title: Persistence of genital human papillomavirus infection in a long-term follow-up study of female university students.
abstract: BACKGROUND
  Little is known about the epidemiology of human papillomavirus (HPV) infections that persist for more than a few years.
  
  
  METHODS
  Four to 12 years after participation in a longitudinal study of incident HPV infection, a cohort of former university students returned for a follow-up visit that included HPV genotyping of cervical and vulvovaginal swab specimens and collection of colposcopy-directed biopsy specimens.
  
  
  RESULTS
  Of 147 women with HPV infection detected during their undergraduate years, 24 (16.3%) were positive for 1 or more of the same HPV types at follow-up. Overall, 27 (4.8%) of 567 type-specific HPV infections persisted, and DNA sequence analyses of a subset revealed that all were variant specific. Long-term HPV persistence was positively associated with frequent but sporadic detection of the same HPV type early during the course of the infection and with abnormal Pap tests and genital warts; it was negatively associated with marriage and was not associated with the number of intercurrent sex partners.
  
  
  CONCLUSIONS
  HPV variant and behavioral risk factor analyses indicated that long-term detection of the same HPV type was more consistent with viral persistence than with reinfection. Although long-term persistence was not common, it was associated with detection of HPV-related pathologies.
authors.affiliation: Departments of Epidemiology, University of Washington, Seattle, WA 98103, USA.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Sycuro
authors.forename: Long Fu
authors.initials: LF
authors.lastname: Xi
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Feng
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Winer
authors.forename: Shu-Kuang
authors.initials: SK
authors.lastname: Lee
authors.forename: Sandra
authors.initials: S
authors.lastname: O'Reilly
authors.forename: Nancy B
authors.initials: NB
authors.lastname: Kiviat
authors.forename: Laura A
authors.initials: LA
authors.lastname: Koutsky
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D012307:Risk Factors; D013334:Students; D014621:Vagina / Q000821:virology*; D014626:Vaginal Smears
chemical_list: D004279:DNA, Viral