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The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women

The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women,10.1016/S0022-3476(98)70445-7,

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The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women   (Citations: 201)
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Anna-Barbara Moscicki, Stephen Shiboski, Jeannette Broering, Kimberly Powell, Lisa Clayton, Naomi Jay, Teresa M. Darragh, Robert Brescia, Saul Kanowitz, Susanna B. Miller, Joanna Stone, Evelyn Hansonhttp://academic.research.microsoft.com/io.ashx?type=5&id=30788101&selfId1=0&selfId2=0&maxNumber=12&query=
Objectives: The objectives of this study were to describe the early natural history of human papillomavirus (HPV) infection by examining a cohort of young women positive for an HPV test and to define within this cohort (1) the probability of HPV regression, (2) the risk of having a squamous intraepithelial lesion, and (3) factors that were associated with HPV regression.Study design: The study was a cohort analytic design. An inception cohort of 618 women positive for HPV participated. HPV testing, cytologic evaluation, and colposcopic evaluation were performed at 4-month intervals. HPV testing was characterized for two groups: low risk (five types rarely associated with cancers) and high risk (nine types most commonly associated with cancers).Results: Estimates provided by Kaplan-Meier curves showed that ~70% of women were found to have HPV regression by 24 months. Women with low-risk HPV type infections were more likely to show HPV regression than were women with high-risk HPV type infections (log rank test p = 0.002). The relative risk for the development of high-grade squamous intraepithelial lesion (HSIL) was 14.1 (95% confidence interval: 2.3, 84.5) for women with at least three positive tests for high-risk HPV preceding the development of the HSIL compared with that for women with negative tests for high-risk HPV. However, 88% of women with persistent positive HPV tests have not had HSIL to date. No factors associated with high-risk HPV type regression were identified except for a negative association with an incident history of vulvar condyloma (relative risk = 0.5 [95% confidence interval: 0.3 to 0.8]).Conclusion: Most young women with a positive HPV test will become negative within a 24-month period. Persistent positive tests with oncogenic HPV types represented a significant risk for the development of HSIL. However, we found that most young women with persistent positive HPV tests did not have cytologically perceptible HSIL over a 2-year period. Factors thought to be associated with the development of HSIL were found not to be important in HPV regression. (J Pediatr 1998;132:277-84)
Journal: Journal of Pediatrics - J PEDIAT , vol. 132, no. 2, pp. 277-284, 1998
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    • ...The median duration of an initial infection is 8–16 months for low-risk HPV types [48 ]a nd 2–5 months longer for high-risk types [15, 33, 67]...
    • ...Approximately 70% of all infections are cleared after 2 years [48], and although it has been reported that subsequent infection with the same HPV type is uncommon [90] there is some debate on this issue...

    José Ramet, et al. Position paper—HPV and the primary prevention of cancer; improving vac...

    • ...Women were eligible to participate if they (1) were between 18 and 60 years of age; (2) were permanent residents of Sa ˜o Paulo (city); (3) were not currently pregnant and had no intention of becoming pregnant during the next 12 months; (4) had an intact uterus and no current referral for hysterectomy; (5) reported no use of vaginal medication in the previous 2 days; and (6) had not had treatment for cervical disease by electrocoagulation, ...

    Nicolas F. Schlecht, et al. Persistent Human Papillomavirus Infection as a Predictor of Cervical I...

    • ...In our base case analysis, the annual incidence infection began at age 15, peaked at age 20 and dropped off after age 35. Given HPV infection, regression rates were highest for women < 25 years (46%/yr) and lowest for women > 50 years (3%/yr), reflecting an observation of more persistent infections in the older age group [33-38]...
    • ... [41] Cost of treatment for cervical cancer 10 000 7 500-12 500 [41] Cost of treatment for high-grade SIL 245 183-306 [41] Utilities Normal population 1 Assumed Diagnosed SIL for 1-year 0.97 0.80-1 [13,40] Cervical cancer 0.70 0.25-1 Assumed Cervical cancer, follow-up 0.95 0.90-1 Assumed Transition probabilities Incidence of high-risk HPV infection 0-0.09 0.5-2 × base case [6-9] HPV infection resolving 0.03-0.46 0.67-1.5 × base case ...

    Pang-Hsiang Liu, et al. Cost-effectiveness of human papillomavirus vaccination for prevention ...

    • ... 1998, Franco et al...

    Maria E. Fernandez, et al. HPV knowledge, attitudes, and cultural beliefs among Hispanic men and ...

    • ... In many women, especially those who were exposed at younger ages, the infection becomes undetectable over time (...

    Christina C. Wee, et al. Obesity and the Likelihood of Sexual Behavioral Risk Factors for HPV a...

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