Association between Hormonal Contraception and Injuries Induced by Human Papillomavirus in the Uterine Cervix

Volpato, Lia Karina; Siqueira, Isabela Ribeiro; Nunes, Rodrigo Dias; Piovezan, Anna Paula

doi:10.1055/s-0038-1642603

Cited by 9 publications

(13 citation statements)

References 36 publications

(66 reference statements)

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“…Regarding the use of OC, the findings confirm previous studies (5,18) . One of these showed that the intake of contraceptives, regardless of the type, was a risk factor for cervical alterations, and, when associated with the number of sexual partners, made the outcome more likely, corroborating the characteristics of the latter as an independent factor for cervical changes in this research.…”

Section: Discussionsupporting

confidence: 89%

“…Other factors contribute for the natural history of the disease. These include the immunological response of the host, viral genetic profiles, the early beginning of sexual activities, multiple partners, a previous history of Sexually Transmitted Infections (STIs), the use of oral contraceptives (OC), smoking, nutritional deficiencies, low socioeconomic level of the host (5) , all of which are potential axes for interventions.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and factors associated to cervical changes in units from the Single Health System

Treco

Vieira

Silva

et al. 2021

Rev. Gaúcha Enferm.

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Objective: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. Method: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. Results: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. Conclusion: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated to cervical changes in units from the Single Health System

Treco

Vieira

Silva

et al. 2021

Rev. Gaúcha Enferm.

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“…There have been differing opinions on the use of hormonal contraceptives and cervical HPV persistence where some authors reported association (13,24) while some others reported no association (25,26). In this study, use of hormonal contraceptive was associated with HPV clearance instead of persistence though this should be interpreted with caution as the duration of hormonal contraceptive use and the type of contraceptives were not specified.…”

Section: Discussionmentioning

confidence: 60%

Persistence of cervical human papillomavirus infection among cohort of women in Awka, Nigeria

Ezebialu¹,

Ezebialu²,

Ezenyeaku³

2021

Af J Clin Exp Micro

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Background: Many women are known to contract human papilloma virus (HPV) infection in their lifetime but only a few develop cervical cancer. One of the major factors that contribute to development of cervical cancer is HPV persistence. Several other factors including viral load have been implicated in cervical cancer development. This work therefore intends to investigate the persistence of cervical HPV infection among cohort of women in Awka, Nigeria.Methodology: A cohort of 58 women with normal Papanicolaou (Pap) test but positive HPV DNA selected from a population of 410 women at baseline were followed up over a period of 6 months from April to October 2015. Cervical specimens collected were subjected to HPV DNA test and viral quantification using TaqMan Real Time PCR and cervical cytology. Risk factors were obtained using semi structured interviewer administered questionnaires. Variables were analysed using descriptive statistics and T-test on IBM SPSS statistics version 21.0 and EPI INFOTM 7.0Results: At the 6-month follow up, cervical HPV infection persisted in 29 women, representing 50% of the women followed up. Among the 29 women, 7 (24.1%) developed abnormal Pap smear (Low grade Squamous Intraepithelial Lesion). Factors significantly associated with persistence at bivariate analysis of HPV include previous sexually transmitted infection (STI) (p=0.005), HIV positivity (p=0.04), HIV positivity but no anti-retroviral drugs (p=0.014), HPV 16 infection (p<0.0001) and age less than 40 years (p<0.0001). At multinomial logistic regression, only age above 17 years at first sexual intercourse (p=0.003, CI=0.012-0.392) and multiple lifetime sexual partners (p=0.021, CI=0.20-0.726) were statistically significant.Conclusion: High risk HPV infection, in addition to other factors peculiar to an individual may influence HPV persistenceKey words: cervical cancer, human papillomavirus, persistence, cytology, risk factors, infection French Title: Persistance de l'infection cervicale par le papillomavirus humain parmi une cohorte de femmes à Awka, Nigéria Contexte: De nombreuses femmes sont connues pour contracter une infection au virus du papillome humain (VPH) au cours de leur vie, mais seules quelques-unes développent un cancer du col de l'utérus. L'un des principaux facteurs qui contribuent au développement du cancer du col de l'utérus est la persistance du VPH. Plusieurs autres facteurs, y compris la charge virale, ont été impliqués dans le développement du cancer du col de l'utérus. Ce travail vise donc à étudier la persistance de l'infection cervicale au VPH parmi la cohorte de femmes à Awka, au Nigeria. Méthodologie: Une cohorte de 58 femmes avec un test de Papanicolaou (Pap) normal mais un ADN HPV positif sélectionné parmi une population de 410 femmes au départ ont été suivis sur une période de 6 mois d'avril à octobre 2015. Les échantillons cervicaux collectés ont été soumis à l'ADN HPV. test et quantification virale à l'aide de la PCR en temps réel TaqMan et de la cytologie cervicale. Les facteurs de risque ont été obtenus à l'aide de questionnaires semi-structurés administrés par les intervieweurs. Les variables ont été analysées à l'aide de statistiques descriptives et d'un test T sur IBM SPSS statistics version 21.0 et EPI INFOTM 7.0 Résultats: Au suivi de 6 mois, l'infection cervicale au VPH persistait chez 29 femmes, soit 50% des femmes suivies. Parmi les 29 femmes, 7 (24,1%) ont développé un test Pap anormal (lésion squameuse intraépithéliale de bas grade). Les facteurs significativement associés à la persistance lors de l'analyse bivariée du VPH comprennent les antécédents d'infection sexuellement transmissible (IST) (p=0,005), la positivité au VIH (p=0,04), la positivité au VIH mais pas d'antirétroviraux (p=0,014), l'infection au VPH 16 (p<0,0001) et moins de 40 ans (p<0,0001). Lors de la régression logistique multinomiale, seuls les âges supérieurs à 17 ans lors du premier rapport sexuel (p=0,003, IC=0,012-0,392) et les multiples partenaires sexuels à vie (p=0,021, IC=0,20-0,726) étaient statistiquement significatifs. Conclusion: Une infection au VPH à haut risque, en plus d'autres facteurs propres à un individu, peut influencer la persistance du VPH Mots clés: cancer du col de l'utérus, papillomavirus humain, persistance, cytologie, facteurs de risque, infection

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“…HPV-positive women raise some concerns about choosing their contraceptive method. Although, to conclude causality between COCs and HPV lesions, more studies are needed [ 16 ], particular attention should be given to discuss contraception methods with HPV-positive women.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, long-term use of birth control pills increases cervical cancer risk, importantly for women with persistent HPV infection. However, users of combined oral contraceptives (COCs) have a decrease in immune cells providing a favorable environment for the appearance of HPV lesions [ 16 ]. Women may worry about these issues but the literature is limited.…”

Section: Introductionmentioning

confidence: 99%

'Does HPV affect my fertility?' Reproductive concerns of HPV-positive women: a qualitative study

et al. 2021

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Background Reproductive health changes can occur following infection with Human papillomavirus. HPV is the most prevalent sexually transmitted infection causing a variety of clinical manifestations ranging from warts to cancer. This study aimed to explore the reproductive concerns of women infected with HPV. Methods In this qualitative study, we used the conventional content analysis approach, with the aid of MAXQDA.10 software, to analyze data extracted from the face-to-face semi-structured interviews with 20 Iranian HPV-positive women (sampled by maximum variation purposive sampling). The accuracy of this research was ensured according to the four criteria proposed by Guba and Lincoln. Results Exploring participants' reproductive concerns, three main categories were identified from the interviews including concerns about fertility potential, pregnancy and non-pregnancy reproductive issues. HPV-positive women concerned about reduced female/ male fertility due to HPV, the impact of the HPV on the fetal health, adverse pregnancy outcomes such as miscarriage and preterm delivery, and mother-to-child transmission of HPV during breastfeeding. HPV-positive women with abnormal cytology results were anxious that becoming pregnant or taking hormonal contraception might worsen their abnormalities. Most married women were reluctant to use a condom. Participants requested further information about the potential reproductive risks of the HPV vaccine. They also wanted to know about the safety of HPV vaccine during pregnancy and breastfeeding. Conclusions HPV-positive women had some reproductive concerns that should be considered in the designing of educational-consulting interventions. Women need to be better understood and informed about the impact of HPV on their reproductive health. Health care providers may lack knowledge about these specific areas, and they could benefit from additional up-to-date information to address women's reproductive concerns.

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Association between Hormonal Contraception and Injuries Induced by Human Papillomavirus in the Uterine Cervix

Cited by 9 publications

References 36 publications

Prevalence and factors associated to cervical changes in units from the Single Health System

Prevalence and factors associated to cervical changes in units from the Single Health System

Persistence of cervical human papillomavirus infection among cohort of women in Awka, Nigeria

'Does HPV affect my fertility?' Reproductive concerns of HPV-positive women: a qualitative study

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