title: Association of Chlamydia trachomatis infection with redetection of human papillomavirus after apparent clearance.
abstract: BACKGROUND
  Persistent infection with oncogenic human papillomavirus (HPV) is associated with an increased risk of cervical malignancy. Redetection of type-specific HPV after a period of nondetection may be caused by reactivation of a low-level persistent infection. Little is known about factors associated with type-specific HPV redetection.
  
  
  METHODS
  For a longitudinal cohort of adolescent women with frequent behavioral and sexually transmitted infection (STI) information (every 3 months), Cox proportional hazard models were used to assess the influence of sexual behaviors and STIs on the redetection of oncogenic or high-risk HPV infections.
  
  
  RESULTS
  A total of 210 type-specific high-risk HPV detection episode periods were identified in this longitudinal cohort; 71 (33.8%) were characterized by a period of nondetection followed by redetection. Chlamydia trachomatis (hazard ratio [HR], 3.14; 95% confidence interval [CI], 1.44-6.86) was associated with redetection; redetection was >2 times more likely with each additional self-reported sex partner in the past 3 months (HR, 2.26; 95% CI, 1.35-3.78).
  
  
  CONCLUSIONS
  This study demonstrates the role of C. trachomatis and number of recent sexual partners in type-specific HPV redetection. Given that persistent oncogenic HPV infections are associated with cancer-related outcomes, understanding the potential role of such factors in the pathogenesis of HPV-related outcomes is important.
authors.affiliation: Departments of Pediatrics.
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Shew
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Ermel
authors.forename: Bree A
authors.initials: BA
authors.lastname: Weaver
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.forename: Laura M
authors.initials: LM
authors.lastname: Kester
authors.forename: Cheryl
authors.initials: C
authors.lastname: Denski
authors.forename: J D
authors.initials: JD
authors.lastname: Fortenberry
authors.forename: Darron R
authors.initials: DR
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D002692:Chlamydia trachomatis; D060085:Coinfection / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D012008:Recurrence; D012725:Sexual Behavior; D012747:Sexual Partners
keywords: HPV redetection; chlamydia; human papillomavirus
references.citation: J Natl Cancer Inst. 2005 Apr 20;97(8):577-86
references.pmid: 15840880
references.citation: Obstet Gynecol. 2010 Jun;115(6):1150-1158
references.pmid: 20502284
references.citation: Arch Pediatr Adolesc Med. 2012 Aug;166(8):774-6
references.pmid: 22869412
references.citation: APMIS. 2010 Jun;118(6-7):422-49
references.pmid: 20553526
references.citation: Arch Pediatr Adolesc Med. 2006 Feb;160(2):151-6
references.pmid: 16461870
references.citation: Cancer Epidemiol Biomarkers Prev. 2011 Apr;20(4):699-707
references.pmid: 21173170
references.citation: JAMA. 2001 Jan 3;285(1):47-51
references.pmid: 11150108
references.citation: J Clin Invest. 2011 Dec;121(12):4593-9
references.pmid: 22133884
references.citation: Vaccine. 2006 Aug 31;24 Suppl 3:S3/42-51
references.pmid: 16950017
references.citation: J Adolesc Health. 2011 May;48(5):473-80
references.pmid: 21501806
references.citation: J Clin Microbiol. 2011 Dec;49(12):4185-9
references.pmid: 21998422
references.citation: J Infect Dis. 2005 Jan 15;191(2):182-92
references.pmid: 15609227
references.citation: Int J Cancer. 2000 Jan 1;85(1):35-9
references.pmid: 10585579
references.citation: J Infect Dis. 2013 Jan 15;207(2):272-80
references.pmid: 23242540
references.citation: J Natl Cancer Inst. 2010 Dec 1;102(23):1794-804
references.pmid: 21098758
references.citation: Am J Epidemiol. 2005 Oct 1;162(7):668-75
references.pmid: 16120706
references.citation: J Clin Microbiol. 2011 Aug;49(8):3029-32
references.pmid: 21632892
references.citation: J Med Virol. 2011 Aug;83(8):1362-9
references.pmid: 21678439
references.citation: Cancer Epidemiol Biomarkers Prev. 2010 Dec;19(12):3044-54
references.pmid: 20952561
references.citation: Sex Transm Dis. 2001 May;28(5):247-51
references.pmid: 11354261
references.citation: J Acquir Immune Defic Syndr. 2009 Jul 1;51(3):274-82
references.pmid: 19387354
references.citation: J Virol Methods. 2010 Oct;169(1):154-61
references.pmid: 20670658
references.citation: Cancer Res. 2010 Nov 1;70(21):8569-77
references.pmid: 20978200
references.citation: Sex Transm Infect. 2011 Aug;87(5):372-6
references.pmid: 21471141
references.citation: Int J Cancer. 2002 Oct 1;101(4):371-4
references.pmid: 12209962
references.citation: Open Virol J. 2012;6:190-7
references.pmid: 23341854
references.citation: Future Virol. 2011 Jan 1;6(1):45-57
references.pmid: 21318095