R, Vanden Broeck D, et al. Lesson of the month: Natural history and clearance of HPV after treatment of precancerous cervical lesions. HISTOPATHOLOGY. 2008;52(3):381–6.
MLA
Aerssens, Annelies, Patricia Claeys, A Garcia, et al. “Lesson of the Month: Natural History and Clearance of HPV After Treatment of Precancerous Cervical Lesions.” HISTOPATHOLOGY 52.3 (2008): 381–386. Print.
@article{439590,
  abstract     = {Aims: To assess the clearance rate of human papillomavirus (HPV) after out-patient treatment of cervical intraepithelial neoplasia (CIN).
Methods and results: A total of 122 Nicaraguan women with HPV DNA-positive and histologically confirmed CIN lesions were included in the study. Fifty-five patients with CIN1 and 67 with CIN2-3 were treated by cryotherapy and loop electrosurgical excision procedure (LEEP), respectively. Follow-up visits were scheduled at 6 weeks, 6 months, 1 year and 2 years. Investigations included cytology, HPV DNA testing and colposcopy/biopsy if needed. The clearance rate of HPV was calculated by multivariate logistic regression. Immediately after treatment, a pronounced decrease in presence of HPV was observed in both groups, with a significantly higher clearance in the LEEP group than in the cryotherapy group (P = 0.019). Subsequently, clearance continued over time and was similar between the cryotherapy group and the LEEP group (P = 0.73). Approximately the same detection rates were obtained for persistence of all HPV types and for high-risk types separately: 43.9, 37.6, 29.9 and 17.7\% in the cryotherapy group and 24.9, 20.3, 15.3 and 8.4\% in the LEEP group at 6 weeks, 6 months, 1 year and 2 years, respectively.
Conclusions: Out-patient treatment of precancerous lesions of the cervix usually results in clearance of HPV. Both LEEP and cryotherapy are highly effective methods of eradicating HPV. HPV DNA testing may have added value in the follow-up of patients.},
  author       = {Aerssens, Annelies and Claeys, Patricia and Garcia, A and Sturtewagen, Yolande and Velasquez, R and Vanden Broeck, Davy and Vansteelandt, Stijn and Temmerman, Marleen and Cuvelier, CA},
  issn         = {0309-0167},
  journal      = {HISTOPATHOLOGY},
  keyword      = {clearance,precancerous cervical lesion,human papillomavirus},
  language     = {eng},
  number       = {3},
  pages        = {381--386},
  title        = {Lesson of the month: Natural history and clearance of HPV after treatment of precancerous cervical lesions},
  url          = {http://dx.doi.org/10.1111/j.1365-2559.2007.02956.x},
  volume       = {52},
  year         = {2008},
}

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