title: Chlamydia trachomatis infection and persistence of human papillomavirus.
abstract: Human papillomavirus (HPV) persistence is the major cause of cervical cancer, but most HPV infections will not persist and risk factors for HPV persistence are not well known. Chlamydia (C.) trachomatis infection seems to also be associated with cervical cancer. We investigated whether C. trachomatis infection is a risk factor for HPV persistence. In a cohort of 12,527 women participating in a population-based HPV screening trial in Sweden, 6,418 women completed testing for HPV DNA by general primer PCR and typing by reverse dot blot hybridization. On average 19 months later, 303 women that had been HPV-positive and had normal cytology at enrollment completed a new HPV test. Environmental exposures were assessed by an 87-item questionnaire. Previous sexually transmitted infections were also investigated by serology. At follow-up, 44% of the women were positive for the same type of HPV DNA as at enrollment. Persistence correlated with length of follow-up (p < 0.01) and condom use seemed to protect against HPV persistence (p < 0.05). The most significant risk factor for persistent presence of HPV DNA was self-reported history of previous C. trachomatis infection (relative risk in multivariate model = 2.09; 95% confidence interval = 1.05-4.18). We conclude that persistence of oncogenic HPV infections is more likely among women with a previous C. trachomatis infection.
authors.affiliation: Department of Medical Microbiology, Lund University, University Hospital at Malmö, Sweden.
authors.forename: Ilvars
authors.initials: I
authors.lastname: Silins
authors.forename: Walter
authors.initials: W
authors.lastname: Ryd
authors.forename: Anders
authors.initials: A
authors.lastname: Strand
authors.forename: Göran
authors.initials: G
authors.lastname: Wadell
authors.forename: Sven
authors.initials: S
authors.lastname: Törnberg
authors.forename: Bengt Göran
authors.initials: BG
authors.lastname: Hansson
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Wang
authors.forename: Lisen
authors.initials: L
authors.lastname: Arnheim
authors.forename: Viktor
authors.initials: V
authors.lastname: Dahl
authors.forename: Daniel
authors.initials: D
authors.lastname: Bremell
authors.forename: Kenneth
authors.initials: K
authors.lastname: Persson
authors.forename: Joakim
authors.initials: J
authors.lastname: Dillner
authors.forename: Eva
authors.initials: E
authors.lastname: Rylander
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000150:complications*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008403:Mass Screening; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014412:Tumor Virus Infections / Q000150:complications*; D002583:Uterine Cervical Neoplasms / Q000209:etiology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000209:etiology
chemical_list: D004279:DNA, Viral