title: Cervical HPV natural history among young Western Cape, South African women: The randomized control EVRI Trial.
abstract: OBJECTIVE
  The objective of this analysis was to assess human papillomavirus (HPV) infection persistence and incidence 7-months post-enrollment by HPV vaccine study arm (vaccine or placebo).
  
  
  METHODS
  HIV-negative, sexually active women aged 16-24 years in the Western Cape, South Africa, were enrolled in the EVRI Trial and were randomized to receive 4-valent HPV vaccine or placebo. Cervical specimens were collected at enrollment and at the 7-month visit and were genotyped for HPV. HPV prevalence, persistence, and incidence were calculated. Prevalence ratios and odds ratios were calculated to assess factors associated with a prevalent and incident HPV infection.
  
  
  RESULTS
  HPV incidence rates were marginally higher for the placebo group (n = 163) compared to the vaccine group (n = 169). A large proportion of the prevalent high-risk (HR-HPV) HPV types (49%) persisted over the 7-month period in both arms. Prevalent HR-HPV infection was significantly associated with a prevalent gonorrhea infection and detection of Herpes simplex type 2 antibodies. Incident HR-HPV infection was significantly associated with abnormal cervical cytology at enrollment and younger age.
  
  
  CONCLUSIONS
  Women living in geographic areas, such as southern Africa, at high-risk for HPV need to receive HPV vaccination at a very young age to maximally prevent infection and subsequent disease.
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Staci L
authors.initials: SL
authors.lastname: Sudenga
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: B Nelson
authors.initials: BN
authors.lastname: Torres
authors.affiliation: Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa.
authors.forename: Matthys H
authors.initials: MH
authors.lastname: Botha
authors.affiliation: Department of Medicine and Centre for Infectious Diseases, Stellenbosch University, Cape Town, South Africa.
authors.forename: Michele
authors.initials: M
authors.lastname: Zeier
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Abrahamsen
authors.affiliation: Division of Medical Virology, Stellenbosch University and NHLS Tygerberg, Cape Town, South Africa.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Glashoff
authors.affiliation: Division of Medical Virology, Stellenbosch University and NHLS Tygerberg, Cape Town, South Africa.
authors.forename: Susan
authors.initials: S
authors.lastname: Engelbrecht
authors.affiliation: Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Center for Infection and Immunity Amsterdam (CINIMA), Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Maarten F
authors.initials: MF
authors.lastname: Schim Van der Loeff
authors.affiliation: Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa.
authors.forename: Louvina E
authors.initials: LE
authors.lastname: Van der Laan
authors.affiliation: Department of Obstetrics and Gynaecology and Unit for Gynaecological Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kipping
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Taylor
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA. Electronic address: Anna.Giuliano@moffitt.org.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Clinical trial; EVRI; HPV vaccine; STIs