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Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women
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Autores
Insinga, Ralph P.
Perez, Gonzalo
Wheeler, Cosette M.
Koutsky, Laura A.
Garland, Suzanne M.
Leodolter, Sepp
Joura, Elmar A.
Ferris, Daron G.
Steben, Marc
Brown, Darron R.
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Fecha
2010
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American Association for Cancer Research Inc.
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Abstract
Background: We describe the incidence and duration of cervical human papillomavirus (HPV) infection episodes along with the risk of infection reappearance following a period of nondetection. Methods:Women (1,788) ages 16 to 23 years underwent cytologic testing and PCR-based testing of cervical swab samples for HPV DNA (HPV-16/18/31/33/35/45/52/58/59) at ?6-month intervals for up to 4 years in the context of a phase 3 clinical trial (placebo arm). HPV type - specific incidence rates were estimated per 100 person-years. Duration of type-specific cervical infection episodes and risk of reappearance following a period of nondetection were estimated using Kaplan-Meier methods. Results: HPV-16 exhibited the highest (5.9), and HPV-35 and HPV-33 exhibited the lowest (1.0) incidence rates per 100 person-years. Mean cervical infection durations ranged from 13 months for HPV-59 to 20 months for HPV-16 and 58 (with ongoing infections censored at the time of treatment, if done). The risk of cervical infection reappearance within ?3 years following a period of nondetection ranged from 0% to 16% across HPV types, with a mean of 8%. Limited evidence was found for a role of false-positive HPV tests, missed infections that were above the threshold for detection, or new acquisition of infection in accounting for patterns of infection reappearance. Conclusions: Incidence of high-risk cervical infection was observed to vary considerably more across HPV types than infection duration. A nontrivial proportion of women exhibited infection reappearance following a period of nondetection, with a potential explanation for many such events observed within this analysis being a return to detectable levels of a previously acquired infection. Impact: The risk of HPV infection reappearance following a period of nondetection has not been previously reported for individual HPV types, and this study finds that a nontrivial proportion of infected women exhibit reappearances. Future studies could ascertain subject-level factors that potentially modify the risk of infection reappearance. ©2010 AACR.
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Keywords
Adolescent , phase iii as topic , Article , Clinical feature , Clinical trial , Controlled study , Cytology , Disease classification , Disease duration , Female , Human , Human tissue , Incidence , Major clinical study , Papillomavirus infection , Polymerase chain reaction , Priority journal , Uterine cervix , Double blind procedure , Genetics , Isolation and purification , Papilloma virus , Papillomavirus infections , Phase 3 clinical trial (topic) , Prevalence , Randomized controlled trial (topic) , Uterine cervical diseases , Virology , Young adult , Virus dna , Adolescent , Clinical trials , Dna , Double-blind method , Female , Humans , Incidence , Papillomaviridae , Papillomavirus infections , Polymerase chain reaction , Prevalence , Randomized controlled trials as topic , Uterine cervical diseases , Young adult
