Determinants of clearance of human papillomavirus infections in Colombian women with normal cytology: a population-based, 5-year follow-up study.
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).
Molano
Monica
M
Department of Pathology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.
Van den Brule
Adriaan
A
Plummer
Martyn
M
Weiderpass
Elisabete
E
Posso
Hector
H
Arslan
Annie
A
Meijer
Chris J L M
CJ
Muñoz
Nubia
N
Franceschi
Silvia
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000166:cytology / Q000821:virology*; D015331:Cohort Studies; D003105:Colombia / Q000453:epidemiology; D003276:Contraceptives, Oral; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000145:classification / Q000453:epidemiology* / Q000821:virology*; D010298:Parity; D011897:Random Allocation; D012016:Reference Values; D012075:Remission, Spontaneous; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014412:Tumor Virus Infections / Q000145:classification / Q000453:epidemiology* / Q000821:virology*; D019562:Viral Load / Q000706:statistics & numerical data
D003276:Contraceptives, Oral