Natural history of cervicovaginal papillomavirus infection in young women

被引:1841
作者
Ho, GYF
Bierman, R
Beardsley, L
Chang, CJ
Burk, RD
机构
[1] Yeshiva Univ Albert Einstein Coll Med, Albert Einstein Canc Ctr, Bronx, NY 10461 USA
[2] Yeshiva Univ Albert Einstein Coll Med, Dept Epidemiol & Social Med, Bronx, NY 10461 USA
[3] Yeshiva Univ Albert Einstein Coll Med, Dept Pediat, Bronx, NY 10461 USA
[4] Yeshiva Univ Albert Einstein Coll Med, Dept Microbiol & Immunol, Bronx, NY 10461 USA
[5] Rutgers State Univ, Student Hlth Serv, New Brunswick, NJ 08903 USA
关键词
D O I
10.1056/NEJM199802123380703
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Genital human papillomavirus (HPV) infection is highly prevalent in sexually active young women. However, precise risk factors for HPV infection and its incidence and duration are not well known. Methods We followed 608 college women at six-month intervals for three years. At each visit, we collected information about lifestyle and sexual behavior and obtained cervicovaginal-lavage samples for the detection of HPV DNA by polymerase chain reaction and Southern blot hybridization. Pap smears were obtained annually. Results The cumulative 36-month incidence of HPV infection was 43 percent (95 percent confidence interval, 36 to 49 percent). An increased risk of HPV infection was significantly associated with younger age, Hispanic ethnicity, black race, an increased number of vaginal-sex partners, high frequencies of vaginal sex and alcohol consumption, anal sex, and certain characteristics of partners (regular partners having an increased number of lifetime partners and not being in school). The median duration of new infections was 8 months (95 percent confidence interval, 7 to 10 months). The persistence of HPV for greater than or equal to 6 months was related to older age, types of HPV associated with cervical cancer, and infection with multiple types of HPV but not with smoking. The risk of an abnormal Pap smear increased with persistent HPV infection, particularly with high-risk types (relative risk, 37.2; 95 percent confidence interval, 14.6 to 94.8). Conclusions The incidence of HPV infection in sexually active young college women is high. The short duration of most HPV infections in these women suggests that the associated cervical dysplasia should be managed conservatively. (C) 1998, Massachusetts Medical Society.
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页码:423 / 428
页数:6
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