The natural history of human papillomavirus infection and cervical Intraepithelial neoplasia among young women in the guanacaste cohort shortly after initiation of sexual life
The natural history of human papillomavirus infection and cervical Intraepithelial neoplasia among young women in the guanacaste cohort shortly after initiation of sexual life
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DOI：
10.1097/01.olq.0000251241.03088.a0
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发表时间：
2007-07-01
影响因子：
3.1
通讯作者：
Schiffman, Mark
中科院分区：
文献类型：
--
作者：
Rodriguez, Ana Cecilia;Burk, Robert;Schiffman, Mark
目的：我们对10，000名妇女的横断面分析，以人群为基础的瓜纳卡斯特队列研究表明，人乳头瘤病毒（HPV）感染的高峰期与后来的宫颈上皮内瘤变3级（CIN 3）高峰期之间存在≥ 10年的滞后期。我们想探索早期HPV自然史和CIN 3 prospectively.Study Design：作为Guanacaste队列的一部分，我们每半年随访206名年龄在18至26岁的初次处女女性，平均随访时间为3.6年，开始性生活后。很少有感染持续>1至2年。3名妇女经组织学证实为CIN 3，其中2名显示持续性HPV 16。另1例血清学检查有HPV31感染的证据。结论：HPV感染在大多数初次性交的年轻女性中发生率高，且感染后迅速清除。持续性HPV 16可导致早期CIN 3。CIN 3的高峰年龄将随着纵向研究的筛查强度和敏感性的增加而下降。
Objective: Cross-sectional analyses of our 10,000-woman, population-based Guanacaste cohort suggest a lag of >= 10 years between the peak of human papillomavirus (HPV) infection and the later peak of cervical intraepithelial neoplasia grade 3 (CIN 3). We wanted to explore early HPV natural history and CIN 3 prospectively.Study Design: As part of the Guanacaste cohort, we followed 206 initially virginal women aged 18 to 26 semiannually for a median of 3.6 years after initiation of sexual life.Results: A total of 53.4% of women tested positive during the study for 1 HPV type. Very few infections persisted for >1 to 2 years. Three women had histologically confirmed CIN 3, of which 2 showed persistent HPV 16. The other had serologic evidence of HPV 31.Conclusions: HPV infection occurs frequently and clears rapidly in most young women initiating sexual intercourse. Persistent HPV 16 can cause early CIN 3. The peak age for CIN 3 will decline with the increased screening intensity and sensitivity typical of longitudinal studies.