Akaaboune Mohamed, Kenfack Bruno, Viviano Manuela, Temogne Liliane, Catarino Rosa, Tincho Eveline, Mbobda Joel, Tran Phuong Lien, Camail Roxane, Vassilakos Pierre, Petignat Patrick
1 Gynecology Division, Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland.
2 Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.
Womens Health (Lond). 2018 Jan-Dec;14:1745506518805642. doi: 10.1177/1745506518805642.
Persistent infection with human papillomavirus is the prerequisite for the development of cervical precancerous and cancerous lesions. The aim of this study was to determine the time-to-viral clearance in a population of human papillomavirus-infected Cameroonian women and to examine the possible predictors of viral persistence.
We conducted a prospective cohort study based on a population of human papillomavirus-positive women having previously been recruited in a self-human papillomavirus-based cervical cancer screening campaign, who were invited for a control visit at 6 and 12 months. We determined human papillomavirus clearance using self-sampling (Self-HPV) and physician-sampling (Dr-HPV), which were analyzed with a point-of-care assay (GeneXpert IV; Cepheid, Sunnyvale, CA, USA). Logistic regression was performed to assess the relationship between sociodemographic and clinical characteristics with HPV clearance according to the two sampling techniques.
A total of 187 participants were included in the study. At the 12 months follow-up, 79.5% (n = 104) and 65.3% (n = 86) had cleared their human papillomavirus infection according to Dr-HPV and self-HPV, respectively (p = 0.001). Only parity (>5 children) was statistically associated with viral persistence (p = 0.033). According to Dr-HPV, clearance of women treated with thermoablation at 12 months was of 84.1% versus 70.2% for non-treated women (p = 0.075).
The human papillomavirus clearing rates found in our study are close to those found in other studies worldwide. Parity was significantly associated with human papillomavirus persistence. Larger, prospective studies are needed to confirm our results.
人乳头瘤病毒持续感染是宫颈癌前病变和癌性病变发生的前提条件。本研究的目的是确定喀麦隆感染人乳头瘤病毒的女性群体中病毒清除的时间，并检查病毒持续存在的可能预测因素。
我们基于先前在一项基于自我人乳头瘤病毒的宫颈癌筛查活动中招募的人乳头瘤病毒阳性女性群体进行了一项前瞻性队列研究，邀请她们在6个月和12个月时进行对照访视。我们使用自我采样（Self-HPV）和医生采样（Dr-HPV）来确定人乳头瘤病毒清除情况，并用即时检测法（GeneXpert IV；美国加利福尼亚州森尼韦尔市的Cepheid公司）进行分析。根据两种采样技术，进行逻辑回归以评估社会人口统计学和临床特征与HPV清除之间的关系。
共有187名参与者纳入研究。在12个月的随访中，根据Dr-HPV和Self-HPV，分别有79.5%（n = 104）和65.3%（n = 86）的人清除了人乳头瘤病毒感染（p = 0.001）。只有产次（>5个孩子）与病毒持续存在有统计学关联（p = 0.033）。根据Dr-HPV，12个月时接受热消融治疗的女性清除率为84.1%，未治疗女性为70.2%（p = 0.075）。
我们研究中发现的人乳头瘤病毒清除率与世界其他研究中发现的相近。产次与人乳头瘤病毒持续存在显著相关。需要更大规模的前瞻性研究来证实我们的结果。
