Prevalence of Human Papillomavirus Infection in the Female Genital Tract of Kidney Transplant Recipients: A Systematic Review

Abstract

Estimation of the prevalence of high-risk human papillomavirus (HR-HPV) genotypes and cervical intraepithelial neoplasia (CIN) in female renal transplant recipients (RTRs) is important for formulating strategies for the prevention and screening of cervical cancer in this susceptible group. A systematic review of cohort studies was conducted to evaluate the prevalence of HR-HPV cervical infection and CIN in female kidney graft recipients in comparison to healthy controls. This study adhered to the meta-analysis of observational studies in epidemiology guidelines. Studies had to meet the following criteria: (1) Cohort studies of female RTRs that assessed results of cervical cytology and/or HPV prevalence, (2) studies including adult and nonpregnant subjects, (3) the description of the study's methodological and statistical methods is provided, and (4) the prevalence of HPV was clearly stated. The prevalence of HPV infection and CIN reported in the assessed studies ranged, respectively, from 4% to 45% and 0% to more than 48% in female RTR groups, while in the control groups the prevalence ranged from 17.5% to 38% and 0% to 13%. There are relatively few publications dealing with the prevalence of CIN and HPV infection in the population of transplant recipients, and the current available studies show important methodological differences. Therefore, new observational studies with larger numbers of transplanted women, proper design and control of these biases are needed to see if, among this population, the prevalence of HR-HPV infection and CIN is greater.