The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women - 09/09/11
Abstract |
Objectives: The objectives of this study were to describe the early natural history of human papillomavirus (HPV) infection by examining a cohort of young women positive for an HPV test and to define within this cohort (1) the probability of HPV regression, (2) the risk of having a squamous intraepithelial lesion, and (3) factors that were associated with HPV regression.
Study design: The study was a cohort analytic design. An inception cohort of 618 women positive for HPV participated. HPV testing, cytologic evaluation, and colposcopic evaluation were performed at 4-month intervals. HPV testing was characterized for two groups: low risk (five types rarely associated with cancers) and high risk (nine types most commonly associated with cancers).
Results: Estimates provided by Kaplan-Meier curves showed that ~70% of women were found to have HPV regression by 24 months. Women with low-risk HPV type infections were more likely to show HPV regression than were women with high-risk HPV type infections (log rank test p = 0.002). The relative risk for the development of high-grade squamous intraepithelial lesion (HSIL) was 14.1 (95% confidence interval: 2.3, 84.5) for women with at least three positive tests for high-risk HPV preceding the development of the HSIL compared with that for women with negative tests for high-risk HPV. However, 88% of women with persistent positive HPV tests have not had HSIL to date. No factors associated with high-risk HPV type regression were identified except for a negative association with an incident history of vulvar condyloma (relative risk = 0.5 [95% confidence interval: 0.3 to 0.8]).
Conclusion: Most young women with a positive HPV test will become negative within a 24-month period. Persistent positive tests with oncogenic HPV types represented a significant risk for the development of HSIL. However, we found that most young women with persistent positive HPV tests did not have cytologically perceptible HSIL over a 2-year period. Factors thought to be associated with the development of HSIL were found not to be important in HPV regression. (J Pediatr 1998;132:277-84)
Le texte complet de cet article est disponible en PDF.Abbreviations : CIN, HPV, HSIL, LSIL, PCR
Plan
 | From the Division of Adolescent Medicine, Department of Pediatrics, the Department of Epidemiology and Biostatistics, the Department of Laboratory Medicine and Stomatology, and the Department of Anatomic Pathology, University of California, San Francisco. |
| Supported in part by National Cancer Institute No. R01CA51323 and No. R01CA54053, NIAIDS No. P01A121912, National Institutes of Health grant No. M01 RR01271, Maternal and Child Health Bureau Training Grant No. MCJ000978, the Cigarette and Tobacco Surtax Fund of the State of California through the Tobacco-related Research Program of the University of California, grant No. RT 487 and grant No. RT 484, AIDS Clinical Research Center, University of California, San Francisco. |
 | Reprint requests: Anna-Barbara Moscicki, MD, 400 Parnassus Ave., Room AC-01, Box 0503, San Francisco, CA 94143. |
| 0022-3476/98/$5.00 + 0 9/21/83685 |
Vol 132 - N° 2
P. 277-284 - février 1998 Retour au numéro
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