Hogewoning Cornelis J A, Bleeker Maaike C G, van den Brule Adriaan J C, Voorhorst Feja J, Snijders Peter J F, Berkhof Johannes, Westenend Pieter J, Meijer Chris J L M
Department of Gynaecology and Obstetrics, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
Int J Cancer. 2003 Dec 10;107(5):811-6. doi: 10.1002/ijc.11474.
Women with persistent HPV infections have increased risk of progressive CIN lesions. Transmission of HPV between sexual partners might maintain viral infection and, consequently, may influence the clinical course of CIN. We investigated the effect of condom use on regression of CIN lesions and on clearance of HPV. Women with CIN and their male sexual partners were randomized for condom use (condom group n = 72 and noncondom group n = 76). They were conservatively managed and followed every 3-6 months by colposcopy, cytology and HPV testing by GP5+/6+ PCR. Baseline cervical biopsy specimens were taken. Median follow-up time for women was 15.2 months (range 3.0-85.4). Outcomes of interest were clinical regression of CIN at colposcopy and clearance of HPV. Outcomes were assessed in 64 women of the condom group and 61 women of the noncondom group. Women in the condom group showed a 2-year cumulative regression rate of 53% vs. 35% in the noncondom group (p = 0.03). The 2-year cumulative rates of HPV clearance were 23% vs. 4%, respectively (p = 0.02). Although lower regression rates were found if women were HPV-positive and had > or =CIN2 lesions at baseline, effects of condom use were found both in women with CIN1 and in women with > or =CIN2 lesions. Condom use promotes regression of CIN lesions and clearance of HPV.
持续感染人乳头瘤病毒（HPV）的女性发生CIN病变进展的风险增加。HPV在性伴侣之间的传播可能会维持病毒感染，进而可能影响CIN的临床病程。我们研究了使用避孕套对CIN病变消退及HPV清除的影响。患有CIN的女性及其男性性伴侣被随机分为使用避孕套组（避孕套组n = 72，非避孕套组n = 76）。对他们进行保守治疗，并由全科医生每3 - 6个月通过阴道镜检查、细胞学检查及采用GP5+/6+ PCR法进行HPV检测来随访。采集了基线宫颈活检标本。女性的中位随访时间为15.2个月（范围3.0 - 85.4个月）。感兴趣的结局是阴道镜检查时CIN的临床消退及HPV的清除。在避孕套组的64名女性和非避孕套组的61名女性中评估了结局。避孕套组女性的2年累积消退率为53%，而非避孕套组为35%（p = 0.03）。HPV清除的2年累积率分别为23%和4%（p = 0.02）。尽管如果女性在基线时HPV呈阳性且患有≥CIN2病变则消退率较低，但在CIN1女性和≥CIN2病变女性中均发现了使用避孕套的效果。使用避孕套可促进CIN病变的消退及HPV的清除。
