Determinants of human papillomavirus 16 serological conversion and persistence in a population-based cohort of 10 000 women in Costa Rica

S. S. Wang, M. Schiffman, R. Herrero, J. Carreon, A. Hildesheim, A. C. Rodriguez, M. C. Bratti, M. E. Sherman, J. Morales, D. Guillen, M. Alfaro, B. Clayman, R. D. Burk, R. P. Viscidi

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69 Scopus citations


Determinants of human papillomavirus (HPV)-16 serological conversion and persistence were assessed in a population-based cohort of 10049 women in Guanacaste, Costa Rica. Serologic responses to HPV-16 were measured in 7986 women by VLP-based enzyme-linked immunosorbent assay at both study enrolment (1993/94) and at 5-7 years of follow-up. Seropositive women were defined as ≥ 5 standard deviations above the mean optical density obtained for studied virgins at enrolment (n = 573). Seroconnversion (n = 409), persistence (n = 675), and clearance (n = 541) were defined based on enrolment and follow-up serology measurements. Age-specific distributions revealed that HPV-16 seroconversion was highest among 18- to 24-year-old women, steadily declining with age; HPV-16 seropersistence was lowest in women 65 + years. In age-adjusted multivariate logistic regression models, a 10-fold risk increase for HPV-16 seroconversion was associated with HPV-16 DNA detection at enrolment and follow-up; two-fold risk of seroconversion to HPV-16 was associated with increased numbers of lifetime and recent sexual partners and smoking status. Determinants of HPV-16 seropersistence included a 1.5-fold risk increase associated with having one sexual partner during follow-up, former oral contraceptive use, and a 3-fold risk increase associated with HPV-16 DNA detection at both enrolment and follow-up. Higher HPV-16 viral load at enrolment was associated with seroconversion, and higher antibody titres at enrolment were associated with seropersistence.

Original languageEnglish (US)
Pages (from-to)1269-1274
Number of pages6
JournalBritish Journal of Cancer
Issue number7
StatePublished - Oct 4 2004


  • Cancer
  • Cervix
  • Conversion
  • HPV
  • Persistence
  • Serology

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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