title: Episodic detection of human papillomavirus within a longitudinal cohort of young women.
abstract: Redetection of a type-specific human papillomavirus (HPV) infection may represent reinfection. However, a growing body of literature suggests that reactivation of HPV is common and that episodic detection of a HPV infection may represent reactivation of a persistent virus. A cohort of prospectively followed adolescent women (N = 150), ages 14-17, was observed on average 6.4 years. The authors describe the redetection of 37 HPV types and associated factors of redetection of high-risk (HR) and low-risk (LR) types using Cox proportional hazard models. Of 1,248 HPV type-specific infections, 286 (22.9%) were associated with redetection after apparent clearance. Chlamydia infections (HR = 1.99 [95%CI, 1.15-3.49]) and non-condom use (HR = 1.1 [95%CI, 1.04-1.99]) were associated with increased redetection of HR-HPV infections. Oral contraceptive pills (HR = 2.73 [95%CI, 1.52-4.90]) and number of sexual partners (HR = 1.44 [95%CI, 1.04-1.99]) were associated with increased redetection of LR-HPV infections. Episodic detection of HPV is common for HR- and LR-HPV types. This finding and identified factors or redetection have clinical implications and enhances the understanding of HPV natural history.
authors.affiliation: Departments of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Shew
authors.affiliation: Departments of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Ermel
authors.affiliation: Departments of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.affiliation: Departments of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.affiliation: Departments of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Brahim
authors.initials: B
authors.lastname: Qadadri
authors.affiliation: Departments of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.|Departments of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Darron R
authors.initials: DR
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000150:complications; D005260:Female; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D027383:Papillomaviridae / Q000145:classification* / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012725:Sexual Behavior; D014775:Virus Activation
keywords: episodic detection; human papillomavirus; latency; sexual behaviors; sexually transmitted infections