title: Cervical Human Papillomavirus in transplanted Italian women: a long-term prospective follow-up study.
abstract: BACKGROUND
  Human Papillomavirus (HPV) is the leading cause of cervical cancer among women. Immunosuppression is recognized as one of the major risk factors for HPV infection and persistence.
  
  
  OBJECTIVE
  Aim of this study was to determine if solid organs (24 kidney and 24 kidney/pancreas) transplanted Italian women undergoing immunosuppressive therapies were at higher risk of HPV genital infection and cervical precancerous lesions in a ten-year follow-up.
  
  
  METHODS
  Forty-eight women that underwent transplant from 1990 to 2000, receiving multi-drug immunosuppressive therapy, were enrolled prospectively in a long-term follow-up protocol. Patients were cytologically (Pap smear) and virologically (HPV-DNA test) tested each year for 10 years. Incidence of HPV-DNA positivity and of cervical cytological/histological abnormalities was collected. Results were statistically analyzed and compared to a matching control group of 200 healthy women.
  
  
  RESULTS
  HPV-DNA positivity and cytological High-Grade (HG-SIL) cervical lesions did not show statistically significant differences in cases compared to controls, while statistical significance was observed in Low-Grade (LG-SIL) cytological diagnoses. No statistically significant difference was observed in histology-proven cervical lesions.
  
  
  CONCLUSIONS
  Women receiving immunosuppression therapy following transplant do not seem to require intensive follow-up, and should not be considered a high-risk subgroup, as they do not show a statistically significant higher incidence of HPV infections or high-grade cervical dysplasia compared to healthy immunocompetent matching controls.
authors.affiliation: Department of Obstetrics & Gynecology, Vita-Salute San Raffaele University, School of Medicine at San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milano, Italy. massimo.origoni@hsr.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Origoni
authors.forename: Chiara
authors.initials: C
authors.lastname: Stefani
authors.forename: Giacomo
authors.initials: G
authors.lastname: Dell'Antonio
authors.forename: Guia
authors.initials: G
authors.lastname: Carminati
authors.forename: Marta
authors.initials: M
authors.lastname: Parma
authors.forename: Massimo
authors.initials: M
authors.lastname: Candiani
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000821:virology*; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D011446:Prospective Studies; D014180:Transplantation; D014621:Vagina / Q000166:cytology / Q000821:virology; D014626:Vaginal Smears
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents