Influence of intrauterine dispositive in human papillomavirus clearance.
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2018
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European Journal of Obstetrics & Gynecology and Reproductive Biology
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Abstract
Introduction: An important inverse relation between IUD use and risk of cervical cancer has been proved.
Women who used IUD had half the risk of developing cervical cancer. The mechanism how IUD is a
protector factor is still unknown. Could be improving the clearance of HPV infection or stopping
progression to cancer from preneoplasic lesion.
The aim of the study is to check if IUD increases HPV clearance, that is, checking if after 1 year HPV
infection disappears in more patients using IUD than those not using it.
Study design: This is a cohort case-control prospective study, carried out in Universitary Hospital La
Zarzuela in Madrid, Spain, performed between October 2015 and April 2018.
No pregnant women between 25–50 years old, with HPV cervical infection were enrolled. We
separated the participants into two groups: an IUD group, with women starting using IUD and non IUD
group, with women using any other contraceptive method or none. HPV genotyping of cervical cytology
samples were performed initially on enrolment day and one year after.
Results: 254 participants were enrolled at the beginning of the study, 85 in the IUD group and 169 in the
control group (non IUD). 179 participants completed the study, 54 (31%) in IUD group and 120
participants in non IUD group (69%).
38 women from IUD group cleared HPV infection (69.5%) and 65 women from control group cleared it
(54.2%) (p = 0.044).
An association in logistic regression was observed in HPV clearance with different factors. Firstly,
higher percentage of patients with IUD clear the HPV infection than those in control group significantly
associated (OR = 0.698, CI 95%; 0.251–0.998, p = 0.046). Clearance was higher in patients with low-risk
HPV infection comparing with high risk HPV (OR = 1.078, CI 95%; 1.126–4.6.281, p = 0.026) and in patients
with only one HPV type than those with more than one (OR = 0.194, CI 95%; 0.084–0.403, p<0.001).
Conclusions: In Spanish women with HPV infection, the HPV clearance between IUD and non IUD
groups show results with statistical significance, patients with IUD have higher clearance rates. There
were differences also between suffering one HPV type or more than one, and having low-risk HPV or
high-risk HPV infection.
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Keywords
Human papillomavirus, Cervical cancer, HPV