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


CONCLUSIONS
LEEP may reduce the acquisition of certain carcinogenic HPV genotypes related to HPV-16.
Castle
Philip E
PE
Divisions of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. castlep@mail.nih.gov
Kreimer
Aimée R
AR
Wacholder
Sholom
S
Wheeler
Cosette M
CM
Koutsky
Laura A
LA
Rydzak
Greg
G
Buckman
Dennis W
DW
Graubard
Barry
B
Schiffman
Mark
M
D004598:Electrosurgery / Q000379:methods; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*