title: Clearance of oncogenic human papillomavirus (HPV) infection: effect of smoking (United States).
abstract: OBJECTIVE
  The purpose of this investigation was to assess the association between smoking and clearance of oncogenic human papillomavirus (HPV) infection.
  
  
  METHODS
  A prospective cohort study of 346 women aged 18-35 years was conducted. HPV testing was conducted with the Hybrid Capture II (HC II) system and polymerase chain reaction (PCR) with genotyping using the reverse line blot method. At each visit tobacco exposure, reproductive, and sexual histories were assessed. Probability of clearing an oncogenic HPV infection and duration of oncogenic HPV infections by smoking status was assessed.
  
  
  RESULTS
  Regardless of method used, HC II or PCR, ever smokers maintained an HPV infection significantly longer (median duration of 8.5 months vs 10.7 months, never vs ever smokers), and had a lower probability of clearing an oncogenic infection compared with women who never smoked. Smoking duration was significantly associated with HPV clearance, and a dose response was observed. Older age (>13 years) at smoking initiation was significantly associated with a reduced probability of clearing an oncogenic HPV infection.
  
  
  CONCLUSIONS
  This is the first study to demonstrate that smoking promotes early cervical carcinogenic events by increasing duration of oncogenic HPV infections and decreasing probability of clearing oncogenic infections.
authors.affiliation: Arizona Cancer Center, University of Arizona, Tucson 85724-5024, USA. agiuliano@azcc.arizona.edu
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Sedjo
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Roe
authors.forename: Robin
authors.initials: R
authors.lastname: Harri
authors.forename: Susie
authors.initials: S
authors.lastname: Baldwi
authors.forename: Mary R
authors.initials: MR
authors.lastname: Papenfuss
authors.forename: Martha
authors.initials: M
authors.lastname: Abrahamsen
authors.forename: Paula
authors.initials: P
authors.lastname: Inserra
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014412:Tumor Virus Infections / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology