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Original Article|Articles in Press

Human papillomavirus prevalence, persistence and cervical dysplasia in females with cystic fibrosis

  • C. Rousset-Jablonski
    Correspondence
    Corresponding author: Cystic Fibrosis Adult Refence Center, Groupe Hospitalier Sud, 165 chemin du grand Revoyet, 69130 Pierre-Bénite, France.
    Affiliations
    Hospices Civils de Lyon (HCL), Cystic Fibrosis Adult Refence Center, Department of Internal Medicine, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France

    Hospices Civils de Lyon. Department of Obstetrics and Gynecology, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France

    Leon Berard Cancer Center. Department of Surgical Oncology, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France

    INSERM U1290 RESHAPE Research in Health Care Performance, Lyon 1 Claude Bernard University, Lyon, France
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  • Y. Mekki
    Affiliations
    Hospices Civils de Lyon, Laboratory of Virology IAI, Lyon, France
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  • A. Denis
    Affiliations
    Hospices Civils de Lyon, Pôle de Santé Publique –Service de Recherche et d'Epidémiologie Cliniques. Groupement Hospitalier Est. 59 Boulevard Pinel - 69677 Bron Cedex, France
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  • Q. Reynaud
    Affiliations
    Hospices Civils de Lyon (HCL), Cystic Fibrosis Adult Refence Center, Department of Internal Medicine, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France

    INSERM U1290 RESHAPE Research in Health Care Performance, Lyon 1 Claude Bernard University, Lyon, France
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  • R. Nove-Josserand
    Affiliations
    Hospices Civils de Lyon (HCL), Cystic Fibrosis Adult Refence Center, Department of Internal Medicine, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France
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  • S. Durupt
    Affiliations
    Hospices Civils de Lyon (HCL), Cystic Fibrosis Adult Refence Center, Department of Internal Medicine, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France
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  • S. Touzet
    Affiliations
    INSERM U1290 RESHAPE Research in Health Care Performance, Lyon 1 Claude Bernard University, Lyon, France

    Hospices Civils de Lyon, Pôle de Santé Publique –Service de Recherche et d'Epidémiologie Cliniques. Groupement Hospitalier Est. 59 Boulevard Pinel - 69677 Bron Cedex, France
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  • M. Perceval
    Affiliations
    Hospices Civils de Lyon (HCL), Cystic Fibrosis Adult Refence Center, Department of Internal Medicine, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France
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  • I. Ray-Coquard
    Affiliations
    Leon Berard Cancer Center, Departement of medical oncology, Centre Léon Bérad, 28 rue Laënnec, 69008 Lyon
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  • F. Golfier
    Affiliations
    Hospices Civils de Lyon. Department of Obstetrics and Gynecology, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France
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  • I. Durieu
    Affiliations
    Hospices Civils de Lyon (HCL), Cystic Fibrosis Adult Refence Center, Department of Internal Medicine, Groupe Hospitalier Sud, 69495 Pierre Benite Cedex, France

    INSERM U1290 RESHAPE Research in Health Care Performance, Lyon 1 Claude Bernard University, Lyon, France
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Published:December 14, 2022DOI:https://doi.org/10.1016/j.jcf.2022.11.005

      Highlights

      • Transplanted CF females are at higher risk of HR-HPV infection than non-CF females.
      • Transplanted CF females have high frequencies of abnormal cervical cytology.
      • HR-HPV prevalence in non-transplanted CF females seems similar to non -CF females.
      • Non-transplanted CF females have high frequencies of abnormal cervical cytology.
      • Cervical cancer screening and prevention should be promoted among females with CF.

      Abstract

      Background

      A higher risk of human papillomavirus (HPV)-related cervical intra-epithelial neoplasia (CIN) is suspected among females with cystic fibrosis (CF).

      Methods

      We conducted a single center prospective cohort study among females attending the Lyon adult CF center. We performed a cervical cytology (Hologic Thinprep®) and HPV testing with genotyping (Clinical Arrays Papillomavirus; Genomica, enabling 35 genotype detection, 20 of which are high-risk (HR-HPV)) at inclusion. We followed all females with positive HPV tests at 6, 12 and 24 months to evaluate HPV persistence, and performed a colposcopy in cases of abnormal cytology.

      Results

      We included eighty-five participants, 18 (21%) of whom were lung-transplanted. The mean age at inclusion was 31.9 (range 18-59) years. The prevalence of HPV (all types) was 31.8%. HR-HPV was found in 25.9% of the whole cohort, 44.4% of transplanted patients, and 20.1% of nontransplanted patients. Genotype-specific HR-HPV persistence at 12 months was 43.5% among transplanted and 34.6% among nontransplanted patients. Overall, 17.6% (15/85) of females had an abnormal cytology: 44.4% (8/18) among transplanted and 10.4% (7/67) among nontransplanted patients. CIN was identified in 12 (14.1%) patients (6 low-grade, 6 high-grade). High-grade CIN developed in 4 nontransplanted patients.

      Conclusion

      Transplanted females had high HR-HPV, abnormal cervical cytology and CIN prevalence rates compared to large published cohorts in the general non-CF population. Although HR-HPV prevalence and persistence were globally not significantly different in nontransplanted females compared to the general population, we reported high frequencies of abnormal cytology and CIN. Cervical cancer screening and prevention should be promoted among females with CF.
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