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Persistence and clearance of human papillomavirus infection: a prospective cohort study
Maria Inês Rosa1, Jandira M G Fachel, Daniela D Rosa
1Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Criciúma, Brazil.
Objective:
The objective of the study was to identify epidemiological correlates for persistence and clearance of human papillomavirus (HPV) infection.
Study Design:
Cervical smears collected in a prospective cohort study to perform Papanicoloau cytology and HPV deoxyribonucleic acid (DNA) detection at baseline and during the follow-up. Outcomes analyzed were: (1) persistence of HPV DNA; (2) conversion; and (3) clearance of HPV.
Results:
Among 501 women the incidence of HPV was 12.3%. Thirty-four women were persistently infected with HPV, which was associated with age below 21 years at first intercourse and 4 or more sexual partners during their lifetime. In a median of 19 months, 80.7% of women had clearance of HPV, which was associated with black race, coinfection with Chlamydia trachomatis at baseline, and a history of previous Papanicoloau smear.
Conclusion:
Strategies for sexual orientation may modify the rates of HPV persistence. The association of HPV clearance with a history of previous Papanicolaou smear screening highlights the importance of improving cervical screening programs. Further studies on the association of gynecological infections with HPV clearance are needed.