Determinants of human papillomavirus 16 serological conversion and persistence in a population-based cohort of 10 000 women in Costa Rica.
Determinants of human papillomavirus (HPV)-16 serological conversion and persistence were assessed in a population-based cohort of 10 049 women in Guanacaste, Costa Rica. Serologic responses to HPV-16 were measured in 7986 women by VLP-based enzyme-linked immunosorbent assay at both study enrollment (1993/94) and at 5-7 years of follow-up. Seropositive women were defined as >/=5 standard deviations above the mean optical density obtained for studied virgins at enrollment (n=573). Seroconnversion (n=409), persistence (n=675), and clearance (n=541) were defined based on enrollment and follow-up serology measurements. Age-specific distributions revealed that HPV-16 seroconversion was highest among 18- to 24-year-old women, steadily declining with age; HPV-16 seropersistence was lowest in women 65+ years. In age-adjusted multivariate logistic regression models, a 10-fold risk increase for HPV-16 seroconversion was associated with HPV-16 DNA detection at enrollment and follow-up; two-fold risk of seroconversion to HPV-16 was associated with increased numbers of lifetime and recent sexual partners and smoking status. Determinants of HPV-16 seropersistence included a 1.5-fold risk increase associated with having one sexual partner during follow-up, former oral contraceptive use, and a 3-fold risk increase associated with HPV-16 DNA detection at both enrollment and follow-up. Higher HPV-16 viral load at enrollment was associated with seroconversion, and higher antibody titres at enrollment were associated with seropersistence.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7234, USA. wangso@mail.nih.gov
S S
SS
Wang
M
M
Schiffman
R
R
Herrero
J
J
Carreon
A
A
Hildesheim
A C
AC
Rodriguez
M C
MC
Bratti
M E
ME
Sherman
J
J
Morales
D
D
Guillen
M
M
Alfaro
B
B
Clayman
R D
RD
Burk
R P
RP
Viscidi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis; D015331:Cohort Studies; D003276:Contraceptives, Oral; D003364:Costa Rica; D004279:DNA, Viral / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D027383:Papillomaviridae / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000150:complications* / Q000276:immunology*; D012307:Risk Factors; D012698:Serologic Tests; D012725:Sexual Behavior; D002583:Uterine Cervical Neoplasms / Q000821:virology*
D000914:Antibodies, Viral; D003276:Contraceptives, Oral; D004279:DNA, Viral