Longitudinal Study of Human Papillomavirus Persistence and Cervical Intraepithelial Neoplasia Grade 2/3: Critical Role of Duration of Infection

Rodríguez, Ana Cecilia; Schiffman, Mark; Herrero, Rolando; Hildesheim, Allan; Bratti, Concepción; Sherman, Mark E.; Solomon, Diane; Guillén, Diego Miguel Gracia; Alfaro, Mario; Morales, Jorge; Hutchinson, Martha L.; Katki, Hormuzd A.; Cheung, Li C.; Wacholder, Sholom; Burk, Robert D.

doi:10.1093/jnci/djq001

Cited by 346 publications

(328 citation statements)

References 48 publications

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“…23,43 Clearance In this 12-month follow-up study, the overall clearance proportion of the newly detected (i.e., incident) hr-HPV and lr-HPV infections was 61.2% and 69.0%, respectively. Confirming the finding that most incident HPV types are not detected 6-12 months later.…”

Section: Incidencementioning

confidence: 77%

“…Therefore, we can only measure presumed incidence because it is presently impossible to distinguish a new infection from an accidental pick-up or reactivation of a latent infection. 13,43 Although women aged 24-29 years had a higher incidence rate compared to 18-23 years old women, age was not an independent risk factor for HPV incidence. When analyzing the age groups compared to the variable 'having a new sexual partner during follow-up', women in the age group 24-29 years have more new sexual partners compared to the younger women (p-value ¼ 0.145).…”

Section: Incidencementioning

confidence: 95%

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Prospective follow‐up of 2,065 young unscreened women to study human papillomavirus incidence and clearance

Schmeink

Massuger

Lenselink

et al. 2013

Intl Journal of Cancer

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Human papillomavirus (HPV) is a necessary factor in the development of cervical intraepithelial neoplasia and cervical cancer. However, HPV is also a very common sexually transmitted virus and many women clear their infection. To study HPV incidence and clearance, 2,065 women, aged 18-29 years, were followed for 12 months and were asked to provide a self-collected cervicovaginal sample and fill-out a questionnaire every 3 months. For HPV DNA detection, the SPF 10 -DEIA LiPA 25 system was used. Incidence rates of any-type high-risk HPV and low-risk HPV were 17.0 per 1,000-person months, and 14.3 per 1,000-person months, respectively. HPV types 16, 52, 51 and 31 had the highest type-specific incidence rates. HPV incidence was increased in singles, and women having a new relationship. A higher number of lifetime sex partners, and a higher frequency of sexual contacts in the past 3 months was associated with an increased HPV incidence. The overall clearance of the newly detected typespecific high-risk HPV infections and low-risk HPV infections was 61.2% and 69.0%, respectively. Having a sexual relationship compared to being single, and a higher sexual age both positively influenced the clearance of any-type high-risk HPV. Among the women infected with HPV 16, the women who had a co-infection had a lower proportion of clearance of HPV 16. In conclusion, in this young Dutch study population, HPV incidence rates are not related to age and comparable to other western countries. Clearance was only independently related to factors associated with sexual behavior, either past or current.It is generally accepted that a persistent human papillomavirus (HPV) infection is the necessary cause of cervical cancer. Acquisition of an HPV infection is therefore the main precursor of the series of events that eventually lead to cervical cancer.1-4 Fortunately, most of the acquired HPV infections are transient and clear spontaneously within 12 months after first detection, and about 90% of the women will have cleared their HPV infection within 24 months. [5][6][7][8][9][10][11][12][13] HPV is a very common sexually transmitted virus, mainly acquired early in sexual life.14,15 Rates of acquiring an HPV infection are high following first sexual intercourse, and with each new sexual partner. 7,16,17 The risk factors associated with acquiring an HPV infection are therefore mainly related to the individuals sexual behavior. 18HPV prevalence, however, is not only influenced by sexual activity but also varies by age and geography, as shown by the International Agency for Research on Cancer (IARC) and others. [19][20][21] Young women have high rates of HPV acquisition, and incidence tends to decline with age. 10,17,22,23 Whether age is also related to the duration of the infection remains controversial. Some studies report that there is no influence of age on the clearance rate of the HPV infection. 10,24,25 Whereas other studies report a lower clearance rate with increasing age, 26,27 or in contrary a faster clearance rate in older women (>4...

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Section: Incidencementioning

confidence: 77%

Section: Incidencementioning

confidence: 95%

Prospective follow‐up of 2,065 young unscreened women to study human papillomavirus incidence and clearance

Schmeink

Massuger

Lenselink

et al. 2013

Intl Journal of Cancer

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show abstract

“…It has been shown that different oncogenic HPV genotypes5 have different cross‐sectional6 and longitudinal7 strengths of association with high‐grade CIN and invasive cervical cancer. In particular, HPV16 has been shown to be strongly associated with both high‐grade CIN and invasive cervical cancer 8, 9, 10.…”

Section: Introductionmentioning

confidence: 99%

Human papilloma virus genotyping for the cross‐sectional and longitudinal probability of developing cervical intraepithelial neoplasia grade 2 or more

Mistro

Adcock

Carozzi

et al. 2018

Intl Journal of Cancer

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Human papilloma virus (HPV) testing is more sensitive but less specific than cytology. We evaluated stand‐alone genotyping as a possible triage method. During a multicentre randomised controlled trial comparing HPV testing to conventional cytology, HPV‐positive women were referred to colposcopy and followed up if no high‐grade lesion was detected. HPV‐positive samples were genotyped by GP5+/GP6+ primed polymerase chain reaction followed by reverse line blot. Genotypes were hierarchically ordered by positive predictive value (PPV) for CIN grade 2 or more (CIN2+), and grouped by cluster analysis into three groups (A, B and C in decreasing order). Receiver operating characteristic curves were computed. Among 2,255 HPV‐positive women with genotyping, 239 CIN2+ (including 113 CIN3+) were detected at baseline or during a 3‐year follow‐up. HPV33 had the highest PPV with CIN2+ and CIN3+ as the endpoint and when considering lesions detected at baseline or also during follow‐up. HPV16 and HPV35 were the second and third, respectively. Cross‐sectional sensitivity for CIN2+ at baseline was 67.3% (95% CI 59.7–74.2), 91.8% (95% CI 86.6–95.5) and 94.7% (95% CI 90.2–97.6), respectively, when considering as “positive” any of the HPV types in group A (33, 16 and 35), A or B (31, 52, 18, 59 and 58) and A or B or C (39, 51, 56, 45 and 68). The corresponding cross‐sectional PPVs for CIN2+ were 15.8% 95% (CI 13.2–18.7), 12.0% (95% CI 10.3–13.9) and 9.6% (95% CI 8.2–11.1), respectively. HPV33, 16 and 35 confer a high probability of CIN2+ but this rapidly decreases when adding other genotypes.

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“…Only a very small fraction (about 10%) of women will develop viral persistence, and only some of those who are chronically infected with a high-risk HPV type will have a high risk of infection progressing to neoplastic lesions (9). The average total time from infection with a carcinogenic HPV type to the occurrence of invasive cervical cancer is 25-30 years or longer (11). HPV infection is basically a sexually transmitted disease.…”

Section: Introductionmentioning

confidence: 99%

APOBEC-mediated genomic alterations link immunity and viral infection during human papillomavirus-driven cervical carcinogenesis

Lanting

Zhang

Wang

et al. 2017

BST

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Longitudinal Study of Human Papillomavirus Persistence and Cervical Intraepithelial Neoplasia Grade 2/3: Critical Role of Duration of Infection

Cited by 346 publications

References 48 publications

Prospective follow‐up of 2,065 young unscreened women to study human papillomavirus incidence and clearance

Prospective follow‐up of 2,065 young unscreened women to study human papillomavirus incidence and clearance

Human papilloma virus genotyping for the cross‐sectional and longitudinal probability of developing cervical intraepithelial neoplasia grade 2 or more

APOBEC-mediated genomic alterations link immunity and viral infection during human papillomavirus-driven cervical carcinogenesis

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