title: Persistence and clearance of human papillomavirus infection: a prospective cohort study.
abstract: OBJECTIVE
  The objective of the study was to identify epidemiological correlates for persistence and clearance of human papillomavirus (HPV) infection.
  
  
  METHODS
  Cervical smears collected in a prospective cohort study to perform Papanicoloau cytology and HPV deoxyribonucleic acid (DNA) detection at baseline and during the follow-up. Outcomes analyzed were: (1) persistence of HPV DNA; (2) conversion; and (3) clearance of HPV.
  
  
  RESULTS
  Among 501 women the incidence of HPV was 12.3%. Thirty-four women were persistently infected with HPV, which was associated with age below 21 years at first intercourse and 4 or more sexual partners during their lifetime. In a median of 19 months, 80.7% of women had clearance of HPV, which was associated with black race, coinfection with Chlamydia trachomatis at baseline, and a history of previous Papanicoloau smear.
  
  
  CONCLUSIONS
  Strategies for sexual orientation may modify the rates of HPV persistence. The association of HPV clearance with a history of previous Papanicolaou smear screening highlights the importance of improving cervical screening programs. Further studies on the association of gynecological infections with HPV clearance are needed.
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Criciúma, Brazil.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Rosa
authors.forename: Jandira M G
authors.initials: JM
authors.lastname: Fachel
authors.forename: Daniela D
authors.initials: DD
authors.lastname: Rosa
authors.forename: Lidia R
authors.initials: LR
authors.lastname: Medeiros
authors.forename: Cristine N
authors.initials: CN
authors.lastname: Igansi
authors.forename: Mary C
authors.initials: MC
authors.lastname: Bozzetti
mesh_terms: D000328:Adult; D017677:Age Distribution; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D002908:Chronic Disease; D015344:DNA Probes, HPV; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification* / Q000378:metabolism; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000821:virology*
chemical_list: D015344:DNA Probes, HPV