Persistence and clearance of human papillomavirus infection: a prospective cohort study

Am J Obstet Gynecol. 2008 Dec;199(6):617.e1-7. doi: 10.1016/j.ajog.2008.06.033. Epub 2008 Sep 16.

Abstract

Objective: The objective of the study was to identify epidemiological correlates for persistence and clearance of human papillomavirus (HPV) infection.

Study design: Cervical smears collected in a prospective cohort study to perform Papanicoloau cytology and HPV deoxyribonucleic acid (DNA) detection at baseline and during the follow-up. Outcomes analyzed were: (1) persistence of HPV DNA; (2) conversion; and (3) clearance of HPV.

Results: Among 501 women the incidence of HPV was 12.3%. Thirty-four women were persistently infected with HPV, which was associated with age below 21 years at first intercourse and 4 or more sexual partners during their lifetime. In a median of 19 months, 80.7% of women had clearance of HPV, which was associated with black race, coinfection with Chlamydia trachomatis at baseline, and a history of previous Papanicoloau smear.

Conclusion: Strategies for sexual orientation may modify the rates of HPV persistence. The association of HPV clearance with a history of previous Papanicolaou smear screening highlights the importance of improving cervical screening programs. Further studies on the association of gynecological infections with HPV clearance are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Chlamydia trachomatis / isolation & purification
  • Chronic Disease
  • DNA Probes, HPV
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Papanicolaou Test
  • Papillomaviridae / isolation & purification*
  • Papillomaviridae / metabolism
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / epidemiology*
  • Polymerase Chain Reaction
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / pathology
  • Precancerous Conditions / virology*
  • Prognosis
  • Risk Assessment
  • Severity of Illness Index
  • Uterine Cervical Dysplasia / epidemiology
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / virology*
  • Vaginal Smears
  • Young Adult

Substances

  • DNA Probes, HPV