TY - JOUR
T1 - Human Papillomavirus Intermittence and Risk Factors Associated With First Detections and Redetections in the Ludwig-McGill Cohort Study of Adult Women
AU - Ludwig-McGill Cohort Study
AU - Malagón, Talía
AU - Trottier, Helen
AU - El-Zein, Mariam
AU - Villa, Luisa L.
AU - Franco, Eduardo L.
AU - Baggio, Maria Luiza
AU - Galan, Lenice
AU - Sobrinho, João Simão
AU - Prado, José Carlos Mann
AU - Termini, Lara
AU - Costa, Maria Cecília
AU - Miyamura, Romulo
AU - Trevisan, Andrea
AU - Thomann, Patricia
AU - Candeias, João
AU - Sichero, Laura
AU - Rahal, Paula
AU - Ruiz, Antonio
AU - Kaiano, Jane
AU - Santos, Monica
AU - Savio, Patricia
AU - Maciag, Paulo
AU - Rabachini, Tatiana
AU - Ferreira, Silvaneide
AU - Villa, Luisa
AU - El-Zein, Mariam
AU - Rousseau, Marie Claude
AU - Mahmud, Salaheddin
AU - Schlecht, Nicolas
AU - Trottier, Helen
AU - Richardson, Harriet
AU - Ferenczy, Alex
AU - Rohan, Thomas
AU - Chevarie-Davis, Myriam
AU - Louvanto, Karolina
AU - Tota, Joseph
AU - Shaw, Eileen
AU - Ramanakumar, Agnihotram
AU - Duarte, Eliane
AU - Kulaga, Sophie
AU - Robitaille, Juliette
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.
PY - 2023/8/15
Y1 - 2023/8/15
N2 - Background. We assessed the incidence and risk factors for first detection and redetection with the same human papillomavirus (HPV) genotype, and prevalence of cytological lesions during HPV redetections. Methods. The Ludwig-McGill cohort study followed women aged 18–60 years from São Paulo, Brazil in 1993–1997 for up to 10 years. Women provided cervical samples for cytology testing and HPV DNA testing at each visit. A redetection was defined as a recurring genotype-specific HPV positive result after 1 or more intervening negative visits. Predictors of genotype-specific redetection were assessed using adjusted hazard ratios (aHR) with Cox regression modeling. Results. In total, 2184 women contributed 2368 incident HPV genotype-specific first detections and 308 genotype-specific redetections over a median follow-up of 6.5 years. The cumulative incidence of redetection with the same genotype was 6.6% at 1 year and 14.8% at 5 years after the loss of positivity of the first detection. Neither age (aHR 0.90; 95% confidence interval [CI], .54–1.47 for ≥45 years vs < 25 years) nor new sexual partner acquisition (aHR 0.98; 95% CI, .70–1.35) were statistically associated with genotype-specific redetection. High-grade squamous intraepithelial lesion prevalence was similar during first HPV detections (2.9%) and redetection (3.2%). Conclusions. Our findings suggest many HPV redetections were likely reactivations of latent recurring infections.
AB - Background. We assessed the incidence and risk factors for first detection and redetection with the same human papillomavirus (HPV) genotype, and prevalence of cytological lesions during HPV redetections. Methods. The Ludwig-McGill cohort study followed women aged 18–60 years from São Paulo, Brazil in 1993–1997 for up to 10 years. Women provided cervical samples for cytology testing and HPV DNA testing at each visit. A redetection was defined as a recurring genotype-specific HPV positive result after 1 or more intervening negative visits. Predictors of genotype-specific redetection were assessed using adjusted hazard ratios (aHR) with Cox regression modeling. Results. In total, 2184 women contributed 2368 incident HPV genotype-specific first detections and 308 genotype-specific redetections over a median follow-up of 6.5 years. The cumulative incidence of redetection with the same genotype was 6.6% at 1 year and 14.8% at 5 years after the loss of positivity of the first detection. Neither age (aHR 0.90; 95% confidence interval [CI], .54–1.47 for ≥45 years vs < 25 years) nor new sexual partner acquisition (aHR 0.98; 95% CI, .70–1.35) were statistically associated with genotype-specific redetection. High-grade squamous intraepithelial lesion prevalence was similar during first HPV detections (2.9%) and redetection (3.2%). Conclusions. Our findings suggest many HPV redetections were likely reactivations of latent recurring infections.
KW - age
KW - cervical lesions
KW - human papillomavirus infections
KW - longitudinal studies
KW - recurrence
KW - risk factors
KW - virus latency
KW - women
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U2 - 10.1093/infdis/jiad043
DO - 10.1093/infdis/jiad043
M3 - Article
C2 - 36790831
AN - SCOPUS:85166956777
SN - 0022-1899
VL - 228
SP - 402
EP - 411
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -