Influence of loop electrosurgical excision procedure on subsequent acquisition of new human papillomavirus infections

J Infect Dis. 2009 Jun 1;199(11):1612-20. doi: 10.1086/598981.

Abstract

Background: The impact of loop electrosurgical excision procedure (LEEP) treatment for cervical precancerous lesions on subsequent acquisition of new human papillomavirus (HPV) infections is not well described.

Methods: The acquisition of new HPV infections was compared in HPV-positive women who underwent colposcopy and were treated by LEEP (n = 195) and those who were untreated (n = 1625) at entry into a 2-year study. Cumulative incidence rate ratios (IRRs) for treated versus untreated women at 6- and 24-months of follow-up, with 95% confidence intervals (CIs), were calculated for infection by individual HPV genotypes, any HPV genotypes, any carcinogenic HPV genotypes, any noncarcinogenic HPV genotypes, and phylogenetic groups of HPV genotypes.

Results: Treated women were 29% less likely than untreated women to have carcinogenic HPV genotypes detected at 6-month follow-up visits (IRR, 0.71; 95% CI, 0.50-1.00) and were 18% less likely to have these genotypes detected at 24-month follow-up visits (IRR, 0.82; 95% CI, 0.68-1.01). Treated women were 56% less likely to have HPV genotypes of the alpha9 phylogenetic species (which includes HPV-16) detected at 6-month follow-up visits (IRR, 0.44; 95% CI, 0.23-0.85) and were 40% less likely to have these genotype detected at 24-month follow-up visits (IRR, 0.60; 95% CI, 0.42-0.85).

Conclusion: LEEP may reduce the acquisition of certain carcinogenic HPV genotypes related to HPV-16.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Electrosurgery / methods
  • Female
  • Genotype
  • Humans
  • Incidence
  • Papillomaviridae / genetics*
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / surgery*
  • Prevalence
  • Randomized Controlled Trials as Topic
  • Uterine Cervical Dysplasia / epidemiology*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / surgery*