title: Detection of oncogenic genital human papillomavirus (HPV) among HPV negative older and younger women after 7 years of follow-up.
abstract: The knowledge on risk factors of being human papillomavirus (HPV)-positive among older women is sparse. The aim was to determine the frequency of oncogenic HPV appearance after 7 years among initially HPV-negative women and to examine potential risk factors that influence the occurrence of HPV in older women using multiple logistic regression. For comparison, a younger cohort of women examined under identical study settings was included. This prospective cohort study comprised 1,577 older women (age 40-50 at enrolment) and 2,920 women aged 22-32. Participants were interviewed and underwent a gynecological examination at two time points (7 years apart). Cervical samples were tested for HPV using Hybrid Capture 2 (HC2) and only women who tested HC2-negative at baseline were included. The HPV prevalence among older and younger women was 6.4% and 10.7%, respectively, and there was no "second peak" observed among older women. Recent sexual partners were a strong determinant of HPV appearance irrespective of age. Lifetime number of sexual partners was a significant risk factor for HPV appearance among older women, even after adjustment for recent sexual behavior. In addition, menopause was associated with a non-significantly increased risk of HPV appearance at follow-up. In conclusion, appearance of HPV in previously HPV-negative older women may be due to both recent sexual behavior and previous exposure that is, reactivation of a latent HPV infection.
authors.affiliation: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Kim Agerholm
authors.initials: KA
authors.lastname: Brogaard
authors.forename: Christian
authors.initials: C
authors.lastname: Munk
authors.forename: Thomas
authors.initials: T
authors.lastname: Iftner
authors.forename: Kirsten
authors.initials: K
authors.lastname: Frederiksen
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjaer
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D055815:Young Adult
keywords: epidemiology; natural history; population-based; risk factors; sexual behavior