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Rate of Human Papillomavirus Clearance After Treatment of Cervical Intraepithelial Neoplasia

Kristina Elfgren, MD, Marcel Jacobs, MD, Jan M. M. Walboomers, PhD, Chris J. L. M. Meijer, MD, PhD and Joakim Dillner, MD, PhD

From the Department of Obstetrics and Gynecology, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Pathology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands; Department of Medical Virology, Malmö University Hospital, Malmö, Sweden; and School of Public Health, University of Tampere, Tampere, Finland.

Address reprint requests to: Kristina Elfgren, MD, Huddinge University Hospital, Department of Obstetrics and Gynecology, K57, S-141 86 Stockholm, Sweden; E-mail: kristina.elfgren{at}obgyn.hs.sll.se.

OBJECTIVE: To investigate the rate of clearance of human papillomavirus (HPV) infection after surgical treatment for cervical intraepithelial neoplasia (CIN).

METHODS: One hundred nine women with CIN I–III, treated with cryosurgery or conization at a university hospital, were observed with cervical HPV deoxyribonucleic acid (DNA) testing by general primer polymerase chain reaction and HPV typing at 0, 3, 6, 9, 12, and 24 months after treatment. Penile HPV DNA was analyzed from current sexual partners.

RESULTS: Eighty-one percent of evaluable women were HPV DNA positive at treatment or enrollment. One year later, seven women (9%) remained positive for the same HPV type. Most women had cleared the HPV infection diagnosed at treatment within 3 months. The cryotherapy group had lower CIN grades, was younger, and had a slower HPV clearance rate (P < .002). Only four couples had HPV DNA of the same type detected.

CONCLUSION: Surgical treatment of CIN usually results in clearance of HPV infection within 3 months. Human papillomavirus DNA testing may be useful as a rapid intermediate end point for monitoring the efficacy of treatments.

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