title: Development and duration of human papillomavirus lesions, after initial infection.
abstract: BACKGROUND
  To determine the potential value of human papillomavirus (HPV) vaccines, information concerning the incidence and duration of clinically important lesions is needed.
  
  
  METHODS
  A total of 603 female university students were followed for a mean duration of 38.8 months. Triannual gynecologic examinations included cervical and vulvovaginal specimen collection for Pap and HPV DNA testing. Women with cytologic evidence of a high-grade squamous intraepithelial lesion (SIL) were referred for colposcopically directed biopsy.
  
  
  RESULTS
  Among women with incident HPV infection, the 36-month cumulative incidence of cervical SILs found by cytologic testing (47.2%; 95% confidence interval [CI], 38.9%-56.4%) was higher than that of vaginal SILs (28.8%; 95% CI, 21.3%-38.2%). The median time to clearance of cervical and vaginal SILs was 5.5 and 4.7 months, respectively. Among women with incident HPV-16 or HPV-18 infection, the 36-month cumulative incidence of cervical intraepithelial neoplasia (CIN) grade 2 was 20.0% (95% CI, 10.8%-35.1%), and that of CIN grade 3 was 6.7% (95% CI, 2.5%-17.0%). The 36-month cumulative incidence of clinically ascertained genital warts among women with incident HPV-6 or HPV-11 infection was 64.2% (95% CI, 50.7%-77.4%).
  
  
  CONCLUSIONS
  Intraepithelial lesions are common early events among women with incident HPV infection, and the interval between incident HPV-16 or HPV-18 infection and biopsy-confirmed CIN grade 2-3 appears to be relatively short.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, Washington 98103, USA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Winer
authors.forename: Nancy B
authors.initials: NB
authors.lastname: Kiviat
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Diane E
authors.initials: DE
authors.lastname: Adam
authors.forename: Shu-Kuang
authors.initials: SK
authors.lastname: Lee
authors.forename: Jane M
authors.initials: JM
authors.lastname: Kuypers
authors.forename: Laura A
authors.initials: LA
authors.lastname: Koutsky
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology; D003218:Condylomata Acuminata / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D027383:Papillomaviridae / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000473:pathology / Q000503:physiopathology*; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000821:virology