Gynecologic infection rates after ablation treatment for cervical intraepithelial neoplasia grade 2 and higher (CIN2+): Secondary analysis of a non-inferiority randomized trial.

Autor:	Masch R; Department of Obstetrics, Gynecology and Reproductive Science, The Mount Sinai Hospital, New York, New York, United States of America.; Basic Health International, Pittsburgh, Pennsylvania, United States of America., Conzuelo-Rodriguez G; Basic Health International, Pittsburgh, Pennsylvania, United States of America., Mitchell JA; Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America., Alfaro K; Basic Health International, Pittsburgh, Pennsylvania, United States of America., Soler M; Obstetrics, Gynecology Institute, Cleveland Clinic, Cleveland, Ohio, United States of America., Chavez LF; Basic Health International, Pittsburgh, Pennsylvania, United States of America., Wu S; Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China., Sun J; Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China., Hu L; Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China., Marinela-Hernandez D; Hospital Primero de Mayo, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador., Alonzo TA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America., Felix JC; Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America., Cremer ML; Basic Health International, Pittsburgh, Pennsylvania, United States of America.; Obstetrics, Gynecology Institute, Cleveland Clinic, Cleveland, Ohio, United States of America.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2024 Jul 10; Vol. 4 (7), pp. e0003333. Date of Electronic Publication: 2024 Jul 10 (Print Publication: 2024).
DOI:	10.1371/journal.pgph.0003333
Abstrakt:	Although concerns have been raised regarding potential infection and morbidity in women undergoing ablation treatment for cervical precancer in low- and middle-income countries (LMIC), there is extremely limited data to substantiate this claim. This is a secondary analysis of a randomized non-inferiority trial (id: NCT03084081) that compares the efficacy and safety of three ablation treatments for biopsy-confirmed cervical intraepithelial neoplasia grade 2 or higher (CIN2+): CO2 gas-based cryotherapy, non-gas cryotherapy, and thermal ablation (TA). Here, we present findings regarding the incidence of sexually transmitted infections (STI) and vaginitis post-treatment. Samples were collected at enrollment and again at 6 weeks post-treatment and assessed for STIs (Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), and Trichomonas vaginalis (TV)) and vaginitis (Bacterial vaginosis (BV) and/or Candida albicans (Candida)). This analysis reflects 864 women with baseline and 6-week follow-up data. None of the ablative treatments put women at increased risk for STIs (CT, NG, TV) or vaginitis (BV, Candida). While most women adhered to post-treatment recommendations (97%) and no difference by treatment arm was observed, the incidence of STIs at follow-up in women that did not adhere with a given recommendation was higher compared to their adherent counterparts. The incidence of gynecologic infection did not increase with any of the ablation treatments from baseline to the six-week follow-up. Non-gas cryotherapy and TA emerge as safe alternatives to gas-based cryotherapy with respect to gynecologic infection rates. Competing Interests: I have read the journal’s policy and the following authors of this manuscript have the following competing interests: Rachel Masch is an Organon Nexplanon trainer. Miriam L. Cremer is an Organon Nexplanon trainer and is on the Merck speaker bureau. Montserrat Soler receives consultant fees from BHI. Juan C. Felix gives expert testimony and is a consultant for Ethicon. The rest of the authors have no competing interests to declare. (Copyright: © 2024 Masch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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