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Older age associated with superior clearance of cervical HPV
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Non-viral determinants, including alcohol consumption and condom use by a sexual partner, were associated with cervical HPV acquisition in a natural history study.
To determine both viral and non-viral causes of HPV acquisition and clearance, researchers from the Cancer Research Center of Hawaii, University of Hawaii and the Kapiolani Medical Center for Women and Children in Honolulu, conducted the Hawaii Human Papillomavirus Cohort Study.
The study included 972 sexually active women aged between 18 and 85 years. The researchers conducted interviews and collected cervical cell specimens at baseline and every four months. Participants were followed during a mean of 15 months. At baseline, cervical HPV prevalence was 25.6%.
During follow-up, the researchers reported 476 genotype-specific infections; the incidence rates of high-risk and low-risk types were similar (9.26 per 1,000 person-months and 8.24 per 1,000 person-months). HPV-52, HPV-16 and HPV-31 were the most common high-risk types acquired and their incidence increased with a coexisting cervical HPV infection.
Age, income and long-term use of oral contraceptives were associated with a decrease in cervical HPV acquisition. Number of sexual partners, use of hormonal creams, alcohol consumption and condom use by a sexual partner were associated with an increase.
During follow-up, 265 of 476 incident infections were cleared, including 134 of 243 high-risk infections (median infection duration: 224 days; 95% CI, 169-248) and 131 of 233 low-risk infections (median infection duration: 180 days; 95% CI, 154-236). According to the researchers, within one year 69% of high-risk and 81% of low-risk infections had cleared.
Women aged 45 years or older cleared their infections faster than women aged younger than 25 years at baseline, according to the researchers. Women with a late age at menarche had a better clearance rate for high-risk HPV and women with three or more pregnancies experienced a reduced clearance.
Cancer Res. 2008;68:8813-8824.