WHEN HPV BECOMES PERSISTENT

Although most HPV infections resolve spontaneously within 1 to 2 years, persistent HPV infection can cause cervical dysplasia (CIN) and cervical cancer.

Furthermore, HPV persistence, as well as viral load, are considered two of the main risk factors that influence the risk of recurrence of cervical dysplasia after conization. However, to date we have no data correlating the persistence of the viral infection with the risk of recurrence.

For this reason, in collaboration with the Italian Society of Colposcopy and Cervix-Vaginal Pathology (SICPCV), we went to study the effects of the persistence of HPV infection over time in women who had already undergone conization for cervical dysplasia.

By analyzing a large database of women undergoing conization for moderate and severe cervical dysplasia (CIN2 and CIN3), cases with persistent HPV (for at least 6 months) were selected.

Data from our study suggest that high-risk HPV genotypes (particularly HPV16 and HPV18) have a greater risk of persistence than low-risk HPV types. We observed that patients with HPV persistence at 12 months had an increased rate of relapse compared to patients with HPV persistence at 6 months; however, prolonged persistence (more than 12 months) does not increase the risk of developing relapses.

Overall, patients with HPV persistence for 6 months experienced a risk of recurrence of approximately 7.5%, while persistence at 12 months correlated with an estimated risk of developing recurrence of 13.1%.

The risk of developing recurrence remains almost stable in patients with persistence of HPV longer than 12 months. These data provide important