title: Time to clearance of human papillomavirus infection by type and human immunodeficiency virus serostatus.
abstract: Persistent infection with high-risk human papillomavirus (HPV) is central to cervical carcinogenesis. Certain high-risk types, such as HPV16, may be more persistent than other HPV types, and type-specific HPV persistence may differ by HIV serostatus. This study evaluated the association between HPV type and clearance of HPV infections in 522 HIV-seropositive and 279 HIV-seronegative participants in the HIV Epidemiology Research Study (HERS, United States, 1993-2000). Type-specific HPV infections were detected using MY09/MY11/HMB01-based PCR and 26 HPV type-specific probes. The estimated duration of type-specific infections was measured from the first HPV-positive visit to the first of two consecutive negative visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) for HPV clearance were calculated using Cox models adjusted for study site and risk behavior (sexual or injection drugs). A total of 1,800 HPV infections were detected in 801 women with 4.4 years median follow-up. HRs for clearance of HPV16 and related types versus low-risk HPV types were 0.79 (95% CI: 0.64-0.97) in HIV-positive women and 0.86 (95% CI: 0.59-1.27) in HIV-negative women. HRs for HPV18 versus low-risk types were 0.80 (95% CI: 0.56-1.16) and 0.57 (95% CI: 0.22-1.45) for HIV-positive and -negative women, respectively. HPV types within the high-risk category had low estimated clearance rates relative to low-risk types, but HRs were not substantially modified by HIV serostatus.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA. koshiolj@mail.nih.gov
authors.forename: Jill E
authors.initials: JE
authors.lastname: Koshiol
authors.forename: Jane C
authors.initials: JC
authors.lastname: Schroeder
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Marshall
authors.forename: Ann
authors.initials: A
authors.lastname: Duerr
authors.forename: Charles M
authors.initials: CM
authors.lastname: Heilig
authors.forename: Keerti V
authors.initials: KV
authors.lastname: Shah
authors.forename: Robert S
authors.initials: RS
authors.lastname: Klein
authors.forename: Susan
authors.initials: S
authors.lastname: Cu-Uvin
authors.forename: Paula
authors.initials: P
authors.lastname: Schuman
authors.forename: David
authors.initials: D
authors.lastname: Celentano
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
mesh_terms: D000328:Adult; D005260:Female; D006678:HIV / Q000502:physiology*; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000821:virology*; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000502:physiology*; D030361:Papillomavirus Infections / Q000097:blood* / Q000145:classification / Q000150:complications / Q000821:virology*; D012307:Risk Factors; D013997:Time Factors