Reduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africa

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dc.contributor.authorTaylor, Sylviaen_ZA
dc.contributor.authorWang, Chunhuien_ZA
dc.contributor.authorWright, Thomasen_ZA
dc.contributor.authorDenny, Lynetteen_ZA
dc.contributor.authorTsai, Wei-Yannen_ZA
dc.contributor.authorKuhn, Louiseen_ZA
dc.date.accessioned2015-10-28T06:57:12Z
dc.date.available2015-10-28T06:57:12Z
dc.date.issued2010en_ZA
dc.description.abstractBACKGROUND:Treatment of women for high-grade cervical cancer precursors frequently results in clearance of the associated high-risk human papillomavirus (hrHPV) infection but the role of treatment among women without hrHPV is unknown. We investigated whether cervical cryotherapy reduces newly detected hrHPV infections among HIV-positive and HIV-negative women who were hrHPV negative when treated. METHODS: The impact of cryotherapy on newly detected hrHPV infections was examined among 612 women of known HIV serostatus, aged 35 to 65 years, who were negative for hrHPV DNA, and randomized to either undergo cryotherapy (n = 309) or not (n = 303). All women underwent repeat hrHPV DNA testing 6, 12, 24, and 36 months later. RESULTS: Among 540 HIV-negative women, cryotherapy was associated with a significant reduction in newly detected hrHPV infections. Women in the cryotherapy group were 55% less likely to have newly detected hrHPV than women in the control group (95% CI 0.28 to 0.71). This association was independent of the influence of changes in sexual behaviors following therapy (adjusted hazards ratio (HR) = 0.49, 95% CI 0.29 to 0.81). Among 72 HIV-positive women, similar reductions were not observed (HR = 1.10, 95% CI 0.53 to 2.29). CONCLUSIONS: Cervical cryotherapy significantly reduced newly detected hrHPV infections among HIV-negative, but not HIV-positive women. These results raise intriguing questions about immunological responses and biological mechanisms underlying the apparent prophylactic benefits of cryotherapy.en_ZA
dc.identifier.apacitationTaylor, S., Wang, C., Wright, T., Denny, L., Tsai, W., & Kuhn, L. (2010). Reduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africa. <i>BMC Medicine</i>, http://hdl.handle.net/11427/14446en_ZA
dc.identifier.chicagocitationTaylor, Sylvia, Chunhui Wang, Thomas Wright, Lynette Denny, Wei-Yann Tsai, and Louise Kuhn "Reduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africa." <i>BMC Medicine</i> (2010) http://hdl.handle.net/11427/14446en_ZA
dc.identifier.citationTaylor, S., Wang, C., Wright, T. C., Denny, L., Tsai, W. Y., & Kuhn, L. (2010). Reduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africa. BMC medicine, 8(1), 40.en_ZA
dc.identifier.ris TY - Journal Article AU - Taylor, Sylvia AU - Wang, Chunhui AU - Wright, Thomas AU - Denny, Lynette AU - Tsai, Wei-Yann AU - Kuhn, Louise AB - BACKGROUND:Treatment of women for high-grade cervical cancer precursors frequently results in clearance of the associated high-risk human papillomavirus (hrHPV) infection but the role of treatment among women without hrHPV is unknown. We investigated whether cervical cryotherapy reduces newly detected hrHPV infections among HIV-positive and HIV-negative women who were hrHPV negative when treated. METHODS: The impact of cryotherapy on newly detected hrHPV infections was examined among 612 women of known HIV serostatus, aged 35 to 65 years, who were negative for hrHPV DNA, and randomized to either undergo cryotherapy (n = 309) or not (n = 303). All women underwent repeat hrHPV DNA testing 6, 12, 24, and 36 months later. RESULTS: Among 540 HIV-negative women, cryotherapy was associated with a significant reduction in newly detected hrHPV infections. Women in the cryotherapy group were 55% less likely to have newly detected hrHPV than women in the control group (95% CI 0.28 to 0.71). This association was independent of the influence of changes in sexual behaviors following therapy (adjusted hazards ratio (HR) = 0.49, 95% CI 0.29 to 0.81). Among 72 HIV-positive women, similar reductions were not observed (HR = 1.10, 95% CI 0.53 to 2.29). CONCLUSIONS: Cervical cryotherapy significantly reduced newly detected hrHPV infections among HIV-negative, but not HIV-positive women. These results raise intriguing questions about immunological responses and biological mechanisms underlying the apparent prophylactic benefits of cryotherapy. DA - 2010 DB - OpenUCT DO - 10.1186/1741-7015-8-40 DP - University of Cape Town J1 - BMC Medicine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Reduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africa TI - Reduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africa UR - http://hdl.handle.net/11427/14446 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14446
dc.identifier.urihttp://dx.doi.org/10.1186/1741-7015-8-40
dc.identifier.vancouvercitationTaylor S, Wang C, Wright T, Denny L, Tsai W, Kuhn L. Reduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africa. BMC Medicine. 2010; http://hdl.handle.net/11427/14446.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2010 Taylor et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Medicineen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcmed/en_ZA
dc.subject.otherCervical cryotherapyen_ZA
dc.subject.otherHuman papillomavirusen_ZA
dc.subject.otherCervical canceren_ZA
dc.titleReduced acquisition and reactivation of human papillomavirus infections among older women treated with cryotherapy: results from a randomized trial in South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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