Incidence and duration of cervical human papillomavirus 6, 11, 16, and 18 infections in young women: an evaluation from multiple analytic perspectives.
OBJECTIVE
To estimate the incidence and duration of cervical human papillomavirus (HPV)-6, HPV-11, HPV-16, and HPV-18 infections in a population of young American women.


METHODS
The study population consisted of U.S. women who at baseline were 16 to 23 years of age, reported zero to five lifetime sexual partners, never having been pregnant, and never having had a prior abnormal Papanicolaou test and were enrolled in the placebo arm of a randomized multicenter clinical trial of a HPV-16 L1 virus-like particle vaccine. Women underwent type-specific endocervical/ectocervical swab HPV DNA testing at approximately 6-month intervals for up to 48 months of follow-up. To contribute person-time in the analyses of type-specific HPV incidence, a woman must have had at least three satisfactory swab specimens available and been negative for the relevant HPV type (HPV-6, HPV-11, HPV-16, or HPV-18) on her first two trial swabs. The duration of incident HPV infections was estimated using Kaplan-Meier survival analysis methods.


RESULTS
Person-years of exposure ranged by type-specific analysis from 2,645 to 3,188, with an incidence rate per 100 person-years of 3.6 for HPV-6, 0.4 for HPV-11, 5.4 for HPV-16, and 2.1 for HPV-18. With censoring at the time of treatment for cervical intraepithelial neoplasia, where done, the mean duration of incident infections was 9.3, 8.4, 18.2, and 16.4 months, respectively, for HPV-6 (n = 103), HPV-11 (n = 13), HPV-16 (n = 142), and HPV-18 (n = 62). When the duration of HPV infections was truncated at the time of cervical intraepithelial neoplasia detection (any grade), where applicable, mean duration figures were 8.4, 8.1, 14.0, and 15.1 months for HPV-6, HPV-11, HPV-16, and HPV-18 infections, respectively.


CONCLUSIONS
Previous studies of the mean duration of cervical HPV infection have been based on prevalent infections and/or featured relatively short duration of follow-up. This study tested women for HPV infection over a period of up to 48 months and observed a mean duration of incident HPV-16/HPV-18 infections approximately twice that of HPV-6/HPV-11.
Insinga
Ralph P
RP
Department of Health Economic Statistics, Merck Research Laboratories, North Wales, PA 19454-1099, USA. ralph_insinga@merck.com
Dasbach
Erik J
EJ
Elbasha
Elamin H
EH
Liaw
Kai-Li
KL
Barr
Eliav
E
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000821:virology; D004311:Double-Blind Method; D005260:Female; D052140:Human papillomavirus 11 / Q000302:isolation & purification; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D052163:Human papillomavirus 6 / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D002577:Uterine Cervical Diseases / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D014626:Vaginal Smears
D053918:Papillomavirus Vaccines