Dynamics of human papillomavirus infection between biopsy and excision of cervical intraepithelial neoplasia: results from the ZYC101a protocol.
J Infect Dis
; 189(8): 1348-54, 2004 Apr 15.
Article
en En
| MEDLINE
| ID: mdl-15073670
ABSTRACT
BACKGROUND:
Little is known about the dynamics of human papillomavirus (HPV) during the follow-up of cervical intraepithelial neoplasia (CIN) 2/3 after biopsy.METHODS:
A total of 127 women with biopsy-confirmed CIN2/3 were enrolled in a phase 2 double-blinded, randomized, placebo-controlled clinical trial of ZYC101a. Colposcopic, cytologic, and HPV testing were performed over the course of 6 months, before a loop electrical surgical excision procedure was performed at study exit.RESULTS:
Of the women tested, 99% were found to be HPV positive at study entry, 50% were found to be HPV type 16 positive at study entry, 22% were found to be positive for multiple HPV types at study entry, and 37% were found to be positive for additional HPV types during follow-up. Of those with a histologic outcome of CIN1 at study exit, 78% were found to be positive for additional HPV types; in 39%, the original type was replaced with a new HPV type. Virus load at study entry did not predict outcome, but pre-study-exit virus load correlated with a histologic outcome of any CIN, and changes in virus load correlated with risk for an outcome of CIN2/3 at study exit.CONCLUSIONS:
The type and number of HPVs at study entry, detection of additional viral types, and virus load changes during follow-up influence histologic outcome at study exit. An outcome of CIN1 at study exit is most likely due to additional HPV infections, rather than morphologic reversion of CIN2/3 to CIN1. Knowledge of the dynamics of HPV infection during the biopsy-to-excision period is critical to understanding the natural history of HPV infection, its contribution to disease outcome, and interpretations of drug efficacy.
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Bases de datos:
MEDLINE
Asunto principal:
Antivirales
/
Papillomaviridae
/
ADN
/
Displasia del Cuello del Útero
/
Neoplasias del Cuello Uterino
/
Infecciones por Papillomavirus
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
J Infect Dis
Año:
2004
Tipo del documento:
Article