RECURRENCIA DEL VPH EN PACIENTES SOMETIDAS A CONIZACIÓN CERVICAL POR NIC I Y VACUNACIÓN.

Abstract

Background: The Human Papillomavirus (HPV) is one of the primary infectious agents involved in the etiology of cervical cancer, which stands as a leading cause of morbidity and mortality among women worldwide, particularly in low- and middle-income countries. According to estimates by the World Health Organization (WHO), HPV is responsible for approximately 70% of cervical cancer cases globally, making it a critical public health issue. The persistence of HPV infection, especially high-risk types such as 16 and 18, is strongly associated with the development of cervical intraepithelial neoplasia (CIN), which can progress to invasive cancer if not properly treated. Methods: An observational, analytical, cross-sectional study was conducted in the Gynecology Department of the Teodoro Maldonado Carbo Specialty Hospital. The study included 199 patients diagnosed with CIN 1, categorized as mild cervical dysplasia, who underwent conization as part of their treatment. The association between HPV vaccination, acquired by the patients as a prophylactic measure, and the absence of lesion recurrence was evaluated. Results: The mean age of the patients was 34.51 years (SD = 4.43), with the majority aged between 30 and 39 years (72.36%). Additionally, 78.89% of the patients had no comorbidities, and 57.29% had toxic habits. HPV vaccination was completed by 56.78% of the patients. Among the patients, 63.82% did not experience recurrence; the recurrence rates were 25.63% for CIN I, 8.54% for CIN II, and 2.01% for CIN III. Chi-square analysis revealed a significant association between vaccination status and lesion recurrence (p < 0.05). Conclusions: The study found a significant protective effect of HPV vaccination on the recurrence of cervical lesions post-conization. Vaccinated patients showed a lower recurrence of neoplasia, consistent with previous studies demonstrating the efficacy of vaccination in reducing CIN 2-3. Furthermore, the systematic review and meta-analysis by Schmucker et al. (2023) corroborate our findings by showing a significant reduction in the risk of recurrence of CIN 2+ and CIN 3+ lesions with vaccination.