Persistence of HPV infection and risk of high-grade cervical intraepithelial neoplasia in a cohort of Colombian women.
Persistence of HPV infection and risk of high-grade cervical intraepithelial neoplasia in a cohort of Colombian women.
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DOI：
10.1038/sj.bjc.6604972
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发表时间：
2009-04-07
影响因子：
8.8
通讯作者：
Munoz, A.
中科院分区：
文献类型：
--
作者：
Munoz, N.;Hernandez-Suarez, G.;Mendez, F.;Molano, M.;Posso, H.;Moreno, V.;Murillo, R.;Ronderos, M.;Meijer, C.;Munoz, A.
人们对人乳头瘤病毒 (HPV) 感染和随后发生的高级别宫颈上皮内瘤变 (CIN2/3) 的动态知之甚少，特别是在 30 岁以上的女性中。需要这些信息来评估 HPV 疫苗的影响并考虑新的筛查策略。对基线时细胞学检查正常的 1728 名 15-85 岁女性进行了随访，每 6 个月进行一次随访，平均随访时间为 9 年。患有鳞状上皮内病变的女性被转诊进行活检和治疗。 Kaplan-Meier 方法用于估计中位感染持续时间，并进行 Cox 回归分析来评估与 HPV 持续性相关的 CIN2/3 清除和风险的决定因素。除了 30 岁以下女性 HPV16 感染的清除率较低之外，未观察到 HPV 类型或女性年龄对清除可能性的影响。病毒载量与清除率呈负相关。总之，病毒载量是持续性的主要决定因素，HPV16 感染的持续性会带来更高的 CIN2/3 风险。
Little is known about the dynamics of human papillomavirus (HPV) infection and subsequent development of high-grade cervical intraepithelial neoplasia (CIN2/3), particularly in women >30 years of age. This information is needed to assess the impact of HPV vaccines and consider new screening strategies. A cohort of 1728 women 15–85 years old with normal cytology at baseline was followed every 6 months for an average of 9 years. Women with squamous intraepithelial lesions were referred for biopsy and treatment. The Kaplan–Meier method was used to estimate the median duration of infection and Cox regression analysis was undertaken to assess determinants of clearance and risk of CIN2/3 associated with HPV persistence. No difference in the likelihood of clearance was observed by HPV type or woman's age, with the exception of lower clearance for HPV16 infection in women under 30 years of age. Viral load was inversely associated with clearance. In conclusion, viral load is the main determinant of persistence, and persistence of HPV16 infections carry a higher risk of CIN2/3.
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