Association of Chlamydia trachomatis with Persistence of High-Risk Types of Human Papillomavirus in a Cohort of Female Adolescents

Samoff, Erika; Koumans, Emilia H.; Markowitz, Lauri E.; Sternberg, Maya; Sawyer, Mary K.; Swan, David C.; Papp, John R.; Black, Carolyn M.; Unger, Elizabeth R.

doi:10.1093/aje/kwi262

Cited by 166 publications

(162 citation statements)

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“…28 Ho et al 8 found older age, multiple infections and high-risk types to be associated with significantly higher HPV persistence rates among university students, and Samoff et al noted multiple infections associated with high-risk HPV persistence in adolescent girls. 13 Hildesheim et al 29 selected 393 women with normal cytology from a larger cohort of 21,000 women. Older age and oncogenic types were related to HPV persistence.…”

Section: Discussionmentioning

confidence: 99%

“…9-11 However, identifying infection of high-risk HPV causes anxiety in the individual woman. Because of lack of adequate knowledge in predicting outcome, the appropriate management is unclear except periodical follow-up.Several 8,13 HPV variants 17 have been reported associated with HPV persistence/decreased clearance, whereas ever users of oral contraceptives were associated with faster clearance. 15 Multiple infections, viral load 15 and smoking 8 were unrelated to clearance in other longitudinal follow-up studies.…”

mentioning

confidence: 99%

“…Several 8,13 HPV variants 17 have been reported associated with HPV persistence/decreased clearance, whereas ever users of oral contraceptives were associated with faster clearance. 15 Multiple infections, viral load 15 and smoking 8 were unrelated to clearance in other longitudinal follow-up studies.…”

mentioning

confidence: 99%

“…Several host factors such as older age, 8 hormone replacement therapy, 12 concurrent other lower genital tract infections, 13 generalized decrease in immune responsiveness, 14 parous women 15 ; and viral variables such as HPV genotype, 8,15,16 multiple HPV infections, 8,13 HPV variants 17 have been reported associated with HPV persistence/decreased clearance, whereas ever users of oral contraceptives were associated with faster clearance. 15 Multiple infections, viral load 15 and smoking 8 were unrelated to clearance in other longitudinal follow-up studies.…”

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confidence: 99%

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Host and viral factors in relation to clearance of human papillomavirus infection: A cohort study in Taiwan

Lai

Chao

Chang

et al. 2008

Intl Journal of Cancer

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Human papillomavirus (HPV) persistence is essential for cervical cancer development. We accrued nested-cohort subjects from a population-based study to investigate the host and viral factors related to outcome of HPV infection. Women (age ≥ 30 years old) with HPV-positive but normal cytology and negative colposcopy were invited to participate. After signing informed consent, every participant completed a structured questionnaire and had 6-monthly follow-ups of Pap smear, HPV testing and colposcopy. Total and type-specific HPV clearance rates as well as host and viral factors associated with clearance in 3-year longitudinal followup were analyzed. Adjusted hazard ratios (HRs) of progression to ≥ cervical intraepithelial neoplasia (CIN) 2 according to baseline HPV of the women with normal cytology were calculated from national registry database. Among the 626 eligible women, 526 (median age 47, 29-75) were enrolled and 412 returned for followup at least once. The median follow-up of enrolled subjects was 23 months (range 6.8-39). The 3-year cumulative total HPV clearance rate was 49.0% (95% confidence interval [CI]: 43.3-54.7%). The median 3-year cumulative type-specific HPV clearance rate was 50.0% (range 0-100.0%) with a median time to clearance of 12.4 months (6.4-24.5). Older age was associated with significantly decreased total HPV clearance and decreased type-specific clearance in HPV-18 and -53, while high viral load was associated with decreased total and type-specific clearance. After adjusting confounding variables, the HR of developing CIN2 in baseline HPVpositive women was 34.0-fold (95% CI: 15.5-74.7) as compared to HPV-negative women. ' 2008 Wiley-Liss, Inc.Key words: human papillomavirus; genotype; viral load; clearance Cervical cancer is one of the leading cancers in female worldwide. 1 There is strong epidemiological and molecular biological evidence indicating that human papillomavirus (HPV) plays a central role in the etiology of cervical cancer. 2,3 Over 90% of cervical cancers and their precursor lesions are attributable to HPV infection. 4,5 However, the prevalence of genital-tract HPV infections has been reported to range from 1.4 to 25.6% in cytologically normal population. 6 It is widely believed that persistent HPV infection is necessary for the development of cervical cancer. 3,7,8 Incorporation of HPV testing into cervical cancer screening has been advocated, although specificity is decreased with expected increase in sensitivity in early detection of high-grade cervical neoplasms. 9-11 However, identifying infection of high-risk HPV causes anxiety in the individual woman. Because of lack of adequate knowledge in predicting outcome, the appropriate management is unclear except periodical follow-up.Several 8,13 HPV variants 17 have been reported associated with HPV persistence/decreased clearance, whereas ever users of oral contraceptives were associated with faster clearance. 15 Multiple infections, viral load 15 and smoking 8 were unrelated to clearance in other longitudinal follow-u...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Host and viral factors in relation to clearance of human papillomavirus infection: A cohort study in Taiwan

Lai

Chao

Chang

et al. 2008

Intl Journal of Cancer

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“…Such inflammation may predispose women to other STDs, including genital HPV infection, by damaging epithelial integrity. 5 Recent studies suggested that a history of C. trachomatis infection was associated with persistence of oncogenic HPV infections, 6,7 and other studies have shown that persistent HPV infections are necessary for progression to high-grade cervical intraepithelial neoplasia (CIN) and carcinoma. 2,8 Thus, chronic cervical inflammation by C. trachomatis could increase the risk of transformation of cervical cells that are persistently infected with oncogenic types of HPV.…”

mentioning

confidence: 99%

Risk of cervical cancer associated with Chlamydia trachomatis antibodies by histology, HPV type and HPV cofactors

Madeleine

Anttila

Schwartz

et al. 2006

Intl Journal of Cancer

123

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Human papillomavirus (HPV) is the central etiologic factor for cervical cancer, and prior studies suggested C. trachomatis may act as an HPV cofactor. We examined the C. trachomatis-cervical cancer association by serotype, histology, HPV type in the tumor, and other HPV cofactors. We conducted a population-based study in the Seattle-Puget Sound area of 302 women with invasive squamous cell carcinomas (SCC), 185 women with adenocarcinomas of the cervix (AC), and 318 HPV seropositive control women. The risk of SCC associated with antibodies to C. trachomatis was increased (OR 1.6, 95% CI 1.1-2.2) but not for AC (OR 1.0, 95% CI 0.6-1.5). This association was independent of HPV type in the SCC tumor tissue. There was an association between specific serotypes of C. trachomatis and SCC for 6 of the 10 serotypes: B (OR 3.6, 95% CI 1.5-8.4), D (OR 2.1, 95% CI, 1.2-3.5), E (OR 2.4, 95% CI, 1.4-3.9), G (OR 3.0, 95% CI, 1.1-7.9), I (OR 4.2, 95% CI, 1.5-11.7), and J (OR 2.3, 95% CI, 1.0-5.1), but not for the 4 types (C, F, H, and K) that were present at very low prevalence in this population. There was an increased risk of SCC, but not AC, associated with antibodies to C. trachomatis that was not serotype specific. ' 2006 Wiley-Liss, Inc.Key words: Chlamydia trachomatis; HPV; cervical cancer; histologic type; microimmunofluorescence Certain oncogenic genital human papillomavirus types (HPV) that are sexually transmitted have been shown to be a necessary but not sufficient cause of cervical cancer. 1 These oncogenic HPVs most often result in transient infections of the cervix, and only a small proportion of exposed women eventually progress to cervical cancer. 2 Since few women exposed to sexually transmitted HPV get cervical cancer, we are interested in cofactors in addition to HPV that promote the development of cancer. One such possible cofactor is Chlamydia trachomatis, which is highly prevalent among sexually active young women and can infect the cervix for long periods of time. Risk factors for C. trachomatis infection are similar to those for genital HPV infections, and include a history of multiple sexual partners, a recent new sexual partner, early age at first intercourse, and sporadic use of condoms or other barrier methods of contraception. 3,4 C. trachomatis often causes cervicitis, which is a chronic infection of the endocervical cells of the transformation zone. Such inflammation may predispose women to other STDs, including genital HPV infection, by damaging epithelial integrity. 5 Recent studies suggested that a history of C. trachomatis infection was associated with persistence of oncogenic HPV infections, 6,7 and other studies have shown that persistent HPV infections are necessary for progression to high-grade cervical intraepithelial neoplasia (CIN) and carcinoma. 2,8 Thus, chronic cervical inflammation by C. trachomatis could increase the risk of transformation of cervical cells that are persistently infected with oncogenic types of HPV.C. trachomatis antibodies are not used for clinical assessment of ...

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Local Inflammation and Human Papillomavirus Status of Head and Neck Cancers

Tezal

Scannapieco²,

Wactawski‐Wende³

et al. 2012

Arch Otolaryngol Head Neck Surg

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Objective To determine whether periodontitis is associated with human papillomavirus (HPV) status of head and neck squamous cell carcinoma (HNSCC). Design and Setting Hospital-based case-control study in a comprehensive cancer center. Patients Evaluation included all patients diagnosed with incident primary squamous cell carcinoma of the oral cavity, oropharynx, and larynx between 1999 and 2007 for whom tissue samples and dental records were available (N = 124). Patients younger than 21 years and those with a history of cancer were excluded. Periodontitis history was assessed by alveolar bone loss in millimeters from panoramic radiographs by one examiner blinded to cancer status. Main Outcome Measure The presence of HPV-16 DNA in paraffin-embedded tumor samples was identified by polymerase chain reaction. Results The prevalence of HPV-positive HNSCC was 50 of 124 patients (40.3%). A higher proportion of oropharyngeal cancers were HPV-positive (32 of 49 [65.3%]) compared with oral cavity (9 of 31 [29.0%]) and laryngeal (9 of 44 [20.5%]) cancers. Each millimeter of alveolar bone loss was associated with 2.6 times increased odds (odds ratio [OR], 2.61; 95% CI, 1.58-4.30) of HPV-positive tumor status after adjustment for age at diagnosis, sex, and smoking status. The strength of the association was greater among patients with oropharyngeal SCC (OR, 11.70; 95% CI, 2.09-65.53) compared with those with oral cavity SCC (OR,2.32; 95% 0,0.65-8.27) and laryngeal SCC (OR, 3.89; 95% CI, 0.95-15.99). Conclusions A history of chronic inflammatory disease in the oral cavity may be associated with tumor HPV status in patients with HNSCC. This association seems to be stronger among palienLs with oropharyngeal cancer compared with those who have oral cavity or laryngeal SCC.

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Association of Chlamydia trachomatis with Persistence of High-Risk Types of Human Papillomavirus in a Cohort of Female Adolescents

Cited by 166 publications

References 40 publications

Host and viral factors in relation to clearance of human papillomavirus infection: A cohort study in Taiwan

Host and viral factors in relation to clearance of human papillomavirus infection: A cohort study in Taiwan

Risk of cervical cancer associated with Chlamydia trachomatis antibodies by histology, HPV type and HPV cofactors

Local Inflammation and Human Papillomavirus Status of Head and Neck Cancers

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