Is stress related to the presence and persistence of oncogenic human papillomavirus infection in young women?

Abstract

Background Persistent infection with high-risk human papillomavirus (HR-HPV) is the most important risk factor for the development of cervical cancer, but factors contributing to HR-HPV persistence are incompletely understood. The objective of this study was to test for associations of chronic stress and two aspects of diurnal cortisol secretion (i.e., the cortisol awakening response [CAR] and total cortisol output over the day [AUCgday]) with HR-HPV status at baseline and 12 months later (follow-up). Methods We evaluated 188 women (25 ± 3 years) at baseline. Follow-up investigation was restricted to HR-HPV infected women at baseline. Of the initial 48 HR-HPV positive participants, 42 completed the follow-up (16 HR-HPV positive and 26 HR-HPV negative). At baseline and follow-up, we determined HR-HPV status in cervical smears, assessed chronic stress, and repeatedly measured salivary cortisol over the day. At baseline, we analyzed salivary cortisol only in a subgroup of 90 participants (45 HR-HPV negative and 45 HR-HPV positive). Results At baseline, higher chronic stress (excessive demands at work: p = .022, chronic worrying: p = .032), and a higher CAR (p = .014) were related to baseline HR-HPV positivity. At follow-up, there was a statistical trend for a positive association between the CAR and HR-HPV positivity (p = .062). Neither the CAR nor the AUCgday mediated the associations between chronic stress and HR-HPV status. Conclusions Our findings suggest that both chronic stress and diurnal cortisol are related to the presence of HR-HPV infection and may thus play a role in HPV-associated cervical carcinogenesis.

Endogenous oestradiol and progesterone as predictors of oncogenic human papillomavirus (HPV) persistence

“…Indeed, a seminal study in healthy women demonstrated that in vitro stimulation with HPV16 virus-like particles combined with an exogenous administration of oestradiol and progesterone decreased lympho-proliferation and pro-inflammatory cytokine production while increasing anti-inflammatory cytokines and transcriptional regulators of regulatory T cells [ 13 ]. This notion echoes the results of a previous report by our group, which found that chronic stress and the stress hormone cortisol, an important modulator of immune responses, were linked to HR-HPV status at baseline and follow-up [ 8 ].…”

“…This study was part of a larger study examining the influence of psychobiological factors on the course of HR-HPV (see [ 8 ] for a participant flow chart). For its main analyses, a power analyses yielded a sample size of N = 90 participants to detect medium-sized effects (see [ 8 ]).…”

“…This study was part of a larger study examining the influence of psychobiological factors on the course of HR-HPV (see [ 8 ] for a participant flow chart). For its main analyses, a power analyses yielded a sample size of N = 90 participants to detect medium-sized effects (see [ 8 ]). For the present analyses, we included all women who were regular users of combined oral contraceptives, which resulted in a total of N = 39 participants aged between 18 and 31 years.…”

Association of Serum Concentrations of Testosterone and Insulin with the Degree of Cervical Squamous Intraepithelial Lesions in Cuban Women

“…Some studies do not refer to a relationship between adverse life events such as divorce, the death of a close relative, or lack of social support and the risk of developing CxCa precursor lesions [61,62]. Nevertheless, other researchers have shown an association between psychosocial stress, cortisol levels, and the risk of HR-HPV infection, suggesting that this hormone may be related to cervical carcinogenesis [63,64]. Moreover, systemic use of glucocorticoids could increase the risk for HR-HPV persistence (OR, 2.04; 95% CI, 1.16-3.56) [65].…”

Investigating the psychometric properties of the Persian version of the quality of life of women infected with HPV questionnaire ( EQUALI-HPV)

“…Chronic psychological stress can affect the durability of HPV clinical symptoms and contribute to the progress of HPV-related cervical cancer. Furthermore, a large number of studies have reported that there is a relationship between psychological stress and the prevalence and progress of this virus in relation to cervical dysplasia and cancer (19,20). People with a positive high-risk HPV test have been shown to have signi cantly higher cortisol levels compared with those with a negative test, and chronic stress and daily cortisol are associated with HPV infection.…”