title: Trends in HPV cervical and seroprevalence and associations between oral and genital infection and serum antibodies in NHANES 2003-2012.
abstract: BACKGROUND
  HPV infects multiple sites in the epithelium, including the genitals and oral cavity. The relation between genital and oral infections and serum antibodies can help explain the natural history and epidemiology of HPV.
  
  
  METHODS
  We analyzed HPV data from NHANES derived from self-collected vaginal swabs (women ages 14-59, 2003-12), oral rinses (men and women 14-69, 2009-12), and serum (men and women 14-59, 2003-10).
  
  
  RESULTS
  Type-concordance of cervicogenital and oral infections in women was found to vary widely by age. Prevalence of oral infections with type-concordant antibodies was low but varied by sex: 0.2 % (95 % CI 0.0-0.8) for women vs 0.8 % (95 % CI 0.4-1.3) for men. Vaccination was associated with a reduced risk of cervicogenital infection for vaccine genotypes among ages 14-17 (0.2 (95 % CI 0.1-0.8)) and 18-24 (0.2 (95 % CI 0.1-0.3). Seroprevalence trends in women showed a dramatic increase for recent birth cohorts, likely due to vaccination. By contrast, trends for men remained relatively constant. Age-specific cervicogenital prevalence showed a consistent peak in the late teens and twenties. Relative cervicogenital prevalence has largely been decreasing since the 1940-50 birth cohort.
  
  
  CONCLUSIONS
  There are complex patterns in HPV prevalence trends and type-concordance across infection sites and serum antibodies. A multisite sampling scheme is needed to better understand the epidemiology and natural history of HPV.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, 48109, USA.|Department of Mathematics, University of Michigan, Ann Arbor, 48109, USA.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Brouwer
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, 48109, USA.
authors.forename: Marisa C
authors.initials: MC
authors.lastname: Eisenberg
authors.affiliation: Department of Otorhinolaryngology, University of Michigan, Ann Arbor, 48109, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Carey
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, 48109, USA. rmeza@umich.edu.
authors.forename: Rafael
authors.initials: R
authors.lastname: Meza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology* / Q000821:virology; D009749:Nutrition Surveys; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D015995:Prevalence; D016036:Seroepidemiologic Studies; D015229:Sexually Transmitted Diseases, Viral / Q000097:blood / Q000453:epidemiology*; D002577:Uterine Cervical Diseases / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral