Predictors of human papillomavirus persistence among women with equivocal or mildly abnormal cytology

Authors

  • Delphine Maucort-Boulch,

    1. Hospices Civils de Lyon, Service de Biostatistique, Lyon, France
    2. Université de Lyon, Université Lyon I, Villeurbanne, France
    3. CNRS, UMR 5558, Laboratoire Biostatistique Santé, Pierre-Bénite, France
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  • Martyn Plummer,

    Corresponding author
    1. International Agency for Research on Cancer, Lyon, France
    • International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
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  • Philip E. Castle,

    1. Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
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  • Franklin Demuth,

    1. Information Management Services, Silver Spring, MD
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  • Mahboobeh Safaeian,

    1. Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
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  • Cosette M. Wheeler,

    1. Departments of Molecular Genetics and Microbiology and Obstetrics and Gynecology, University of New Mexico Health Sciences Center, School of Medicine, Albuquerque, NM
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  • Mark Schiffman

    1. Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
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  • Dr Cosette M. Wheeler has received support through her institution from Roche Molecular Systems for HPV genotyping studies and to conduct HPV vaccine studies for Merck and Co. Ltd. and GlaxoSmithKline. The other named authors do not have a commercial or other association that might pose a conflict of interest.

Abstract

We investigated short-term persistence of human papillomavirus (HPV) infection among 2,408 women with low-grade or equivocal cytological abnormalities followed for 24 months. Odds ratios (ORs) for persistence to the next 6-month visit were estimated by a discrete time survival model. Prevalent HPV infections persisted longer in older women, but no association with age was found for incident HPV infections. Increased likelihood of persistence was found among current smokers of >20 cigarettes per day compared with smokers of ≤10 cigarettes per day (OR=1.43; 95% confidence interval [CI]: 1.02–2.01) and among current injectable contraceptive users (OR=1.15; 95% CI: 1.01–1.32). Persistence was more likely among infections with higher viral load (OR=2.05; 95% CI: 1.65–2.53) or with concurrent cytological abnormalities (OR=1.19; 95% CI: 1.03–1.39 and 1.29; 95% CI: 0.99–1.70 for ASCUS/LSIL and ASC-H/HSIL, respectively). We conclude that new HPV infections in older women are not riskier by the metric of viral persistence than those in younger women. Other risk factors such as oral contraceptive use and multiparity that have been associated with cervical cancer or cervical intraepithelial neoplasia grade 3 were not associated with short-term HPV persistence.

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