title: Prevalence, incidence and persistence of genital HPV infections in a large cohort of sexually active young women in the Netherlands.
abstract: BACKGROUND
  We assessed age- and type-specific HPV prevalence, incidence and persistence and their associated risk factors in young women prior to vaccination, to enable monitoring of the impact of introduction of HPV vaccination in the years before participation in the cervical screening program.
  
  
  METHODS
  The HPV status was assessed in 3282 women aged 16-29 who participated in a Chlamydia trachomatis screening implementation program, of which 2014 women (61%) participated in two rounds (one year apart). Self-collected vaginal swab were analyzed by SPF(10) LiPA on the presence of HPV DNA. Risk factors for prevalent, incident and persistent HPV infections were calculated using generalized estimating equation.
  
  
  RESULTS
  The prevalence of any HPV in the first round amounted to 54%, while 34% of the women who participated in the second round had a persistent infection and 45% an incident infection. The five most common HPV types found in this study were HPV16, -51, -52, -31 and -53. HPV16 and/or HPV18 prevalence, incidence and persistence in the second round were 15%, 8% and 9%, respectively and for HPV6 and/or HPV11 6%, 4% and 2%, respectively. Relatively to other HPV genotypes, hrHPV types were found more often as a persistent infection than as an incident infection. Furthermore, there is an age-dependent increase within this age range for persistent infections but not for incident infections.
  
  
  CONCLUSIONS
  The HPV prevalence (54%), incidence (45%) and persistence (34%) is high among sexually active young women in the Netherlands. The different HPV type distribution and risk factors for prevalent, incident and persistent infections, as well as the observed age-trends should be taken into account in interpreting data obtained after vaccine introduction. Repeating measurements post-immunization are particularly relevant until the age when screening starts (i.e. 30 years in the Netherlands).
authors.affiliation: Center for Infectious Disease Control Epidemiology and Surveillance Unit, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. madelief.mollers@rivm.nl
authors.forename: M
authors.initials: M
authors.lastname: Mollers
authors.forename: J
authors.initials: J
authors.lastname: Boot Hein
authors.forename: J
authors.initials: J
authors.lastname: Vriend Henrike
authors.forename: J
authors.initials: J
authors.lastname: King Audrey
authors.forename: V F
authors.initials: VF
authors.lastname: van den Broek Ingrid
authors.forename: E A M
authors.initials: EA
authors.lastname: van Bergen Jan
authors.forename: A T P
authors.initials: AT
authors.lastname: Brink Antoinette
authors.forename: F G
authors.initials: FG
authors.lastname: Wolffs Petra
authors.forename: J P A
authors.initials: JP
authors.lastname: Hoebe Christian
authors.forename: J L M
authors.initials: JL
authors.lastname: Meijer Chris
authors.forename: A B
authors.initials: AB
authors.lastname: van der Sande Marianne
authors.forename: E
authors.initials: E
authors.lastname: de Melker Hester
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D027383:Papillomaviridae / Q000276:immunology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines