Determinants of Clearance of Human Papillomavirus Infections in Colombian Women with Normal Cytology: A Population-based, 5-Year Follow-up Study

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

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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.

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