Vaccinating female patients following surgical treatment for cervical lesions could reduce the likelihood of a positive human papillomavirus test result, according to a retrospective study of 326 patients aged 25 to 65 years.
In the study, researchers assessed the effect of the 9-valent human papillomavirus (HPV) vaccine in female patients diagnosed with either low-grade (CIN1) or high-grade (CIN2-3) cervical intraepithelial neoplasia. The participants underwent either laser ablation or loop electrosurgical excision procedure (LEEP) and were followed-up at 6 and 15 months.
The researchers divided the cohort into two groups: 68% (n = 222) of the patients received the HPV vaccine prior to or within 30 days following surgery, whereas 32% (n = 104) didn't. The vaccinated group consistently demonstrated lower HPV test positivity at both follow-up points.
At 15 months, 18% of vaccinated patients with CIN1 tested positive for HPV compared with 38% of unvaccinated patients (P = .0169). Among those with CIN2-3, HPV positivity was 8% in vaccinated participants vs 18% in the unvaccinated group (P = .0353).
“Vaccination, also in [patients aged] ≥ 40 years had a statistically significant effect in reducing the proportion of [those] with a positive HPV test (P = .0100),” said lead study author Mario Palumbo, of the Department of Public Health at the School of Medicine at the University of Naples, and colleagues.
Age-stratified results supported the findings. Among patients aged 40 years and older with CIN1, 8% of vaccinated individuals tested positive compared with 40% of those unvaccinated (P = .0100). For CIN2-3, positivity rates were 7% in the vaccinated group and 17% in the unvaccinated group, though the difference wasn't statistically significant (P = .1143).
No vaccine-related adverse events were reported. Six patients experienced minor surgical complications, all involving posttreatment cervical bleeding. Both procedures and vaccination were well tolerated.
Colposcopy results showed comparable lesion resolution between vaccinated and unvaccinated groups, indicating that the surgical treatments were effective. However, vaccination appeared to reduce viral persistence, particularly in CIN1 cases.
Although the HPV vaccine doesn't treat existing infections, the researchers supported the hypothesis that posttreatment vaccination may help prevent reactivation or reinfection. The vaccine’s immune response may assist in clearing residual viruses and promoting long-term viral suppression.
The researchers suggested that posttreatment HPV vaccination could play a role in cervical cancer prevention, even among patients older than 40 years, who are typically outside the standard vaccination age range.
They recommended further research to refine posttreatment vaccination strategies and noted potential benefits such as fewer follow-up visits and reduced health care costs.
The authors reported no conflicts of interest.
Source: The European Journal of Obstetrics & Gynecology and Reproductive Biology