Redetection of human papillomavirus type 16 infections of the cervix in mid-adult life

Ermel, Aaron; Shew, Marcia L.; Imburgia, Teresa M.; Brown, M.R.; Qadadri, Brahim; Tong, Yan; Brown, Darron R.

doi:10.1016/j.pvr.2018.01.001

Cited by 14 publications

(13 citation statements)

References 35 publications

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“…Our study is limited by the modest number of women enrolled. This study is also limited by the lack of serological data, which could potentially identify women who have been infected in the past with specific HPV types but have a negative PCR assay, due to a HPV infection that is below the limit of detection [33].…”

Section: Discussionmentioning

confidence: 99%

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A cross-sectional analysis of factors associated with detection of oncogenic human papillomavirus in human immunodeficiency virus-infected and uninfected Kenyan women

et al. 2019

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Background: Cervical cancer is caused by oncogenic human papillomaviruses (HPV) and is one of the most common malignancies in women living in sub-Saharan Africa. Women infected with the human immunodeficiency virus (HIV) have a higher incidence of cervical cancer, but the full impact on HPV detection is not well understood, and associations of biological and behavioral factors with oncogenic HPV detection have not been fully examined. Therefore, a study was initiated to investigate factors that are associated with oncogenic HPV detection in Kenyan women. Methods: Women without cervical dysplasia were enrolled in a longitudinal study. Data from enrollment are presented as a cross-sectional analysis. Demographic and behavioral data was collected, and HPV typing was performed on cervical swabs. HIV-uninfected women (n = 105) and HIV-infected women (n = 115) were compared for demographic and behavioral characteristics using t-tests, Chi-square tests, Wilcoxon sum rank tests or Fisher's exact tests, and for HPV detection using logistic regression or negative binomial models adjusted for demographic and behavioral characteristics using SAS 9.4 software. Results: Compared to HIV-uninfected women, HIV-infected women were older, had more lifetime sexual partners, were less likely to be married, were more likely to regularly use condoms, and were more likely to have detection of HPV 16, other oncogenic HPV types, and multiple oncogenic types. In addition to HIV, more lifetime sexual partners was associated with a higher number of oncogenic HPV types (aIRR 1.007, 95% CI 1.007-1.012). Greater travel distance to the clinic was associated with increased HPV detection (aOR for detection of ≥ 2 HPV types: 3.212, 95% CI 1. 206-8.552). Older age (aOR for HPV 16 detection: 0.871, 95% CI 0.764-0.993) and more lifetime pregnancies (aOR for detection of oncogenic HPV types: 0.706, 95% CI, 0.565-0.883) were associated with reduced detection. Conclusion: HIV infection, more lifetime sexual partners, and greater distance to health-care were associated with a higher risk of oncogenic HPV detection, in spite of ART use in those who were HIV-infected. Counseling of women about sexual practices, improved access to health-care facilities, and vaccination against HPV are all potentially important in reducing oncogenic HPV infections.

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Section: Discussionmentioning

confidence: 99%

“…(HPV 16,18,26,31,33,35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, 68, 69, 70, 73, 82, IS39). One or more HR-HPV types defined by IARC (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66) were detected in 70 of 220 (31.8%) participants.…”

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confidence: 99%

A cross-sectional analysis of factors associated with detection of oncogenic human papillomavirus in human immunodeficiency virus-infected and uninfected Kenyan women

et al. 2019

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“…A negative result at the HPV testing repeat occurred after more than 12 months and about 10 months in Italy and The Netherlands, respectively, usually reflects true viral clearance (and, being time‐dependent, is less frequent in The Netherlands than in Italy), but it may also reflect a latent infection with low viral load (i.e. below the detection limit of the assay) . Persistence of HPV infection is deemed necessary for the development of high‐grade lesions and cancer, whereas transient and newly detected infections entail a lower risk and require a longer time to induce CIN 2+ .…”

Section: Discussionmentioning

confidence: 99%

Five‐year risk of CIN3 after short‐term HPV‐DNA negativity in cytology‐negative women: a population‐based cohort study

Mistro

Rossi

Frayle

et al. 2019

BJOG

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Objective To assess the 5-year risk of high-grade lesions in women with a transient high-risk HPV infection.Design Population-based cohort study.Setting HPV primary testing within population-based organised cervical cancer screening programmes.Population Italian women enrolled in seven pilot projects and attending the second round.Methods On the basis of the cytology triage performed on HPVpositive women, immediate colposcopy or HPV repeat at 12 months was recommended. Data were collected at the subsequent round 3-4 years after HPV infection clearance.Main outcome measures Rates of HPV infection, CIN2+ and CIN3+ detection at subsequent round after HPV clearance, and relative risks (RR) in comparison with HPV-negative women (with 95% confidence interval).Results Data on 1230 women (1027 aged 25-64 years and 203 aged 35-64 years) have been analysed. Overall compliance with repeat HPV testing was 84%. In comparison with HPV-negative women, those with a transient HPV infection had higher proportions of HPV positivity (15% versus 3.7%) and of CIN2+ lesions (0.87% versus 0.23%) in round two; most of these (7/10) were CIN2; no cancers were detected, and CIN3 occurred in 3/1230 (0.24%).Conclusions HPV-based protocols for cervical cancer screening allow long intervals for HPV-negative women; it is important to monitor the clinical outcome in the women with transient high-risk HPV infection. CIN3 detection is similar to that observed in routine European cytology-based screening programmes (CIN3+: 2.7&); 5-year intervals may provide reasonable protection but longer intervals are not recommended.

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“…According to estimates, approximately 80% of sexually active women will acquire the infection in their lifetime, and in the majority of cases (>90%), it will be a transient, asymptomatic infection cleared by the immune system in six months to two years [17,18,19]. Only after a persistent infection can HPV lead to low- and/or high-grade cervical intraepithelial neoplasia (CIN), which may eventually evolve to cervical cancer [17,20,21]. However, not all HPV types have been linked to cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Chrysostomou

Stylianou

Constantinidou

et al. 2018

Viruses

196

172

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Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.

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Redetection of human papillomavirus type 16 infections of the cervix in mid-adult life

Cited by 14 publications

References 35 publications

A cross-sectional analysis of factors associated with detection of oncogenic human papillomavirus in human immunodeficiency virus-infected and uninfected Kenyan women

A cross-sectional analysis of factors associated with detection of oncogenic human papillomavirus in human immunodeficiency virus-infected and uninfected Kenyan women

Five‐year risk of CIN3 after short‐term HPV‐DNA negativity in cytology‐negative women: a population‐based cohort study

Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

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