title: Natural history of multiple human papillomavirus infections in female adolescents with prolonged follow-up.
abstract: OBJECTIVE
  The aim of the study was to better characterize the natural history of human papillomavirus (HPV) infections in female adolescents.
  
  
  METHODS
  Female adolescents were enrolled in a longitudinal study. Self-vaginal samples were obtained every 3 months and tested for HPV. No participants received HPV vaccination. The findings for 40 female adolescents with the longest follow-up are reported in this study.
  
  
  RESULTS
  Average age at the time of enrollment was 15.2 years (range: 14-17; SD: .97). Mean duration of follow-up was 6.7 years (range: 4.4-9.2; SD: 1.2). In all, 32 participants (80%) reported being involved in sexual activity before their enrollment in the study; all reported being involved in sexual activity before enrollment; all reported being involved in sexual activity during follow-up. Baseline and cumulative prevalence of HPV among participants was 55% and 100%, respectively. During the study, each participant tested positive for a mean of 14 HPV types. Cumulatively, HPV 16 was detected in 29 of 40 participants (72.5%). Mean duration of high- and low-risk infections was 655.9 (median: 433) and 524.1 days (median: 334), respectively.
  
  
  CONCLUSIONS
  With prolonged follow-up, HPV infections with multiple types were found in all participants. Most had infection with HPV-16 or HPV-18, the oncogenic types represented in current vaccines, as well as infection with other oncogenic types. These data reinforce the importance of vaccine and non-vaccine strategies for prevention of HPV infections.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA.
authors.forename: Bree
authors.initials: B
authors.lastname: Weaver
authors.forename: Marcia
authors.initials: M
authors.lastname: Shew
authors.forename: Brahim
authors.initials: B
authors.lastname: Qadadri
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.forename: Cheryl
authors.initials: C
authors.lastname: Denski
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
authors.forename: Darron
authors.initials: D
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008137:Longitudinal Studies; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012725:Sexual Behavior; D014505:Urban Population; D014626:Vaginal Smears