Acquisition of anal human papillomavirus (HPV) infection in women: the Hawaii HPV Cohort study

J Infect Dis. 2008 Apr 1;197(7):957-66. doi: 10.1086/529207.


Background: The majority of anal cancer is associated with human papillomavirus (HPV) infection, yet little is known about women's risk of acquisition of anal HPV infection.

Methods: Risk factors for the acquisition of anal HPV infection were examined in a longitudinal cohort study of 431 women, via repeated measurement of HPV DNA.

Results: Seventy percent of women were positive for anal HPV infection at one or more clinic visits from baseline through a follow-up period that averaged 1.3 years. The incidence of a high-risk (HR) infection was 19.5 (95% confidence interval [CI], 16.0-23.6) per 1000 woman-months. The most common incident HR HPV types were HPV-53, -52 and -16. The presence of an HR anal HPV infection at baseline increased the risk of an incident anal infection by 65%. Baseline HR cervical HPV infection also predicted the acquisition of an HR anal HPV infection (odds ratio, 1.81 [95% CI, 1.09-3.02]). Nonviral risk factors for acquisition of HR HPV infection included younger age, lower socioeconomic status, greater lifetime number of sexual partners, past use of hormones, and condom use.

Conclusions: The results of this study suggest that women's risk of anal HPV infection is as common as their risk of cervical HPV infection.

Publication types

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

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anal Canal / virology*
  • Cervix Uteri / virology
  • Cohort Studies
  • DNA, Viral / isolation & purification
  • Female
  • Hawaii
  • Humans
  • Incidence
  • Longitudinal Studies
  • Middle Aged
  • Papillomaviridae / classification
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / virology*
  • Risk Factors
  • Sexual Behavior
  • Socioeconomic Factors


  • DNA, Viral