Study On The Clinical Outcome And Effective Factors Of HR-HPV Infection In Female Genital Tract

Objectives:To explore the clinically natural outcome of High-risk human papillomavirus (HR-HPV) infection among the women with HR-HPV positive but cytology detection negative or with normal pathology results, and analyze the related factors that affect the natural outcome of HR-HPV infection. This would be valuable in the assessments of the possibility that HR-HPV cannot naturally clear and result in persistent infection, and provide the correct basis for the initial HR-HPV infection in clinical treatment.Method:We Conducted a questionnaire survey to167patients who is HR-HPV positive but with normal cervical pathology result, and then followed up at intervals of six months. During the follow-up,19patients who did not require follow-up were excluded from the study. Finally, total of148patients were enrolled in this study, none of them were treated with drugs during follow-up. LCT and HR-HPV detection were conducted at every visit, to investigate the factors that effect the natural clearance of HR-HPV infection and discuss the relationship to various factors. All patients were followed for three years.Results:In the148women’s initial liquid-based smears,89were normal,59were mildly abnormal(ASCUS or LSIL). To the end of the follow-up,103cases became negative among the148HR-HPV positive, which means that the natural clearance rate of HR-HPV infection was69.59%(103/148). The viral’s median clearance time was18months. Followed up to24months,21.62%(32/148) of women with HR-HPV detection continued to be positive. Followed up to36months,19.59%(29/148) continued to be positive. Among the148women, there were12women (8.11%(12/148))developing into CIN,5of them were CINI,5were CIN Ⅱ,2were CINⅢ. Univariate analysis and multivariate analysis showed that age, occupation, initial viral load, number of sexual partners, spouse’s number of sexual partners, contraception and reproductive tract inflammation are negatively correlated to the natural clearance rate of HR-HPV infection. And smoking, education level and age of first sex have no significant correlation (P>0.05). All patients are currently continually followed-up.ConclusionAmong the women with normal cervical smears or low-grade lesions, natural clearance rate of HR-HPV infection was69.59%, clearance time was6months to2years. Age, initial viral load and genital tract inflammation are the factors that affect the natural clearance of HR-HPV infection in female reproductive tract, which prompts that we can design appropriate treatment plan and avoid overtreatment according to HR-HPV viral load, the subtypes, duration of infection and genital tract inflammation associated to other conditions. The persons who are older, with more numbers of sexual partners, non-condom contraception, genital tract inflammation and high load of viral are high-risk groups with low natural clearance of HR-HPV infections, should be recommended aggressive screening program.