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Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review

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  1. The challenges of defining sample adequacy in an era of HPV based cervical screening

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. FAM19A4/miR124-2 methylation in invasive cervical cancer: A retrospective cross-sectional worldwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Clinical validation of the Cobas 4800 HPV assay using cervical samples in SurePath medium under the VALGENT4 framework

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Jesper Bonde
  • Fabio Bottari
  • Anna D Iacobone
  • Clementina E Cocuzza
  • Maria-Teresa Sandri
  • Fabrizio Bogliatto
  • Khalid S Khan
  • Ditte M Ejegod
  • Devin S Gary
  • Jeffrey C Andrews
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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.

Original languageEnglish
JournalJournal of lower genital tract disease
Volume25
Issue number1
Pages (from-to)27-37
Number of pages11
ISSN1089-2591
DOIs
Publication statusPublished - 1 Jan 2021

Bibliographical note

Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.

    Research areas

  • HPV, HPV genotyping, cervical cancer screening, systematic review, triage

ID: 61112281