Persistence of HPV infection and risk of high-grade cervical intraepithelial neoplasia in a cohort of Colombian women |
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| Authors: | N Mu?oz G Hernandez-Suarez F Méndez M Molano H Posso V Moreno R Murillo M Ronderos C Meijer á Mu?oz |
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| Institution: | 1.Subdirección de Investigaciones y Salud Publica, Instituto Nacional de Cancerología, Bogotá, Colombia;2.Escuela de Salud Pública, Universidad del Valle, Cali, Colombia;3.Cancer Epidemiology Service, Instituto Catalán de Oncología, Barcelona, Spain;4.Department of Pathology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands;5.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA |
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| Abstract: | Little is known about the dynamics of human papillomavirus (HPV) infection and subsequent development of high-grade cervical intraepithelial neoplasia (CIN2/3), particularly in women >30 years of age. This information is needed to assess the impact of HPV vaccines and consider new screening strategies. A cohort of 1728 women 15–85 years old with normal cytology at baseline was followed every 6 months for an average of 9 years. Women with squamous intraepithelial lesions were referred for biopsy and treatment. The Kaplan–Meier method was used to estimate the median duration of infection and Cox regression analysis was undertaken to assess determinants of clearance and risk of CIN2/3 associated with HPV persistence. No difference in the likelihood of clearance was observed by HPV type or woman''s age, with the exception of lower clearance for HPV16 infection in women under 30 years of age. Viral load was inversely associated with clearance. In conclusion, viral load is the main determinant of persistence, and persistence of HPV16 infections carry a higher risk of CIN2/3. |
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| Keywords: | human papillomavirus persistence risk cervical intraepithelial neoplasia |
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