title: Disparity in the persistence of high-risk human papillomavirus genotypes between African American and European American women of college age.
abstract: BACKGROUND
  Cervical cancer incidence and mortality rates are higher in African Americans than in European Americans (white, non-Hispanic of European ancestry). The reasons for this disparity are not known.
  
  
  METHODS
  We recruited a population-based longitudinal cohort of 326 European American and 113 African American female college freshmen in Columbia, South Carolina, to compare clearance of high-risk human papillomavirus (HR-HPV) infection between ethnicities. HPV testing and typing from samples obtained for Papanicolaou testing occurred every 6 months.
  
  
  RESULTS
  African American participants had an increased risk of testing positive for HR-HPV, compared with European American participants, but the frequency of incident HPV infection was the same in African American and European American women. Thus, exposure to HPV could not explain the higher rate of HPV positivity among African American women. The time required for 50% of participants to clear HR-HPV infection was 601 days for African American women (n = 63) and 316 days for European American women (n = 178; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.08-2.53). African American women were more likely than European American women to have an abnormal result of a Papanicolaou test (OR, 1.58; 95% CI, 1.05-2.39).
  
  
  CONCLUSIONS
  We propose that the longer time to clearance of HR-HPV among African American women leads to increased rates of abnormal results of Papanicolaou tests and contributes to the increased rates of cervical cancer observed in African American women.
authors.affiliation: Department of Drug Discovery and Biomedical Sciences, College of Pharmacy.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Banister
authors.affiliation: Department of Drug Discovery and Biomedical Sciences, College of Pharmacy.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Messersmith
authors.affiliation: Department of Epidemiology and Biostatistics.
authors.forename: Bo
authors.initials: B
authors.lastname: Cai
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Spiryda
authors.affiliation: Department of Health Services Policy and Management Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health.
authors.forename: Saundra H
authors.initials: SH
authors.lastname: Glover
authors.affiliation: Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, Columbia.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pirisi
authors.affiliation: Department of Drug Discovery and Biomedical Sciences, College of Pharmacy.
authors.forename: Kim E
authors.initials: KE
authors.lastname: Creek
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000208:ethnology* / Q000821:virology; D012307:Risk Factors; D013022:South Carolina / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: HPV; HPV persistence; health disparities; human papillomavirus; viral clearance