Authors: M. Molano¹; A. van den Brule¹; M. Plummer²; E. Weiderpass²; H. Posso³; A. Arslan²; C.J.L.M. Meijer¹; N. Muñoz²; S. Franceschi²

Source: American Journal of Epidemiology, Volume 158, Number 5, 1 September 2003 , pp. 486-494(9)

Publisher: Oxford University Press

Abstract:

Little is known about the factors that influence clearance of human papillomavirus (HPV), the primary cause of cervical carcinoma. A total of 227 women cytologically normal and HPV positive at baseline were identified from a population-based cohort of 1,995 Bogota, Colombia, women aged 13–85 years followed between 1993 and 2000 (mean follow-up, 5.3 years). HPV DNA detection and viral load determination were based on a GP5+/GP6+ polymerase chain reaction enzyme immunoassay. Rate ratio estimates for HPV clearance were calculated by using methods for interval-censored survival time data. Analyses were based on 316 type-specific HPV infections. HPV 16 had a significantly lower clearance rate than infections with low-risk types (rate ratio (RR) = 0.47, 95% confidence interval (CI): 0.32, 0.72), HPV types related to HPV 16 (types 31, 33, 35, 52, 58) had intermediate clearance rates (RR = 0.62, 95% CI: 0.47, 0.94), and other high-risk types did not show evidence of slower clearance compared with low-risk types. Infections with single and multiple HPV types had similar clearance rates. There was no evidence of a dose-response relation between clearance and viral load. Observed was slower clearance in parous women (RR = 0.64, 95% CI: 0.47, 0.89) and faster clearance in ever users of oral contraceptives (RR = 1.38, 95% CI: 1.07, 1.77).

Document Type: Original article

Affiliations: 1: Department of Pathology, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands. 2: International Agency for Research on Cancer, Lyon, France. 3: Division de Investigacion, Instituto Nacional de Cancerologia, Bogota, Colombia.

Publication date: 2003-09-01

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• The American Journal of Epidemiology is the premier epidemiological journal devoted to the publication of empirical research findings, methodological developments in the field of epidemiological research and opinion pieces. It is aimed at both fellow epidemiologists and those who use epidemiological data, including public health workers and clinicians.

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