Background Genital human papillomavirus (HPV) infection is highlyprevalent in sexually active young women. However, precise riskfactors for HPV infection and its incidence and duration arenot well known.
Methods We followed 608 college women at six-month intervalsfor three years. At each visit, we collected information aboutlifestyle and sexual behavior and obtained cervicovaginal-lavagesamples for the detection of HPV DNA by polymerase chain reactionand Southern blot hybridization. Pap smears were obtained annually.
Results The cumulative 36-month incidence of HPV infection was43 percent (95 percent confidence interval, 36 to 49 percent).An increased risk of HPV infection was significantly associatedwith younger age, Hispanic ethnicity, black race, an increasednumber of vaginal-sex partners, high frequencies of vaginalsex and alcohol consumption, anal sex, and certain characteristicsof partners (regular partners having an increased number oflifetime partners and not being in school). The median durationof new infections was 8 months (95 percent confidence interval,7 to 10 months). The persistence of HPV for >6 months wasrelated to older age, types of HPV associated with cervicalcancer, and infection with multiple types of HPV but not withsmoking. The risk of an abnormal Pap smear increased with persistentHPV infection, particularly with high-risk types (relative risk,37.2; 95 percent confidence interval, 14.6 to 94.8).
Conclusions The incidence of HPV infection in sexually activeyoung college women is high. The short duration of most HPVinfections in these women suggests that the associated cervicaldysplasia should be managed conservatively.
Source Information
From the Departments of Epidemiology and Social Medicine (G.Y.F.H., C.J.C., R.D.B.), Pediatrics (R.D.B.), and Microbiology and Immunology (R.D.B.) and the Albert Einstein Cancer Center (G.Y.F.H., R.D.B.), Albert Einstein College of Medicine, Bronx, N.Y.; and the Rutgers University Student Health Service, New Brunswick, N.J. (R.B., L.B.). Presented in part at the 14th International Papillomavirus Conference, Quebec City, Canada, July 23–28, 1995.
Address reprint requests to Dr. Burk at the Albert Einstein Cancer Center, Albert Einstein College of Medicine, 1300 Morris Park Ave., Ullmann Bldg., Rm. 515, Bronx, NY 10461.
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del Amo, J, Gonzalez, C, Losana, J, Clavo, P, Munoz, L, Ballesteros, J, Garcia-Saiz, A, Belza, M J, Ortiz, M, Menendez, B, del Romero, J, Bolumar, F
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(2005). Human Papillomavirus Capsid Antibody Response to Natural Infection and Risk of Subsequent HPV Infection in HIV-Positive and HIV-Negative Women. Cancer Epidemiol. Biomarkers Prev.
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Shields, T. S., Brinton, L. A., Burk, R. D., Wang, S. S., Weinstein, S. J., Ziegler, R. G., Studentsov, Y. Y., McAdams, M., Schiffman, M.
(2004). A Case-Control Study of Risk Factors for Invasive Cervical Cancer among U.S. Women Exposed to Oncogenic Types of Human Papillomavirus. Cancer Epidemiol. Biomarkers Prev.
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Wang, S. S., Trunk, M., Schiffman, M., Herrero, R., Sherman, M. E., Burk, R. D., Hildesheim, A., Bratti, M. C., Wright, T., Rodriguez, A. C., Chen, S., Reichert, A., von Knebel Doeberitz, C., Ridder, R., von Knebel Doeberitz, M.
(2004). Validation of p16INK4a as a Marker of Oncogenic Human Papillomavirus Infection in Cervical Biopsies from a Population-Based Cohort in Costa Rica. Cancer Epidemiol. Biomarkers Prev.
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de Jong, A., van Poelgeest, M. I. E., van der Hulst, J. M., Drijfhout, J. W., Fleuren, G. J., Melief, C. J. M., Kenter, G., Offringa, R., van der Burg, S. H.
(2004). Human Papillomavirus Type 16-Positive Cervical Cancer Is Associated with Impaired CD4+ T-Cell Immunity against Early Antigens E2 and E6. Cancer Res.
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Kulmala, S.-M., Syrjanen, S., Shabalova, I., Petrovichev, N., Kozachenko, V., Podistov, J., Ivanchenko, O., Zakharenko, S., Nerovjna, R., Kljukina, L., Branovskaja, M., Grunberga, V., Juschenko, A., Tosi, P., Santopietro, R., Syrjanen, K.
(2004). Human Papillomavirus Testing with the Hybrid Capture 2 Assay and PCR as Screening Tools. J. Clin. Microbiol.
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Silverberg, M. J., Thorsen, P., Lindeberg, H., Ahdieh-Grant, L., Shah, K. V.
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(2004). Cigarette Smoking, Oncogenic Human Papillomavirus, Ki-67 Antigen, and Cervical Intraepithelial Neoplasia. Am J Epidemiol
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Melsheimer, P., Vinokurova, S., Wentzensen, N., Bastert, G., Doeberitz, M. v. K.
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Carnes, M., Mahoney, J. E.
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Canadas, M. P., Bosch, F. X., Junquera, M. L., Ejarque, M., Font, R., Ordonez, E., de Sanjose, S.
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