TY - JOUR
T1 - Human Papillomavirus Same Genotype Persistence and Risk
T2 - A Systematic Review
AU - Bonde, Jesper
AU - Bottari, Fabio
AU - Iacobone, Anna D
AU - Cocuzza, Clementina E
AU - Sandri, Maria-Teresa
AU - Bogliatto, Fabrizio
AU - Khan, Khalid S
AU - Ejegod, Ditte M
AU - Gary, Devin S
AU - Andrews, Jeffrey C
N1 - Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - OBJECTIVE: The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HPV infection, or acquisition of a new HPV infection after a negative infection status, during a follow-up testing subsequent to abnormal screening results.MATERIALS AND METHODS: MEDLINE, Cochrane Library, Health Technology Assessment, and clinicaltrials.gov were searched from January 2000 to July 2019 for prospective controlled trials and observational studies of women and retrospective studies using HPV assays with extended- or full-genotype reporting. The primary outcome was high-grade CIN after at least 2 rounds of testing. Overall quality of evidence for the risk estimate outcomes was assessed. Of the 830 identified abstracts, 66 full-text articles were reviewed, and 7 studies were included in the synthesis. The study protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42018091093).RESULTS: Continued HPV-positive women falls in 2 equally large groups: SGTP and GS. Sensitivity, positive predictive value, and positive likelihood ratio of SGTP were significantly higher than for GS. Human papillomavirus genotypes may be ranked into 3 tiers (immediate colposcopy, follow-up testing, return to routine screening), according to associated risk of persistence for high-grade CIN and to prevailing clinical action thresholds.CONCLUSIONS: There is moderately high-quality evidence to support the clinical utility of SGTP to improve risk discrimination for high-grade CIN compared with qualitative HPV testing without genotype-specific information.
AB - OBJECTIVE: The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HPV infection, or acquisition of a new HPV infection after a negative infection status, during a follow-up testing subsequent to abnormal screening results.MATERIALS AND METHODS: MEDLINE, Cochrane Library, Health Technology Assessment, and clinicaltrials.gov were searched from January 2000 to July 2019 for prospective controlled trials and observational studies of women and retrospective studies using HPV assays with extended- or full-genotype reporting. The primary outcome was high-grade CIN after at least 2 rounds of testing. Overall quality of evidence for the risk estimate outcomes was assessed. Of the 830 identified abstracts, 66 full-text articles were reviewed, and 7 studies were included in the synthesis. The study protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42018091093).RESULTS: Continued HPV-positive women falls in 2 equally large groups: SGTP and GS. Sensitivity, positive predictive value, and positive likelihood ratio of SGTP were significantly higher than for GS. Human papillomavirus genotypes may be ranked into 3 tiers (immediate colposcopy, follow-up testing, return to routine screening), according to associated risk of persistence for high-grade CIN and to prevailing clinical action thresholds.CONCLUSIONS: There is moderately high-quality evidence to support the clinical utility of SGTP to improve risk discrimination for high-grade CIN compared with qualitative HPV testing without genotype-specific information.
KW - HPV
KW - HPV genotyping
KW - cervical cancer screening
KW - systematic review
KW - triage
KW - Cervical Intraepithelial Neoplasia/genetics
KW - Meta-Analysis as Topic
KW - Colposcopy
KW - Papillomaviridae/genetics
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Genotype
KW - Papillomavirus Infections/epidemiology
KW - Early Detection of Cancer/methods
KW - Young Adult
KW - Uterine Cervical Neoplasms/genetics
KW - Adult
KW - Female
UR - http://www.scopus.com/inward/record.url?scp=85098179486&partnerID=8YFLogxK
U2 - 10.1097/LGT.0000000000000573
DO - 10.1097/LGT.0000000000000573
M3 - Review
C2 - 33105450
SN - 1089-2591
VL - 25
SP - 27
EP - 37
JO - Journal of lower genital tract disease
JF - Journal of lower genital tract disease
IS - 1
M1 - 0000000000000573
ER -