Persistence of high‐risk human papillomavirus infection in a population‐based cohort of Danish women

Abstract

Persisting human papillomavirus (HPV) infection is a critical step in cervical carcinogenesis. This study was conducted to determine the type-specific HPV persistence and risk factors for persistence of high-risk HPV infections in a large cohort of Danish women. The study was based on a population-based prospective cohort study of women aged 20-29 years. Participants were interviewed and underwent two gynecological examinations 2 years apart. Women with Hybrid Capture 2 results at enrolment and a follow-up visit were included in the analysis (n = 7,418). Persistence was defined as positivity for the same high-risk HPV type at both examinations. Overall, 4.2% of the women had persistent HPV infection, accounting for 26.9% of the initially HPV-positive women. HPV 16, HPV 58, and HPV 31, all from species group alpha 9, were the most persistent types; however, other high-risk HPV types that are detected rarely in cancer cases were also likely to persist. The number of high-risk HPV types and detection of HPV 16 infection at baseline and ever use of oral contraceptives increased the risk for persistence. The risk factor analyses also showed that use of an intrauterine device decreased the risk for persistent high-risk HPV infection among women with one high-risk HPV type at baseline. No association was found with viral load or smoking. In conclusion, persistent high-risk HPV infection, especially HPV 16 persistence, was common among women positive for high-risk HPV.

Genotype‐Specific Persistence of Genital Human Papillomavirus (HPV) Infections in Women Followed for 6 Years in the Finnish Family HPV Study

“…In the present series, HPV35 showed the longest mean persistence (38.7 months, but there was only 1 case), followed by HPV58 (32.1 months), HPV16 (23.9 months), and multiple-type infections (20.9 months). Even though there were only 4 cases of HPV58 infection, these findings are in agreement with some recent reports, in which HPV16 and HPV58 were the 2 genotypes most likely to persist [12,26,27]. In other studies, HPV16 alone has been shown to persist longest [11,12,28], with persistence ranging from 18.3 months [5] to 16.1 months [12] and 118 months [28].…”

“…In fact, 7 mothers (2.4%) had their first sexual intercourse before the age of 13 years, and of those, 42.9% ( ) had a persistent typen p 3 specific infection by species 7/9 genotypes. This corroborates recent data indicating that high-risk HPV infection in women aged !15 years had an increased the risk of becoming persistent [26]. In our multivariate analysis, the early onset of sexual activity lost it statistical significance as independent predictor, which is in line with another study [6].…”

“…Most other studies [5,12,[26][27][28] have only focused on a few high-risk HPV types and report short follow-up times (maximum follow-up, 24 months) [5,[26][27][28][29].…”

Cervicovaginal HPV Infection in Female Renal Transplant Recipients: An Observational, Self-Sampling Based, Cohort Study

“…These percentages are comparable with percentages of the general Dutch population aged 18-29 years (23). Former studies described having multiple HPV infections as a risk factor for hrHPV persistence (26,27). Multiple infections may increase the overall viral load which may overcome immune control.…”

Using Contraceptives for Gynecologic Conditions

“…Possible explanations for these fi ndings include evidence from animal models that estrogen and progesterone use may enhance the growth of chlamydia infection [ 83 ]. It is important to note, however, that COC use has also been [ 89 ]. However, other studies have not found a link between COC use and high-grade cervical dysplasia [ 90 -92 ].…”