Mesut Ali HALISÇELİK, Süleyman Cemil OĞLAK, Erdal ŞEKER, Sevda YELEÇ, Mustafa Fırat AYDIN, Salih Burçin KAVAK
Anatolian Journal of Obstetrics and Gynecology Research - 2026;3(2):112-117
Purpose: To compare one-year human papilloma virus (HPV) deoxyribonucleic acid and cervical cytology outcomes between women with histopathologically confirmed low-grade squamous intraepithelial lesions/cervical intraepithelial neoplasia grade 1 (LSIL/CIN1) who received adjuvant nonavalent HPV vaccination and a contemporaneous unvaccinated control cohort, and to identify baseline predictors of persistent disease. Methods: This single-center retrospective comparative cohort study included women with histopathologically confirmed LSIL/CIN1, divided into vaccinated and unvaccinated (control) subgroups, who were treated between 2020 and 2025. The primary outcomes were one-year HPV clearance and cytological normalization. Complete regression was defined as concurrent HPV negativity and normal cervical cytology, whereas persistent disease was defined as persistent HPV positivity together with abnormal cervical cytology. Univariable logistic regression analysis was performed to identify predictors of persistent disease in the vaccinated cohort. Results: Of the study cohort of 233 women, 153 (65.7%) women completed the three-dose nonavalent HPV vaccination schedule, while 80 (34.3%) women served as controls. Baseline demographic and clinical characteristics were comparable between the groups. At 12 months, HPV clearance was significantly more prevalent in the vaccinated group than in the control group (70.6% vs. 52.5%, p=0.009). Cytological normalization was also more frequent in vaccinated women (72.5% vs. 26.2%, p<0.001). Complete regression occurred in 53.6% of vaccinated women compared with 16.2% of controls (p<0.001), and consequently persistent disease was significantly less common in the vaccinated group (10.5% vs. 37.5%, p<0.001). Although HPV16, HPV18, other high-risk HPV types, and multiple HPV infections decreased in both groups, genotype-specific differences were not statistically significant. Baseline HPV18 positivity was the only significant predictor of persistent disease (odds ratio: 3.97, 95% confidence interval: 1.29-12.24; p=0.017). Conclusion: Adjuvant nonavalent HPV vaccination was associated with higher HPV clearance, improved cervical cytological outcomes, higher complete regression, and lower persistent disease rates in women with histopathologically confirmed LSIL/CIN1. Prospective multicenter studies are warranted to confirm these findings and further define the role of adjuvant HPV vaccination in the conservative management of LSIL/CIN1.
