Prevalence of cervical human papillomavirus in kidney transplant recipients: A systematic review and meta-analysis

Area of Science:

• Oncology
• Virology
• Transplantation Medicine

Background:

• Kidney transplant recipients (KTRs) often undergo immunosuppressive therapy, potentially increasing their susceptibility to viral infections.
• Cervical high-risk human papillomavirus (hrHPV) is a known precursor to cervical cancer.

Purpose of the Study:

• To systematically review and meta-analyze the prevalence of cervical hrHPV in KTRs.
• To compare the prevalence of cervical hrHPV in KTRs with that in immunocompetent controls.

Main Methods:

• A systematic literature search was performed in major databases (PubMed, EMBASE, Cochrane Library) from January 2000 to February 2023.
• Random effects logistic regression models were used to estimate pooled prevalences and odds ratios (ORs) for hrHPV in KTRs versus controls.
• Interstudy heterogeneity was assessed using the I² statistic and Cochrane's Q test.

Main Results:

• The meta-analysis included 16 studies with over 1200 KTRs, revealing a pooled cervical hrHPV prevalence of 27.7% in KTRs.
• Substantial interstudy heterogeneity was observed, with higher prevalence noted in recent years (2019-2023) and in Asia.
• KTRs had a significantly higher odds ratio (OR) of 2.0 for hrHPV compared to controls, based on six studies.

Conclusions:

• Cervical hrHPV prevalence is significantly increased in KTRs compared to immunocompetent individuals.
• Immunosuppressive therapy post-transplantation is a potential contributing factor to this increased risk.
• Further research is warranted to evaluate HPV vaccination and potential revaccination strategies in KTRs.