Host and viral factors in relation to clearance of human papillomavirus infection: A cohort study in Taiwan

✍ Scribed by Chyong-Huey Lai; Angel Chao; Chee-Jen Chang; Fang-Yu Chao; Huei-Jean Huang; Swei Hsueh; Cheng-Tao Lin; Hui-Hsin Cheng; Chu-Chun Huang; Jung-Erh Yang; Tzu-I Wu; Hung-Hsueh Chou; Ting-Chang Chang

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: French
• Weight: 112 KB
• Volume: 123
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.23679

✦ Synopsis

Abstract

Human papillomavirus (HPV) persistence is essential for cervical cancer development. We accrued nested‐cohort subjects from a population‐based study to investigate the host and viral factors related to outcome of HPV infection. Women (age ≥ 30 years old) with HPV‐positive but normal cytology and negative colposcopy were invited to participate. After signing informed consent, every participant completed a structured questionnaire and had 6‐monthly follow‐ups of Pap smear, HPV testing and colposcopy. Total and type‐specific HPV clearance rates as well as host and viral factors associated with clearance in 3‐year longitudinal follow‐up were analyzed. Adjusted hazard ratios (HRs) of progression to ≥ cervical intraepithelial neoplasia (CIN) 2 according to baseline HPV of the women with normal cytology were calculated from national registry database. Among the 626 eligible women, 526 (median age 47, 29–75) were enrolled and 412 returned for follow‐up at least once. The median follow‐up of enrolled subjects was 23 months (range 6.8–39). The 3‐year cumulative total HPV clearance rate was 49.0% (95% confidence interval [CI]: 43.3–54.7%). The median 3‐year cumulative type‐specific HPV clearance rate was 50.0% (range 0–100.0%) with a median time to clearance of 12.4 months (6.4–24.5). Older age was associated with significantly decreased total HPV clearance and decreased type‐specific clearance in HPV‐18 and ‐53, while high viral load was associated with decreased total and type‐specific clearance. After adjusting confounding variables, the HR of developing ≥CIN2 in baseline HPV‐positive women was 34.0‐fold (95% CI: 15.5–74.7) as compared to HPV‐negative women. © 2008 Wiley‐Liss, Inc.