Introduction: Women with kidney transplant (KT) have an increased risk for Human Papillomavirus (HPV) infection, which is related to cervical cancer, reaching an incidence of 11% in this population. Unfortunately, there are no reports about the incidence of cervical dysplasia (CD) associated to HPV infection in Mexican women with KT.

Materials and Methods: A prospective cohort of women with KT was conducted at the Institute between 2012-2014 with the following inclusion criteria: 18 to 65 years old, initiated sexual life, cervical cytology (CC) prior to and after KT with positive PCR for high risk HPV.

Results: A total of 52 women were included, median age was 35y (19-64y), 38, median age for initiation of sexual life was 19y (13-35y), 47% had 1 sexual partner, 36% used male preservative as contraceptive method, 25% had a positive smoking history and 33% was exposed to immunosuppression prior to KT. The median time on dialysis was 12 (0-144) months, 60% were from living donors, 48% received induction with thymoglobulin, 86% had maintenance immunosuppression with tacrolimus, mycophenolic acid and prednisone and the median follow-up was 30 (9-54) months. The incidence of positive PCR for high risk HPV was 25% with a median time after KT of 16.6 (0-37.5) months, risk factors identified in the multivariate analysis were: immunosuppression prior to KT (RR 10.9, CI 95% 1.36-88.57, p= 0.024) and being single (RR 8.03, CI 95% 1.21-59.94, p = 0.03). The incidence of CD due to HPV was 17.31% with a median time of 23.2 (1-39.9) months after KT. The only independent risk factor found in the multivariate analysis was a positive smoking history (RR 5.7, CI 95% 1.07-31.09, p=0.041). Finally, when comparing both tests (CC and PCR for high risk HPV) a percentage of concordance of 81.4% with a kappa of 0.48 was found.

Discussion and conclusions: The incidence of HPV infection and CD is higher in our country than that reported in the literature. The establishment of immunization against HPV, use of male preservative and prompt detection on CC might decrease the incidence of HPV and CD, as well as, allow early treatment of these patients.

CITATION INFORMATION: Parra-Avila I, Alberu J, Marino-Vazquez L, Morales-Buenrostro L, Rosado-Canto R. Incidence and Risk Factors for Cervical Dysplasia Associated to Human Papillomavirus Infection in Women with Kidney Transplant. Am J Transplant. 2017;17 (suppl 3).

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