title: Combined oral contraceptive use increases HPV persistence but not new HPV detection in a cohort of women from Thailand.
abstract: BACKGROUND
  Women diagnosed with cervical cancer report longer duration and more recent use of combined oral contraceptives (COCs). It is unclear how COC use impacts risk of cervical carcinogenesis.
  
  
  METHODS
  We estimated the risk of new human papillomavirus (HPV) DNA detection and persistence among 1135 human immunodeficiency virus (HIV)-negative women aged 20-37 years from Thailand who were followed for 18 months at 6-month intervals. Type-specific HPV DNA, demographic information, hormonal contraceptive use, sexual behavior, genital tract coinfection, and Papanicolaou test results were assessed at baseline and each follow-up.
  
  
  RESULTS
  Women who reported current COC use during follow-up were less likely to clear HPV infection compared with nonusers, independent of sexual behavior, and Papanicolaou test diagnosis (AHR: 0.67 [95% CI: .49-.93]). Similar associations were not observed among women reporting current use of depomedroxyprogesterone acetate (DMPA). Neither COC nor DMPA use was significantly associated with new HPV DNA detection.
  
  
  CONCLUSIONS
  These data do not support the hypothesis that contraceptive use is associated with cervical cancer risk via increased risk of HPV acquisition. The increased risk of HPV persistence observed among current COC users suggests a possible influence of female sex hormones on host response to HPV infection.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Marks
authors.forename: Patti E
authors.initials: PE
authors.lastname: Gravitt
authors.forename: Swati B
authors.initials: SB
authors.lastname: Gupta
authors.forename: Kai-Li
authors.initials: KL
authors.lastname: Liaw
authors.forename: Amha
authors.initials: A
authors.lastname: Tadesse
authors.forename: Esther
authors.initials: E
authors.lastname: Kim
authors.forename: Chailert
authors.initials: C
authors.lastname: Phongnarisorn
authors.forename: Virach
authors.initials: V
authors.lastname: Wootipoom
authors.forename: Pissimai
authors.initials: P
authors.lastname: Yuenyao
authors.forename: Charoen
authors.initials: C
authors.lastname: Vipupinyo
authors.forename: Somchai
authors.initials: S
authors.lastname: Sriplienchan
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D015331:Cohort Studies; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D015344:DNA Probes, HPV; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D020411:Oligonucleotide Array Sequence Analysis; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000139:chemically induced / Q000175:diagnosis / Q000821:virology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012075:Remission, Spontaneous; D012307:Risk Factors; D014626:Vaginal Smears
chemical_list: D003277:Contraceptives, Oral, Combined; D015344:DNA Probes, HPV