Clinical course of cervical human papillomavirus lesions in relation to coexistent cervical infections

A prospective follow-up of 530 women with cervical human papillomavirus (HPV) infection was conducted from 1981 to the present (mean 62.9 months). The patients were examined by PAP smears and colposcopy with or without biopsies every sixth month. Endocervical swabs were taken for culture of cytomegalovirus (CMV), herpes simplex virus (HSV), and Chlamydia trachomatis at each visit. During the follow-up period, 179 of the 530 patients (33.8%) had cervical infection and 351 (66.2%) had no coexistent cervicitis. On average, the patients with coexistent cervicitis were younger than those without cervicitis (32 +/- 7.2 years and 37.1 +/- 11.4 years, respectively; P less than 0.0001). C. Trachomatis was isolated from 95 of the 530 women (17.9%), and 19 of the patients had chlamydial cervicitis twice. Cytomegalovirus was isolated from 27 (5.1%) women, 2 of whom also had HSV, and 12 patients had a chlamydial infection. Herpes simplex virus was isolated from 11 (2.1%) women, including 2 patients with coexistent CMV infection. A total of 60 (1.3%) women had nonspecific cervicitis. Of the HPV lesions without coexistent cervical infection, 56.7% regressed, 24.5% persisted, 16.5% progressed, and recurrence was found in 2.3%. The corresponding figures for HPV lesions with coexistent cervicitis were as follows: 66.5%, 22.9%, 9.5%, and 1.1%, respectively. Coexistent active cervical infections had no influence on the clinical course of HPV lesions.