DIET AND DURATION OF CERVICAL HPV INFECTION

描述：(改编自《调查者摘要》)该项目将 建立多民族妇女队列，进行长期跟踪，以确定 影响人乳头瘤病毒持续或消退的因素 (人乳头瘤病毒)宫颈感染。具体目的是：1)学习 饮食中水果和蔬菜的摄入量与 HPV患者血浆类胡萝卜素、α-生育酚和维生素C水平 持久性；2)检查HPV类型、数量(病毒载量)和 HPV持久性中的多个(同步)HPV感染；以及3)检查 营养(例如，β-胡萝卜素)和病毒(例如，HPV)之间的相互作用 16)持续性HPV感染风险的因素。 由1,152名年龄在18岁及以上的HPV阳性女性组成的多民族队列将是 在去妇产科诊所就诊的患者中建立 火奴鲁鲁的三个大型医疗中心。该队列将包括 数量可观的亚洲人(日本人、菲律宾人、中国人、韩国人) 波利尼西亚人(夏威夷人、萨摩亚人)和高加索人妇女。这批人将是 以下是在基准线、月份收集的纵向数据 4、8个月、12个月、24个月和36个月(6次就诊)：(A)宫颈 细胞学(巴氏)涂片用于病理检查；(B)镜检查 宫颈显影以确认细胞学；(C)宫颈 用于HPV DNA分析的样本；及(D)用于测量微量营养素的血液样本 级别。一份简短的调查问卷将在基线和 将在第4个月进行扩大面谈，包括以下信息 饮食、烟酒使用、性史和生殖史。节食 每一次年度访问都将进行历史和后续访谈。 从队列成员那里获得的宫颈活检样本将由 研究病理学家和切片将免费存档 目前的研究。 对数据的分析将重点放在饮食和血浆的评估上 微量营养素水平和病毒特征影响 用广义估计方程(GEE)研究HPV感染的持久性 纠正重复测量之间的相关性的方法。 对这些因素的识别可以提供对自然环境的洞察 HPV感染史，并可能提高我们描述女性特征的能力 这些人患HPV相关肿瘤的风险最大。是这样的 知识也可能有助于发展适当的筛查。 涉及HPV DNA检测的策略，可能针对以下女性 将从密集的后续行动中受益最大。

DESCRIPTION: (Adapted from Investigator's Abstract) This project will establish a multiethnic cohort of women for long-term follow-up to identify factors that influence the persistence or resolution of human papillomavirus (HPV) infection of the uterine cervix. The specific aims are to 1) study the association of the dietary intake of fruits and vegetables, and the plasma levels of carotenoids, alpha-tocopherol, and vitamin C with HPV persistence; 2) examine the role of HPV type, quantity (viral load), and multiple (synchronous) HPV infections in HPV persistence; and 3) examine the interaction between nutritional (e.g., beta-carotene) and viral (e.g., HPV 16) factors on the risk of persistent HPV infection. A multiethnic cohort of 1,152 HPV-positive women, aged 18 and older, will be established among patients attending the obstetrics and gynecology clinics of three large medical centers in Honolulu. The cohort will include appreciable numbers of Asian (Japanese, Filipino, Chinese, Korean) Polynesian (Hawaiian, Samoan) and Caucasian women. The cohort will be followed longitudinally with the following data collected at baseline, month 4, month 8, month 12, month 24 and month 36 (6 visits): (a) a cervical cytological (Pap) smear for pathological review; (b) colposcopic visualization of the cervix for confirmation of cytology; (c) a cervical sample for HPV DNA analysis; and (d) a blood sample to measure micronutrient levels. An abbreviated questionnaire will be administered at baseline and an expanded interview will be conducted at month 4 including information on diet, tobacco and alcohol use, and sexual and reproductive history. A diet history and follow-up interview will be conducted at each annual visit. Cervical biopsy specimens obtained from cohort members will be reviewed by the study pathologist and sections will be archived at no cost to the present study. Analysis of the data will focus on the evaluation of dietary and plasma micronutrient levels and viral characteristics that influence the persistence of HPV infection using a generalized estimating equation (GEE) approach that corrects for the correlation between the repeated measures. The identification of these factors may provide insight into the natural history of HPV infection, and may improve our ability to characterize women who are at greatest risk for developing HPV-associated neoplasia. Such knowledge may also assist in the development of appropriate screening strategies involving HPV DNA detection that could be targeted at women who would benefit most from intensive follow-up.