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Background <p>COVID-19 related immune dysregulation including impaired interferon signaling, reduced cytotoxic T-cell activity, and sustained inflammatory imbalance may contribute not only to delayed screening but also to true biological persistence of high-risk HPV (HR-HPV). This study investigated whether prior COVID-19 infection influences cervical HR-HPV persistence and associated cytological abnormalities.</p> Methods <p>In this retrospective study, 738&#xa0;h-HPV positive women without baseline high-grade lesions or immunocompromising conditions were included. The study group comprised 372 women with PCR confirmed symptomatic COVID-19, while those without confirmed infection served as controls. Patients with prior excisional cervical procedures, other STDs, pregnancy, or incomplete follow-up data were excluded. HR-HPV DNA and cervical cytology were assessed at standardized follow-ups at at mean intervals of approximately 10 and 19 months, and persistence rates were compared.</p> Results <p>Cervical HR-HPV persistence was significantly higher in COVID-19 positive patients at both follow-up visits (<i>p</i> = 0.007 and <i>p</i> = 0.021). Persistence of HPV 16 was also significantly higher in the COVID-19 positive group (<i>p</i> = 0.021), whereas HPV 18 persistence did not differ between groups (<i>p</i> = 0.851). Cervical cytology and colposcopy findings were comparable between groups at both visits (<i>p</i> = 0.873, <i>p</i> = 0.606, and <i>p</i> = 0.927, <i>p</i> = 0.751). Importantly, after adjusting for potential confounders including age, smoking status, baseline cytology, and COVID-19 vaccination, a history of COVID-19 infection remained a significant independent risk factor for HR-HPV persistence (aOR: 1.81, <i>p</i> &lt; 0.001).</p> Conclusion <p>Prior COVID-19 infection was associated with increased HR-HPV persistence, particularly HPV 16. If confirmed by larger prospective studies, these findings may warrant intensified follow-up protocols for women with concurrent HR-HPV positivity and a history of COVID-19 infection. Prospective immunologic studies are additionally required to clarify how COVID-19 related immune alterations may influence HPV clearance.</p>

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Role of COVID-19 in the persistence of cervical high-risk human papillomavirus: a non-randomized retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月27日

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  • Mustafa Şahin,
  • Ayşe Buran,
  • Tufan Arslanca,
  • Yeşim Özkaya Uçar,
  • Okan Aytekin,
  • Mehmet Ünsal,
  • Fatih Kılıç,
  • Hakan Raşit Yalçın,
  • Ahmet Taner Turan

摘要

Background

COVID-19 related immune dysregulation including impaired interferon signaling, reduced cytotoxic T-cell activity, and sustained inflammatory imbalance may contribute not only to delayed screening but also to true biological persistence of high-risk HPV (HR-HPV). This study investigated whether prior COVID-19 infection influences cervical HR-HPV persistence and associated cytological abnormalities.

Methods

In this retrospective study, 738 h-HPV positive women without baseline high-grade lesions or immunocompromising conditions were included. The study group comprised 372 women with PCR confirmed symptomatic COVID-19, while those without confirmed infection served as controls. Patients with prior excisional cervical procedures, other STDs, pregnancy, or incomplete follow-up data were excluded. HR-HPV DNA and cervical cytology were assessed at standardized follow-ups at at mean intervals of approximately 10 and 19 months, and persistence rates were compared.

Results

Cervical HR-HPV persistence was significantly higher in COVID-19 positive patients at both follow-up visits (p = 0.007 and p = 0.021). Persistence of HPV 16 was also significantly higher in the COVID-19 positive group (p = 0.021), whereas HPV 18 persistence did not differ between groups (p = 0.851). Cervical cytology and colposcopy findings were comparable between groups at both visits (p = 0.873, p = 0.606, and p = 0.927, p = 0.751). Importantly, after adjusting for potential confounders including age, smoking status, baseline cytology, and COVID-19 vaccination, a history of COVID-19 infection remained a significant independent risk factor for HR-HPV persistence (aOR: 1.81, p < 0.001).

Conclusion

Prior COVID-19 infection was associated with increased HR-HPV persistence, particularly HPV 16. If confirmed by larger prospective studies, these findings may warrant intensified follow-up protocols for women with concurrent HR-HPV positivity and a history of COVID-19 infection. Prospective immunologic studies are additionally required to clarify how COVID-19 related immune alterations may influence HPV clearance.