Type-specific persistence and associated risk factors of human papillomavirus infections in women living in central Italy

• Published in: European journal of obstetrics & gynecology and reproductive biology 2013-06, Vol.168 (2), p.222-226
• Main Authors: Sammarco, Michela L, Del Riccio, Ilenia, Tamburro, Manuela, Grasso, Guido M, Ripabelli, Giancarlo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alphapapillomavirus - classification; Alphapapillomavirus - growth & development; Alphapapillomavirus - isolation & purification; Cervix Uteri - microbiology; Cervix Uteri - virology; Chlamydia Infections - complications; Chlamydia Infections - epidemiology; Chlamydia Infections - microbiology; Chlamydia trachomatis; Chlamydia trachomatis - classification; Chlamydia trachomatis - growth & development; Chlamydia trachomatis - isolation & purification; Clearance; Female; Human papillomavirus; Humans; Italy - epidemiology; Longitudinal Studies; Microbial Viability; Middle Aged; Molecular Typing; Mycoplasma; Mycoplasma - classification; Mycoplasma - growth & development; Mycoplasma - isolation & purification; Mycoplasma Infections - complications; Mycoplasma Infections - epidemiology; Mycoplasma Infections - microbiology; Obstetrics and Gynecology; Papillomavirus; Papillomavirus Infections - complications; Papillomavirus Infections - epidemiology; Papillomavirus Infections - virology; Persistence; Prevalence; Reproductive Tract Infections - complications; Reproductive Tract Infections - epidemiology; Reproductive Tract Infections - virology; Risk Factors; Sexually Transmitted Diseases - complications; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - microbiology; Sexually Transmitted Diseases - virology; Vaginal Smears; Young Adult
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2013.01.012

Abstract Objective We examined persistence and clearance of human papillomavirus (HPV) infections and risk factors associated with persistence in 79 women based on the results of two sequential tests performed over 12–24 months. Study design Between February 2008 and August 2009, 398 women aged 18–63 years were examined for presence of cervical HPV infection by cervical scrape specimen and PCR. Detection was performed using Linear Array (LA) HPV Genotyping Test. All women were interviewed, and a short questionnaire was administered to collect information on socio-demographic characteristics, sexual and reproductive history, smoking habits, oral contraceptive use, history of sexually transmitted diseases, and Chlamydia trachomatis or Mycoplasma spp. infections. Pearson's χ2 test was used to verify the association between all independent variables with the response variable. Results Initially, high risk-HPV (HR-HPV) and low risk-HPV (LR-HPV) infection was detected in 69.6% and 30.4% of the women, respectively, whilst multiple infections occurred in 53.2%. HPV 16 was the most common (20.2%) high-risk type, followed by 52, 31 and 53. At follow-up, HR-HPV infection was detected in 50.6% of the women; among these, 67.5% had persistent infection, while 12.5% acquired other high-risk types, and 20.0% of those positive for LR-HPV at entry had a new HR-HPV infection. Multiple infections were detected in 38.0% of the women. HPV 16 and 31 were the most frequent types, followed by HPV 73. Type-specific HR-HPV persistence was found in 49.1% of women. HPV 31, 39 and 73 were the most frequently persistent types, whilst HPV 16 was the least persistent. No significant age difference between women with persistence or clearance was found. The highest HR-HPV persistence occurred in the 22–27 years old group, whereas clearance increased in women aged 28–33 years. No significant association between persistent HR-HPV infection and oral contraceptive use, smoking habits and history of sexually transmitted disease was detected both at entry and follow-up study. The association between C. trachomatis or Mycoplasma spp. and HPV persistence could not be investigated because of the low detection rate of these microorganisms. Conclusions The persistence of HR-HPV infection level was similar to that reported elsewhere, and HPV 31, 39 and 73 showed the highest likelihood of persistence, partially in agreement with other studies. The clinical relevance of the low persistence of HPV 16 and