Integrating Adjuvant HPV Vaccination into Cervical Dysplasia Management After LLETZ/Conization

Background: In this study, we evaluated the effects of the nonavalent Gardasil^® vaccine in a heterogeneous cohort of women who underwent conization or LLETZ for various degrees of CIN, aiming to assess the adjuvant effect of vaccination on HPV clearance. Methods: We conducted a three-year prospective study with a two-year follow-up of 219 patients presenting to our facility for cervical dysplasia. All patients underwent HPV genotyping and were divided into HPV-vaccinated and non-vaccinated groups. Results: We detected a significant association between the final outcome and vaccination timing (p-value = 0.005). All women vaccinated before conization achieved viral clearance; 94.9% of those vaccinated at the time of conization/LLETZ and 68.6% of those vaccinated after the excisional procedure became HPV-negative. Logistic regression showed that, with increasing age, the likelihood of healing after vaccination decreased by approximately 9% per additional year, and non-16/18 HPV-positive women had a 5.5-fold higher chance of healing after vaccination compared with those HPV-positive for 16 and 18 genotypes. Conclusions: Adjuvant prophylactic HPV vaccination in the context of surgical treatment for cervical precancerous lesions is significantly associated with a reduced risk of lesion recurrence and HPV persistence/reinfection when administered prior to or at the same time as the excisional procedures.