Status of human papillomavirus infection after loop electrosurgical excision procedure at the National Referral Hospital, Bhutan, 2022–2023: A retrospective study

OBJECTIVE: To assess risk factors associated with persistent human papillomavirus (HPV) infection 6 months after loop electrosurgical excision procedure (LEEP) among Bhutanese women who tested HPV positive before LEEP at the National Referral Hospital of Bhutan. METHOD: This was a retrospective study with review of patient records of women who tested HPV positive and underwent LEEP between January 1, 2022, and June 30, 2023. Sociodemographic and clinicopathologic factors were entered into EpiData and associations with HPV persistence were assessed using STATA. RESULTS: Among 132 women who tested HPV positive before LEEP, histologic diagnosis was normal in 32.6% (43), cervical intraepithelial neoplasia Grade 1 (CIN 1) in 19.7% (26), CIN 2 in 26.5% (35), CIN 3 in 18.9% (25), and adenocarcinoma in situ in 2.3% (3). HPV persistence 6 months after LEEP was 14.4% (19/132). Factors including age at the time of LEEP, age at marriage, educational status, number of sexual partners, use of oral contraceptive pill, colposcopy diagnosis, histology result, parity, and margin status were not associated with HPV persistence at 6 months. CONCLUSION: This study provides baseline data on the proportion of HPV persistence at 6 months after LEEP in Bhutan. Ongoing follow up of patients after LEEP, including HPV typing and histology, would guide risk assessment for recurrent disease at the time of LEEP.