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Area of Science:

  • Gynecology
  • Oncology
  • Infectious Diseases

Background:

  • Cervical intraepithelial neoplasia (CIN) is a precancerous condition.
  • Human papillomavirus (HPV) infection is the primary cause of CIN.
  • Distinguishing HPV infection dynamics is crucial for accurate risk stratification.

Purpose of the Study:

  • To compare the association of HPV same-genotype persistence (SGTP) versus genotype switch (GS) with high-grade CIN.
  • To evaluate HPV clearance and new infection as predictors of high-grade CIN.
  • To assess the clinical utility of genotype-specific HPV testing for CIN risk.

Main Methods:

  • Systematic review and meta-analysis of prospective and retrospective studies.
  • Inclusion of studies with extended- or full-genotype HPV reporting.
  • Primary outcome: high-grade CIN after at least two testing rounds.

Main Results:

  • Continued HPV-positive women were divided into SGTP and GS groups.
  • SGTP demonstrated significantly higher sensitivity, positive predictive value, and positive likelihood ratio than GS.
  • HPV genotypes can be tiered based on CIN risk and persistence.

Conclusions:

  • Moderately high-quality evidence supports SGTP's clinical utility.
  • SGTP improves risk discrimination for high-grade CIN compared to qualitative HPV testing.
  • Genotype-specific HPV information enhances CIN management.