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Incidence and outcome of acquisition of human papillomavirus infection in women with normal cytology—A population-based cohort study from Taiwan

✍ Scribed by Angel Chao; Chee-Jen Chang; Chyong-Huey Lai; Fang-Yu Chao; Yi-Hsien Hsu; Hung-Hsueh Chou; Huei-Jean Huang; Shih-Ming Jung; Cheng-Tao Lin; Hui-Hsin Cheng; Chu-Chun Huang; Jung-Erh Yang; Ting-Chang Chang


Publisher
John Wiley and Sons
Year
2009
Tongue
French
Weight
185 KB
Volume
126
Category
Article
ISSN
0020-7136

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✦ Synopsis


Abstract

Little is known about acquisition of human papillomavirus (HPV) and its outcome among older women with negative HPV testing and normal cytology. A longitudinal 3‐yr follow‐up of nested‐cohort subjects (n = 8825) from a population‐based cervical cancer screening study whose Pap and HPV tests were negative at baseline were conducted. Every active HPV‐negative (n = 413) participant had 12‐mo follow‐ups of Pap smear and HPV testing. Colposcopy was performed if either HPV‐positive or cytology was abnormal. The cytology and histology information of the remaining subjects (passive HPV‐negative, n = 8412) was obtained from national registry database. Median age of participants was 45 yr (range, 30–73 yr). The incidence of new acquisition was 4.2/100 woman‐years. The 3‐yr cumulative total HPV acquisition rate was 11.1% (95% confidence interval [CI]: 8.1–14.1). Increased number of sexual partners (≥2 vs. 1) of the participant was associated with risk of acquisition (odds ratio [OR]: 5.0, 95% CI: 2.0–12.6) by multivariate analysis. Three cases of ≥ cervical intraepithelial neoplasia (CIN) 2 were identified in 3‐yr follow‐up in active HPV‐negative subjects. HPV genotypes in the dysplastic tissue were actually present at baseline samples after reanalysis. From the passive HPV‐negative group, only 1 case progressed to CIN2 probably after HPV acquisition. Negative Pap and HPV tests assured a very low risk of developing ≥ CIN2 within 3 yr despite incident HPV infection.


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