Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women

Ralph P. Insinga, Gonzalo Perez, Cosette M. Wheeler, Laura A. Koutsky, Suzanne M. Garland, Sepp Leodolter, Elmar A. Joura, Daron Gale Ferris, Marc Steben, Darron R. Brown, Elamin H. Elbasha, Jorma Paavonen, Richard M. Haupt

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Background: We describe the incidence and duration of cervical human papillomavirus (HPV) infection episodes along with the risk of infection reappearance following a period of nondetection. Methods:Women (1,788) ages 16 to 23 years underwent cytologic testing and PCR-based testing of cervical swab samples for HPV DNA (HPV-16/18/31/33/35/45/52/58/59) at ∼6-month intervals for up to 4 years in the context of a phase 3 clinical trial (placebo arm). HPV type - specific incidence rates were estimated per 100 person-years. Duration of type-specific cervical infection episodes and risk of reappearance following a period of nondetection were estimated using Kaplan-Meier methods. Results: HPV-16 exhibited the highest (5.9), and HPV-35 and HPV-33 exhibited the lowest (1.0) incidence rates per 100 person-years. Mean cervical infection durations ranged from 13 months for HPV-59 to 20 months for HPV-16 and 58 (with ongoing infections censored at the time of treatment, if done). The risk of cervical infection reappearance within ∼3 years following a period of nondetection ranged from 0% to 16% across HPV types, with a mean of 8%. Limited evidence was found for a role of false-positive HPV tests, missed infections that were above the threshold for detection, or new acquisition of infection in accounting for patterns of infection reappearance. Conclusions: Incidence of high-risk cervical infection was observed to vary considerably more across HPV types than infection duration. A nontrivial proportion of women exhibited infection reappearance following a period of nondetection, with a potential explanation for many such events observed within this analysis being a return to detectable levels of a previously acquired infection. Impact: The risk of HPV infection reappearance following a period of nondetection has not been previously reported for individual HPV types, and this study finds that a nontrivial proportion of infected women exhibit reappearances. Future studies could ascertain subject-level factors that potentially modify the risk of infection reappearance.

Original languageEnglish (US)
Pages (from-to)1585-1594
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume19
Issue number6
DOIs
StatePublished - Jan 1 2010

Fingerprint

Papillomavirus Infections
Incidence
Infection
Human papillomavirus 16
Human papillomavirus 18
Phase III Clinical Trials
Placebos

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Insinga, R. P., Perez, G., Wheeler, C. M., Koutsky, L. A., Garland, S. M., Leodolter, S., ... Haupt, R. M. (2010). Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women. Cancer Epidemiology Biomarkers and Prevention, 19(6), 1585-1594. https://doi.org/10.1158/1055-9965.EPI-09-1235

Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women. / Insinga, Ralph P.; Perez, Gonzalo; Wheeler, Cosette M.; Koutsky, Laura A.; Garland, Suzanne M.; Leodolter, Sepp; Joura, Elmar A.; Ferris, Daron Gale; Steben, Marc; Brown, Darron R.; Elbasha, Elamin H.; Paavonen, Jorma; Haupt, Richard M.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 19, No. 6, 01.01.2010, p. 1585-1594.

Research output: Contribution to journalArticle

Insinga, RP, Perez, G, Wheeler, CM, Koutsky, LA, Garland, SM, Leodolter, S, Joura, EA, Ferris, DG, Steben, M, Brown, DR, Elbasha, EH, Paavonen, J & Haupt, RM 2010, 'Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women', Cancer Epidemiology Biomarkers and Prevention, vol. 19, no. 6, pp. 1585-1594. https://doi.org/10.1158/1055-9965.EPI-09-1235
Insinga, Ralph P. ; Perez, Gonzalo ; Wheeler, Cosette M. ; Koutsky, Laura A. ; Garland, Suzanne M. ; Leodolter, Sepp ; Joura, Elmar A. ; Ferris, Daron Gale ; Steben, Marc ; Brown, Darron R. ; Elbasha, Elamin H. ; Paavonen, Jorma ; Haupt, Richard M. / Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women. In: Cancer Epidemiology Biomarkers and Prevention. 2010 ; Vol. 19, No. 6. pp. 1585-1594.
@article{487bdd174b7a44caae1354bb99d4e559,
title = "Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women",
abstract = "Background: We describe the incidence and duration of cervical human papillomavirus (HPV) infection episodes along with the risk of infection reappearance following a period of nondetection. Methods:Women (1,788) ages 16 to 23 years underwent cytologic testing and PCR-based testing of cervical swab samples for HPV DNA (HPV-16/18/31/33/35/45/52/58/59) at ∼6-month intervals for up to 4 years in the context of a phase 3 clinical trial (placebo arm). HPV type - specific incidence rates were estimated per 100 person-years. Duration of type-specific cervical infection episodes and risk of reappearance following a period of nondetection were estimated using Kaplan-Meier methods. Results: HPV-16 exhibited the highest (5.9), and HPV-35 and HPV-33 exhibited the lowest (1.0) incidence rates per 100 person-years. Mean cervical infection durations ranged from 13 months for HPV-59 to 20 months for HPV-16 and 58 (with ongoing infections censored at the time of treatment, if done). The risk of cervical infection reappearance within ∼3 years following a period of nondetection ranged from 0{\%} to 16{\%} across HPV types, with a mean of 8{\%}. Limited evidence was found for a role of false-positive HPV tests, missed infections that were above the threshold for detection, or new acquisition of infection in accounting for patterns of infection reappearance. Conclusions: Incidence of high-risk cervical infection was observed to vary considerably more across HPV types than infection duration. A nontrivial proportion of women exhibited infection reappearance following a period of nondetection, with a potential explanation for many such events observed within this analysis being a return to detectable levels of a previously acquired infection. Impact: The risk of HPV infection reappearance following a period of nondetection has not been previously reported for individual HPV types, and this study finds that a nontrivial proportion of infected women exhibit reappearances. Future studies could ascertain subject-level factors that potentially modify the risk of infection reappearance.",
author = "Insinga, {Ralph P.} and Gonzalo Perez and Wheeler, {Cosette M.} and Koutsky, {Laura A.} and Garland, {Suzanne M.} and Sepp Leodolter and Joura, {Elmar A.} and Ferris, {Daron Gale} and Marc Steben and Brown, {Darron R.} and Elbasha, {Elamin H.} and Jorma Paavonen and Haupt, {Richard M.}",
year = "2010",
month = "1",
day = "1",
doi = "10.1158/1055-9965.EPI-09-1235",
language = "English (US)",
volume = "19",
pages = "1585--1594",
journal = "Cancer Epidemiology Biomarkers and Prevention",
issn = "1055-9965",
publisher = "American Association for Cancer Research Inc.",
number = "6",

}

TY - JOUR

T1 - Incidence, duration, and reappearance of type-specific cervical human papillomavirus infections in young women

AU - Insinga, Ralph P.

AU - Perez, Gonzalo

AU - Wheeler, Cosette M.

AU - Koutsky, Laura A.

AU - Garland, Suzanne M.

AU - Leodolter, Sepp

AU - Joura, Elmar A.

AU - Ferris, Daron Gale

AU - Steben, Marc

AU - Brown, Darron R.

AU - Elbasha, Elamin H.

AU - Paavonen, Jorma

AU - Haupt, Richard M.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Background: We describe the incidence and duration of cervical human papillomavirus (HPV) infection episodes along with the risk of infection reappearance following a period of nondetection. Methods:Women (1,788) ages 16 to 23 years underwent cytologic testing and PCR-based testing of cervical swab samples for HPV DNA (HPV-16/18/31/33/35/45/52/58/59) at ∼6-month intervals for up to 4 years in the context of a phase 3 clinical trial (placebo arm). HPV type - specific incidence rates were estimated per 100 person-years. Duration of type-specific cervical infection episodes and risk of reappearance following a period of nondetection were estimated using Kaplan-Meier methods. Results: HPV-16 exhibited the highest (5.9), and HPV-35 and HPV-33 exhibited the lowest (1.0) incidence rates per 100 person-years. Mean cervical infection durations ranged from 13 months for HPV-59 to 20 months for HPV-16 and 58 (with ongoing infections censored at the time of treatment, if done). The risk of cervical infection reappearance within ∼3 years following a period of nondetection ranged from 0% to 16% across HPV types, with a mean of 8%. Limited evidence was found for a role of false-positive HPV tests, missed infections that were above the threshold for detection, or new acquisition of infection in accounting for patterns of infection reappearance. Conclusions: Incidence of high-risk cervical infection was observed to vary considerably more across HPV types than infection duration. A nontrivial proportion of women exhibited infection reappearance following a period of nondetection, with a potential explanation for many such events observed within this analysis being a return to detectable levels of a previously acquired infection. Impact: The risk of HPV infection reappearance following a period of nondetection has not been previously reported for individual HPV types, and this study finds that a nontrivial proportion of infected women exhibit reappearances. Future studies could ascertain subject-level factors that potentially modify the risk of infection reappearance.

AB - Background: We describe the incidence and duration of cervical human papillomavirus (HPV) infection episodes along with the risk of infection reappearance following a period of nondetection. Methods:Women (1,788) ages 16 to 23 years underwent cytologic testing and PCR-based testing of cervical swab samples for HPV DNA (HPV-16/18/31/33/35/45/52/58/59) at ∼6-month intervals for up to 4 years in the context of a phase 3 clinical trial (placebo arm). HPV type - specific incidence rates were estimated per 100 person-years. Duration of type-specific cervical infection episodes and risk of reappearance following a period of nondetection were estimated using Kaplan-Meier methods. Results: HPV-16 exhibited the highest (5.9), and HPV-35 and HPV-33 exhibited the lowest (1.0) incidence rates per 100 person-years. Mean cervical infection durations ranged from 13 months for HPV-59 to 20 months for HPV-16 and 58 (with ongoing infections censored at the time of treatment, if done). The risk of cervical infection reappearance within ∼3 years following a period of nondetection ranged from 0% to 16% across HPV types, with a mean of 8%. Limited evidence was found for a role of false-positive HPV tests, missed infections that were above the threshold for detection, or new acquisition of infection in accounting for patterns of infection reappearance. Conclusions: Incidence of high-risk cervical infection was observed to vary considerably more across HPV types than infection duration. A nontrivial proportion of women exhibited infection reappearance following a period of nondetection, with a potential explanation for many such events observed within this analysis being a return to detectable levels of a previously acquired infection. Impact: The risk of HPV infection reappearance following a period of nondetection has not been previously reported for individual HPV types, and this study finds that a nontrivial proportion of infected women exhibit reappearances. Future studies could ascertain subject-level factors that potentially modify the risk of infection reappearance.

UR - http://www.scopus.com/inward/record.url?scp=77953297415&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953297415&partnerID=8YFLogxK

U2 - 10.1158/1055-9965.EPI-09-1235

DO - 10.1158/1055-9965.EPI-09-1235

M3 - Article

VL - 19

SP - 1585

EP - 1594

JO - Cancer Epidemiology Biomarkers and Prevention

JF - Cancer Epidemiology Biomarkers and Prevention

SN - 1055-9965

IS - 6

ER -