Early natural history of incident, type-specific human papillomavirus infections in newly sexually active young women.
Early natural history of incident, type-specific human papillomavirus infections in newly sexually active young women.
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DOI：
10.1158/1055-9965.epi-10-1108
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发表时间：
2011-04
期刊：
影响因子：
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通讯作者：
Koutsky LA
中科院分区：
文献类型：
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作者：
Winer RL;Hughes JP;Feng Q;Xi LF;Cherne S;O'Reilly S;Kiviat NB;Koutsky LA
描述年轻女性甲型人乳头瘤病毒 (HPV) 感染的短期检测模式可能会进一步了解 HPV 传播。 2000 年至 2007 年间，我们对 18 至 22 岁的女大学生进行了三年一次的 HPV DNA 和 Papanicolau 检测跟踪。使用 Kaplan-Meier 方法，我们估计了： 可检测到的特定类型事件感染的持续时间；重新检测的时间（无法检测到的感染）；以及事件感染后宫颈病变发展的时间。我们通过逻辑回归评估了短期持续性感染与短暂性感染的危险因素。在 85 名性活跃女性中检测到 303 起事件类型特异性感染。感染事件后首次检测呈阴性的中位时间为 9.4 (95%CI:7.8–11.2) 个月； 90.6% 的感染在两年内变得无法检测。 19.4% 无法检测到的感染在一年内被重新检测到。宫颈病变很常见，60% 的宫颈拭子检测结果显示多种 HPV 类型呈阳性。仅在子宫颈（相对于仅外阴/阴道或两个部位）检测到的 HPV 事件与短期短暂性相关。虽然大多数事件感染在两年内就无法检测到，但重新检测到的情况并不少见。宫颈病变是HPV感染的常见早期表现。目前尚不清楚是否可以识别潜在的可改变的风险因素来减少感染持续时间（和传播可能性）。
Characterizing short-term detection patterns of young women’s incident alpha-genus human papillomavirus (HPV) infections may further understanding of HPV transmission. Between 2000–2007, we followed 18–22 year old female university students with triannual HPV DNA and Papanicolau testing. Using Kaplan-Meier methods, we estimated: duration of detectable, type-specific incident infections; time to re-detection (among infections that became undetectable); and time to cervical lesion development after incident infection. We evaluated risk factors for short-term persistent versus transient infection with logistic regression. 303 incident type-specific infections were detected in 85 sexually active women. Median time to first negative test after incident infection was 9.4 (95%CI:7.8–11.2) months; 90.6% of infections became undetectable within two years. 19.4% of infections that became undetectable were re-detected within one year. Cervical lesions were common, and 60% were positive for multiple HPV types in concurrent cervical swabs. Incident HPV detection in the cervix only (versus the vulva/vagina only or both sites) was associated with short-term transience. While most incident infections became undetectable within two years, re-detection was not uncommon. Cervical lesions were a common early manifestation of HPV infection. It remains unclear whether potentially modifiable risk factors can be identified to reduce infection duration (and transmission likelihood).