TY - JOUR
T1 - Incidence and clearance of cervical and anal high-risk human papillomavirus in kidney transplant recipients
T2 - Results from a Danish prospective clinical study
AU - Ring, Linea Landgrebe
AU - Larsen, Helle Kiellberg
AU - Frederiksen, Kirsten
AU - Hædersdal, Merete
AU - Sørensen, Søren Schwartz
AU - Bonde, Jesper Hansen
AU - Thomsen, Louise Thirstrup
AU - Kjær, Susanne K
N1 - Copyright © 2024 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2024/7
Y1 - 2024/7
N2 - This study investigates the incidence and clearance of cervical and anal high-risk human papillomavirus (hrHPV) infection in kidney transplant recipients (KTRs) compared to immunocompetent controls. During 2016-2017, we enrolled 125 female KTRs and 125 female controls. Liquid-based cervical and anal cytology samples collected at enrollment and follow-up were tested for human papillomavirus (HPV) DNA using the CLART HPV2 test. All participants answered a questionnaire on lifestyle and sexual behavior at both examinations. KTRs had an increased age-adjusted risk of incident cervical hrHPV infection compared to controls (hazard ratio [HR] = 3.6, 95% CI = 1.2-11.2). Probability of cervical hrHPV clearance at 18 months was lower among KTRs (8.3%) than controls (66.7%). There was no statistically significant difference in anal hrHPV incidence between KTRs and controls (HR = 0.9, 95% CI = 0.4-2.0). Clearance of anal hrHPV was similar between KTRs and controls at 18 months. During the total follow-up, a lower anal hrHPV clearance, although not statistically significant, was observed among KTRs (HR = 0.3, 95% CI = 0.06-1.2). KTRs had higher incidence of cervical hrHPV and lower probability of clearance, especially of cervical hrHPV infections, than controls. Our findings support that KTRs are at increased risk of HPV infection and point to the need for targeted HPV prevention strategies, such as cervical cancer screening.
AB - This study investigates the incidence and clearance of cervical and anal high-risk human papillomavirus (hrHPV) infection in kidney transplant recipients (KTRs) compared to immunocompetent controls. During 2016-2017, we enrolled 125 female KTRs and 125 female controls. Liquid-based cervical and anal cytology samples collected at enrollment and follow-up were tested for human papillomavirus (HPV) DNA using the CLART HPV2 test. All participants answered a questionnaire on lifestyle and sexual behavior at both examinations. KTRs had an increased age-adjusted risk of incident cervical hrHPV infection compared to controls (hazard ratio [HR] = 3.6, 95% CI = 1.2-11.2). Probability of cervical hrHPV clearance at 18 months was lower among KTRs (8.3%) than controls (66.7%). There was no statistically significant difference in anal hrHPV incidence between KTRs and controls (HR = 0.9, 95% CI = 0.4-2.0). Clearance of anal hrHPV was similar between KTRs and controls at 18 months. During the total follow-up, a lower anal hrHPV clearance, although not statistically significant, was observed among KTRs (HR = 0.3, 95% CI = 0.06-1.2). KTRs had higher incidence of cervical hrHPV and lower probability of clearance, especially of cervical hrHPV infections, than controls. Our findings support that KTRs are at increased risk of HPV infection and point to the need for targeted HPV prevention strategies, such as cervical cancer screening.
KW - Adult
KW - Anal Canal/virology
KW - Case-Control Studies
KW - DNA, Viral/analysis
KW - Denmark/epidemiology
KW - Female
KW - Follow-Up Studies
KW - Human Papillomavirus Viruses
KW - Humans
KW - Incidence
KW - Kidney Failure, Chronic/surgery
KW - Kidney Transplantation/adverse effects
KW - Middle Aged
KW - Papillomaviridae/isolation & purification
KW - Papillomavirus Infections/epidemiology
KW - Postoperative Complications/epidemiology
KW - Prognosis
KW - Prospective Studies
KW - Risk Factors
KW - Transplant Recipients/statistics & numerical data
UR - http://www.scopus.com/inward/record.url?scp=85189137280&partnerID=8YFLogxK
U2 - 10.1016/j.ajt.2024.03.005
DO - 10.1016/j.ajt.2024.03.005
M3 - Journal article
C2 - 38458364
SN - 1600-6143
VL - 24
SP - 1295
EP - 1302
JO - American Journal of Transplantation (Online)
JF - American Journal of Transplantation (Online)
IS - 7
ER -