Persistence and clearance of human papillomavirus infection: a prospective cohort study.
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.
Rosa
Maria Inês
MI
Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Criciúma, Brazil.
Fachel
Jandira M G
JM
Rosa
Daniela D
DD
Medeiros
Lidia R
LR
Igansi
Cristine N
CN
Bozzetti
Mary C
MC
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*
D015344:DNA Probes, HPV