Determinants of Human Papillomavirus 16 Serological Conversion and Persistence in a Population-Based Cohort of 10 000 Women in Costa Rica

Br J Cancer. 2004 Oct 4;91(7):1269-74. doi: 10.1038/sj.bjc.6602088.

Abstract

Determinants of human papillomavirus (HPV)-16 serological conversion and persistence were assessed in a population-based cohort of 10 049 women in Guanacaste, Costa Rica. Serologic responses to HPV-16 were measured in 7986 women by VLP-based enzyme-linked immunosorbent assay at both study enrollment (1993/94) and at 5-7 years of follow-up. Seropositive women were defined as >/=5 standard deviations above the mean optical density obtained for studied virgins at enrollment (n=573). Seroconnversion (n=409), persistence (n=675), and clearance (n=541) were defined based on enrollment and follow-up serology measurements. Age-specific distributions revealed that HPV-16 seroconversion was highest among 18- to 24-year-old women, steadily declining with age; HPV-16 seropersistence was lowest in women 65+ years. In age-adjusted multivariate logistic regression models, a 10-fold risk increase for HPV-16 seroconversion was associated with HPV-16 DNA detection at enrollment and follow-up; two-fold risk of seroconversion to HPV-16 was associated with increased numbers of lifetime and recent sexual partners and smoking status. Determinants of HPV-16 seropersistence included a 1.5-fold risk increase associated with having one sexual partner during follow-up, former oral contraceptive use, and a 3-fold risk increase associated with HPV-16 DNA detection at both enrollment and follow-up. Higher HPV-16 viral load at enrollment was associated with seroconversion, and higher antibody titres at enrollment were associated with seropersistence.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Viral / analysis
  • Cohort Studies
  • Contraceptives, Oral
  • Costa Rica
  • DNA, Viral / analysis*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Models, Theoretical*
  • Papillomaviridae / pathogenicity*
  • Papillomavirus Infections / complications*
  • Papillomavirus Infections / immunology*
  • Risk Factors
  • Serologic Tests
  • Sexual Behavior
  • Uterine Cervical Neoplasms / virology*

Substances

  • Antibodies, Viral
  • Contraceptives, Oral
  • DNA, Viral