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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Article info
Publication history
Published online: December 14, 2022
Accepted:
November 27,
2022
Received in revised form:
November 14,
2022
Received:
September 4,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
