The natural history of human papillomavirus infection and cervical intraepithelial neoplasia among young women in the Guanacaste cohort shortly after initiation of sexual life

Sex Transm Dis. 2007 Jul;34(7):494-502. doi: 10.1097/01.olq.0000251241.03088.a0.

Abstract

Objective: Cross-sectional analyses of our 10,000-woman, population-based Guanacaste cohort suggest a lag of > or =10 years between the peak of human papillomavirus (HPV) infection and the later peak of cervical intraepithelial neoplasia grade 3 (CIN 3). We wanted to explore early HPV natural history and CIN 3 prospectively.

Study design: As part of the Guanacaste cohort, we followed 206 initially virginal women aged 18 to 26 semiannually for a median of 3.6 years after initiation of sexual life.

Results: A total of 53.4% of women tested positive during the study for > or =1 HPV type. Very few infections persisted for >1 to 2 years. Three women had histologically confirmed CIN 3, of which 2 showed persistent HPV 16. The other had serologic evidence of HPV 31.

Conclusions: HPV infection occurs frequently and clears rapidly in most young women initiating sexual intercourse. Persistent HPV 16 can cause early CIN 3. The peak age for CIN 3 will decline with the increased screening intensity and sensitivity typical of longitudinal studies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Cervical Intraepithelial Neoplasia / epidemiology*
  • Cervical Intraepithelial Neoplasia / etiology
  • Cervical Intraepithelial Neoplasia / prevention & control
  • Cohort Studies
  • Costa Rica / epidemiology
  • Cross-Sectional Studies
  • DNA, Viral / analysis
  • Female
  • Humans
  • Office Visits / statistics & numerical data
  • Papillomaviridae / classification
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / etiology
  • Papillomavirus Infections / prevention & control
  • Physical Examination / statistics & numerical data
  • Polymerase Chain Reaction
  • Prospective Studies
  • Sexual Behavior*
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / etiology
  • Uterine Cervical Neoplasms / prevention & control

Substances

  • DNA, Viral