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||Influence of loop electrosurgical excision procedure on subsequent acquisition of new human papillomavirus infections.
||Castle PE, Kreimer AR, Wacholder S, Wheeler CM, Koutsky LA, Rydzak G, Buckman DW, Graubard B, Schiffman M
||J Infect Dis
||2009 Jun 1
||MEB, IIB, BB
||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.