Cervical Human Papilloma Virus Infection and Cytological Abnormalities in Solid-Organ Transplant Recipients: A Study of Screening and Clinical Outcomes

Abstract

Objective: This study's objective was to evaluate the outcomes of cervical cancer screening, including human papilloma virus (HPV) testing and cytology, in solid-organ transplantation (SOT) recipients at our institution. Materials and Methods: The clinical data of 112 patients who underwent SOT were reviewed in this retrospective observational study. The HPV DNA test was conducted using the Hybrid Capture 2 HPV DNA test (hc2; Qiagen, Hilden, Germany). Cytological and histopathological samples were evaluated by expert gynecological pathologists per the Bethesda system. Results: Data from 40 patients were included in the analysis. Among the transplant recipients, 27 patients (67.5%) had kidney transplants, and 13 (32.5%) had liver transplants. Four patients (10%) had at least one abnormal test result. Excluding the undetermined significance of atypical squamous cells with a concordance-negative HPV test, the combined rate of HPV positivity or abnormal cytology was 7.5%. The rate of high-grade squamous intraepithelial lesions was 2.5%. Two patients who had HPV DNA other than the 16–18 type had persistent HPV DNA results after the 1-year follow-up. Conclusion: This study showed that the prevalence of high-risk HPV among unvaccinated Turkish women with SOT was higher than that in the general population. Improving early collaboration between transplantation and gynecology clinics may help reduce HPV rates in SOT recipients.

Keywords

• human papilloma virus
• HPV
• transplantation
• immunosuppression
• cervical intraepithelial neoplasia
• SIL
• solid-organ transplantation

References

1. Liao JB, Fisher CE, Madeleine MM. Gynecologic cancers and solid organ transplantation. American Journal of Transplantation. 2019;19(5):1266-77. 2. Pierangeli A, Antonelli G, Gentile G. Immunodeficiency-associated viral oncogenesis. Clinical Microbiology and Infection. 2015;21(11):975-83.