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Incidence of cervical intraepithelial lesions and human papilloma virus infection in female renal transplant recipients
Author(s) -
ParraAvila Idalia,
JiménezSantana María Luisa,
BarrónSánchez Rosa Elena,
MartínezGamboa Rosa Areli,
Alberú Josefina,
MoralesBuenrostro Luis Eduardo,
Cravioto Ma.delCarmen
Publication year - 2021
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13622
Subject(s) - medicine , incidence (geometry) , hpv infection , cervical cancer , cervical intraepithelial neoplasia , gynecology , cancer , physics , optics
Abstract 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% to 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 two had HSIL (18.2%). The incidence of HPV infection, determined in a subgroup of 30 RTR, was 53.3% (95% CI, 35% to 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 11 patients (36.6%), HPV infection was not associated to IL. Conclusions HPV infection and cervical IL are common in the early posttransplant 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.