title: Incidence, persistence, and determinants of human papillomavirus infection in a population of Inuit women in northern Quebec.
abstract: BACKGROUND
  To study the incidence, persistence, and determinants of human papillomavirus (HPV) infection in a population of Inuit women from Nunavik, Quebec, by overall HPV infection, Alphapapillomavirus (α) species, and oncogenic risk grouping.
  
  
  METHODS
  We recruited a cohort of Inuit women living in communities in Nunavik when they presented for routine care. Baseline sociodemographic and lifestyle characteristics were collected and cervical specimens collected throughout the follow-up period were tested for HPV-DNA using the PGMY Line-blot assay.
  
  
  RESULTS
  A total of 416 women were eligible for this analysis. Almost 40% of women acquired a new any-type HPV infection, at a rate of 14.44 infections per 1000 women-months. High-risk HPV infections were acquired at a higher rate than low-risk infections and persisted for longer durations. Multivariate logistic regression found age and marital status to be the most important predictors of overall HPV infection acquisition. Over the study period, 36.1% of women cleared their incident infections. The cumulative incidence of any HPV type at 12 months was 10.3% (95% confidence interval, 7.9-13.1). No predictors of clearance were found.
  
  
  CONCLUSIONS
  The high incidence and persistence of HPV infections found demonstrate that this population is at high risk for HPV infection. These data provide a deeper understanding of the HPV infection experience of Inuit women, but they may also help evaluate vaccination strategies currently used for this high-risk population.
authors: From the *Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada; †Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Canada; Departments of ‡Oncology and §Medicine, McGill University, Montreal, Canada; and ¶Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, Canada.
authors: Rachel
authors: R
authors: Bennett
authors: Helen
authors: H
authors: Cerigo
authors: François
authors: F
authors: Coutlée
authors: Michel
authors: M
authors: Roger
authors: Eduardo L
authors: EL
authors: Franco
authors: Paul
authors: P
authors: Brassard
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D002584:Cervix Uteri / Q000821:virology*; D002648:Child; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000453:epidemiology; D006266:Health Education; D006801:Humans; D015994:Incidence; D004930:Inuit / Q000706:statistics & numerical data*; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D015995:Prevalence; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D012572:School Health Services; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D004279:DNA, Viral; D053918:Papillomavirus Vaccines