Natural history of persistent high-risk human papillomavirus infections in Korean women

Objective. This prospective study was performed to evaluate the clearance of high-risk human papillomavirus (HPV) infection and incidence of cytologic abnormality and cervical intraepithelial neoplasia (CIN) during the follow-up of persistent infection in Korean women. Methods. A total of 4170 women who were screened for cervical cancer, were aged 30 years or older, had no abnormal last Pap smear results for 3 years, had no history of treatment for cervical neoplastic disease, and were not pregnant were analyzed for high-risk HPV prevalence using the Hybrid capture (HC) II assay. The 224 women with normal cytology but positive for high-risk HPV DNA using the HC-II assay were analyzed for their clearance of HPV infection. Results. The median time to clearance in women with initially normal cytology was 7.5 months from initial detection (95% CI, 5.2-9.8 months). There were significant differences in the median time to clearance (4.5 vs. 14.5 months, p<0.001) of high-risk HPV infection between women with the initial relative light unit/cutoff (RLU/CO) ratio values <10.0 and >= 10.0, as determined by the HC-II assay. In Kaplan-Meier analysis, probability of development of cytologic abnormalities, CIN and high-grade CIN was 38.2%, 21.7% and 8.5% respectively at 24 months of persistent high-risk HPV infection. Conclusion. The prevalence and clearance of high-risk infection in Korean women was similar to that in Western countries. Persistent high-risk HPV infection was associated with high viral load. (C) 2009 Elsevier Inc. All rights reserved.