title: Long-term persistence of prevalently detected human papillomavirus infections in the absence of detectable cervical precancer and cancer.
abstract: BACKGROUND
  Detailed descriptions of long-term persistence of human papillomavirus (HPV) in the absence of cervical precancer are lacking.
  
  
  METHODS
  In a large, population-based natural study conducted in Guanacaste, Costa Rica, we studied a subset of 810 initially HPV-positive women with ≥ 3 years of active follow-up with ≥ 3 screening visits who had no future evidence of cervical precancer. Cervical specimens were tested for >40 HPV genotypes using a MY09/11 L1-targeted polymerase chain reaction method.
  
  
  RESULTS
  Seventy-two prevalently-detected HPV infections (5%) in 58 women (7%) persisted until the end of the follow-up period (median duration of follow-up, 7 years) without evidence of cervical precancer. At enrollment, women with long-term persistence were more likely to have multiple prevalently-detected HPV infections (P < .001) than were women who cleared their baseline HPV infections during follow-up. In a logistic regression model, women with long-term persistence were more likely than women who cleared infections to have another newly-detected HPV infection detectable at ≥ 3 visits (odds ratio, 2.6; 95% confidence interval, 1.2-5.6).
  
  
  CONCLUSIONS
  Women with long-term persistence of HPV infection appear to be generally more susceptible to other HPV infections, especially longer-lasting infections, than are women who cleared their HPV infections.
authors.affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-7234, USA. castlep@mail.nih.gov
authors.forename: Philip E
authors.initials: PE
authors.lastname: Castle
authors.forename: Ana Cecilia
authors.initials: AC
authors.lastname: Rodríguez
authors.forename: Robert D
authors.initials: RD
authors.lastname: Burk
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
authors.forename: Sholom
authors.initials: S
authors.lastname: Wacholder
authors.forename: Allan
authors.initials: A
authors.lastname: Hildesheim
authors.forename: Jorge
authors.initials: J
authors.lastname: Morales
authors.forename: Greg
authors.initials: G
authors.lastname: Rydzak
authors.forename: Mark
authors.initials: M
authors.lastname: Schiffman
mesh_terms: D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000235:genetics / Q000472:pathogenicity*; D002584:Cervix Uteri / Q000821:virology; D003364:Costa Rica / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000821:virology; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000821:virology; D014626:Vaginal Smears