Association of Chlamydia trachomatis infection with redetection of human papillomavirus after apparent clearance

J Infect Dis. 2013 Nov 1;208(9):1416-21. doi: 10.1093/infdis/jit346. Epub 2013 Aug 2.

Abstract

Background: Persistent infection with oncogenic human papillomavirus (HPV) is associated with an increased risk of cervical malignancy. Redetection of type-specific HPV after a period of nondetection may be caused by reactivation of a low-level persistent infection. Little is known about factors associated with type-specific HPV redetection.

Methods: For a longitudinal cohort of adolescent women with frequent behavioral and sexually transmitted infection (STI) information (every 3 months), Cox proportional hazard models were used to assess the influence of sexual behaviors and STIs on the redetection of oncogenic or high-risk HPV infections.

Results: A total of 210 type-specific high-risk HPV detection episode periods were identified in this longitudinal cohort; 71 (33.8%) were characterized by a period of nondetection followed by redetection. Chlamydia trachomatis (hazard ratio [HR], 3.14; 95% confidence interval [CI], 1.44-6.86) was associated with redetection; redetection was >2 times more likely with each additional self-reported sex partner in the past 3 months (HR, 2.26; 95% CI, 1.35-3.78).

Conclusions: This study demonstrates the role of C. trachomatis and number of recent sexual partners in type-specific HPV redetection. Given that persistent oncogenic HPV infections are associated with cancer-related outcomes, understanding the potential role of such factors in the pathogenesis of HPV-related outcomes is important.

Keywords: HPV redetection; chlamydia; human papillomavirus.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Chlamydia Infections / complications*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / microbiology
  • Chlamydia trachomatis*
  • Coinfection / diagnosis*
  • Coinfection / epidemiology
  • Coinfection / microbiology
  • Coinfection / prevention & control
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Longitudinal Studies
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / microbiology
  • Papillomavirus Infections / prevention & control
  • Recurrence
  • Sexual Behavior
  • Sexual Partners