Risk factors for HR-HPV persistence and residual or recurrent high-grade squamous intraepithelial neoplasia after LEEP

The study investigated factors associated with persistent high-risk human papillomavirus (HR-HPV) infection and disease recurrence in 903 patients with high-grade intraepithelial lesions who underwent LEEP surgery between January 2021 and May 2024. HR-HPV persistence was detected in 23.3% of patients at 6 months, 19.0% at 12 months, and 17.5% at 18 months after surgery. Risk factors for viral persistence included multiple HR-HPV infections, menopausal status, and positive endocervical margins. During follow-up, 32 patients (3.5%) developed residual or recurrent disease. Persistent type-specific HR-HPV infection, extent of cervical involvement, and positive surgical margins were independent predictors of disease recurrence.