Regular disappearance of the human papillomavirus genome after conization of cervical dysplasia by carbon dioxide laser

OBJECTIVE: We wished to evaluate the effectiveness of treatment of cervical dysplasia by laser conization in relation to persistence of human papillom avirus after treatment. STUDY DESIGN: Of 203 women referred to colposcopy because of an abnormal Pa panicolaou smear, 149 women could be followed up for 3 years. A total of 10 8 women were treated by carbon dioxide laser excision, 4 women were treated by carbon dioxide laser evaporation, and 37 women were merely followed up. Cervical samples were taken before treatment and at follow-up 3 years late r and were analyzed by nested general primer polymerase chain reaction for human papillomavirus deoxyribonucleic acid. RESULTS: Among women treated by laser conization, 82 (73.2%) had positive r esults for human papillomavirus deoxyribonucleic acid before treatment. Thr ee women (2.7%) had a positive finding at follow-up, but no woman had the s ame human papillomavirus type on both occasions. Eighty-eight women had gra de 1 to grade 3 cervical intraepithelial neoplasia before treatment, wherea s during follow-up only 2 squamous cells atypias were found. CONCLUSION: The human papillomavirus genome present before treatment was re gularly cleared, and there was also no recurrence of dysplasia. The results suggest that human papillomavirus testing is useful for monitoring the eff icacy of treatment and that treatment modalities resulting in clearance of human papillomavirus should be favored.