Determinants of Persistent Detection of Human Papillomavirus DNA in the Uterine Cervix

J. Brisson, I. Bairati, C. Morin, M. Fortier, C. Bouchard, A. Christen, P. Bernard, M. Roy, A. Meisels
1996 Journal of Infectious Diseases  
To identify factors associated with persistence of human papillomavirus (HPV) DNA in the uterine cervix, 179 women who were 18-49 years old and who had normal cytologies and positive cer~ical HPV DNA tests at a routine periodic examination were analyzed. Among them, 91 (50.8%) remained HPV-positive a few months (mean, 11 weeks) later. Persistence was higher in women who had used oral contraceptives for ;::2 years (odds ratio, 3.9; 95% confidence interval, 1.5-10.3) compared with those who never
more » ... ith those who never used oral contraceptives or used them for <2 years. HPV types 16, 18, and 31/33/35 appeared more persistent (odds ratio, 2.5; 95% confidence interval, 1.0-6.2) than other types. Persistence seemed to increase with virus load and decrease with increasing interval between examinations. Human papillomavirus (HPV) infection appears to play a critical role in the etiology of most cervical intraepithelial neoplasia (erN) and invasive cervical cancer [1] [2] [3] [4] . HPV DNA is found in a relatively large proportion of women [5], but presence of detectable viral DNA appears to be transient in many instances [6] [7] [8] [9] [10] [11] [12] [13] [14] . Persistence of HPV DNA has been hypothesized to be a determinant of the risk of cervical neoplasia [14] . The aim of this study was to assess potential determinants of persistent detection of HPV DNA in cervical cells. Materials and Methods Subjects. Women included in this analysis were recruited in six family practice physician clinics, the Laval University Health Clinic, and one gynecology clinic located in Quebec City. The family practice clinics were chosen in an attempt to ensure representation from the different neighborhoods in the Quebec City area. The gynecology and university clinics were added to include groups of women who are seen in contexts other than family physicians' offices. All participating clinics sent their Pap smears to the cytology laboratory of Saint-Sacrement Hospital for review. This laboratory evaluates~140,000 cervicovaginal smears each year and serves most Quebec City clinicians. Participating clinicians recruited women who consulted for a routine gynecologic examination. Women were eligible if they were 18-49 years old. This is the age group in which the incidence of crN is highest and when the prevalence of HPV infections also
doi:10.1093/infdis/173.4.794 pmid:8603956 fatcat:dz5jis4h7jewdknjxzsgusmujq