HPV conversion rates after LEEP, cold-knife conization, and laser and drug therapy: A 4-year follow-up study

Abstract

Objective: To assess the clinical outcomes of women with human papilloma virus (HPV) infection and cervical lesions after treatment with the loop electrosurgical excision procedure (LEEP), cold-knife conization, laser and drug therapies.Methods: This retrospective study reviewed medical data from 215 women with HPV infection and cervical lesions, treated with LEEP [n=122 (56.74%)], cold-knife conization [n=24 (11.16%)], laser therapy [n=10 (4.66%)], or pharmacotherapy [n=59 (27.44%)], respectively, between October 2016 and August 2017 at Fujian Provincial Maternal and Children’s Health Hospital. The risk factors and clinical outcomes of HPV infection and cervical lesions were follow-up for at least 4 years. Furthermore, the Kaplan-Meier method was utilized to analyze the time to HPV regression after treatment.Results: Overall, 145 patients (67.44%) showed improvement after treatment. The efficacy of conization and LEEP in achieving short-term HPV conversion was significantly better than that of laser and drug treatment (26.43% vs. 5.01%, P=0.04). The study revealed that menopause[odds ratio (OR), 2.61, 95% confidence interval (CI), 0.41-4.81, P=0.01];, high-risk HPV infection (OR, 3.6, 95% CI, 0.69-2.71, P=0.02) and a short follow-up (<6 months) (OR, 4.2, 95% CI, 0.31-8.09, P=0.02) were risk factors for poor treatment outcomes ;and OR, 3.25, 95% CI, 1.24-5.17, 2 P=0.01, respectively).Conclusions: Menopause affected outcomes in women with HPV infection. Conization was beneficial for short-term HPV conversion and may be indicated in individuals who were older than 50 years and had high-level cervical lesions and persistent HPV infection. The treatment of HPV infection with laser and pharmacological therapies needs more time.