Klinisch I - P10 - HPV prevalence before and after renal transplantation in females with end-stage renal disease

F Hinten, L.B. Hilbrands, K. Meeuwis, J. IntHout, W.G.V Quint, A.J. Hoitsma, L. Massuger, W. Melchers, J. de Hullu

Chair(s): prof. dr. Hans de Frijter, neuroloog, LUMC

Thursday 10 march 2016

13:00 - 13:30h at Foyer

Categories: Postersessie

Parallel session: Postersessies XI - Opgesplitst in 3 tijdblokken en 3 categoriëen (klinisch, basaal, donatie)

Organ transplant recipients have increased risk for developing human papillomavirus (HPV) related (pre)malignancies of the lower genital tract. The HPV prevalence is mainly assessed in females who underwent renal transplantation (RT) and ranges from 27-66%. The natural course of HPV infections during the period before and after RT is largely unknown. The aim of this study is to assess the genital prevalence of HPV in female renal transplant recipients before and after RT. Knowledge with respect to the biological behaviour might provide a scientific basis for rational prevention, such as HPV vaccination, screening and novel therapies with respect to immunosuppression.

All female patients who were referred to the outpatient clinic of the Radboudumc between the 28th of February 2012 and the 1st of April 2015 to judge whether they were suitable for RT, were invited to participate in the study. Full gynaecological examination with HPV self-sampling and cervical smear, was performed at first visit, after 1 and after 2 years. Furthermore, HPV self-sampling was performed every 3 months. All patients were asked to fill out questionnaires on relationships/sexual behaviour.

In total 123 patients were included and 65 patients underwent a transplantation. The median age of the graft recipients was 54 years. HPV prevalence before transplantation was 24% (95% CI 13-35) and after transplantation 31% (95% CI 19-43), p-value 0.20. The hrHPV prevalence before transplantation was 17% (95% CI 8-27) and after 26% (95% CI 15-37), p-value 0.08.  Eight patients (12.3%) had cytological abnormalities of which 3 patients had high-grade lesions. No relevant changes in sexual behaviour after RT were reported. 

In this cohort of patients with end-stage renal disease, the HPV prevalence  was higher than in the general population, before as well as after the transplantation. The increase in prevalence after transplantation, mainly of hrHPV types,suggests activation of latent HPV infections during immunosuppression. Our data support regular HPV testing after transplantation, with gynaecological examination in case of hrHPV positivity.