Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity: Analysis of women in the control arm of the randomized, controlled PATRICIA trial

HPV PATRICIA Study Group

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13 Citations (Scopus)

Abstract

Background: More information is needed about time between sexual initiation and human papillomavirus (HPV) infection and development of cervical precancer. Methods: The objectives were to investigate the time between first sexual activity and detection of first cervical HPV infection or development of first cervical intraepithelial neoplasia (CIN), and associated factors in women from the double-blind, multinational, 4-year PATRICIA trial. PATRICIA enroled women aged 15-25 years with no more than 6 lifetime sexual partners. Women were randomized 1:1 to the HPV-16/18 AS04-adjuvanted vaccine or to control, but only women from the control arm who began sexual intercourse during the study or within 6 months before enrolment, and had no HPV infection detected before the recorded date of their first sexual intercourse, were included in the present analysis. The time between onset of sexual activity and detection of the first cervical HPV infection or development of the first CIN lesion was analyzed using Kaplan-Meier and univariate and multivariable Cox proportional-hazards models. Results: A total of 9337 women were enroled in the control arm of PATRICIA of whom 982 fulfilled the required inclusion criteria for analysis. A cumulative total of 28%, 44%, and 62% of the subjects had HPV infection within 12, 24, and 48 months, respectively. The overall incidence rate was 27.08 per 100 person-years. The most common oncogenic types associated with 6-month persistent infection were HPV-16 (incidence rate: 2.74 per 100 person-years), HPV-51 (2.70), HPV-52 (1.66), HPV-66 (1.14), and HPV-18 (1.09). Increased infection risk was associated with more lifetime sexual partners, being single, Chlamydia trachomatis history, and duration of hormone use. CIN1+ and CIN2+ lesions were most commonly associated with HPV-16, with an overall incidence rate of 1.87 and 1.07 per 100 person-years, respectively. Previous cervical HPV infection was most strongly associated with CIN development. Conclusions: More than 25% of women were infected with HPV within 1 year of beginning sexual activity. Without underestimating the value of vaccination at older ages, our findings emphasize its importance before sexual initiation.

Original languageEnglish (US)
Article number551
JournalBMC Infectious Diseases
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Papillomavirus Infections
Sexual Behavior
Randomized Controlled Trials
Cervical Intraepithelial Neoplasia
Human papillomavirus 16
Coitus
Human papillomavirus 18
Sexual Partners
Incidence
Chlamydia trachomatis
Infection
Proportional Hazards Models
Vaccination
Vaccines
History
Hormones

Keywords

  • CIN
  • HPV
  • Risk
  • Sexual intercourse
  • Time

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

@article{25ab2f21b49741cb8f256824261dede1,
title = "Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity: Analysis of women in the control arm of the randomized, controlled PATRICIA trial",
abstract = "Background: More information is needed about time between sexual initiation and human papillomavirus (HPV) infection and development of cervical precancer. Methods: The objectives were to investigate the time between first sexual activity and detection of first cervical HPV infection or development of first cervical intraepithelial neoplasia (CIN), and associated factors in women from the double-blind, multinational, 4-year PATRICIA trial. PATRICIA enroled women aged 15-25 years with no more than 6 lifetime sexual partners. Women were randomized 1:1 to the HPV-16/18 AS04-adjuvanted vaccine or to control, but only women from the control arm who began sexual intercourse during the study or within 6 months before enrolment, and had no HPV infection detected before the recorded date of their first sexual intercourse, were included in the present analysis. The time between onset of sexual activity and detection of the first cervical HPV infection or development of the first CIN lesion was analyzed using Kaplan-Meier and univariate and multivariable Cox proportional-hazards models. Results: A total of 9337 women were enroled in the control arm of PATRICIA of whom 982 fulfilled the required inclusion criteria for analysis. A cumulative total of 28{\%}, 44{\%}, and 62{\%} of the subjects had HPV infection within 12, 24, and 48 months, respectively. The overall incidence rate was 27.08 per 100 person-years. The most common oncogenic types associated with 6-month persistent infection were HPV-16 (incidence rate: 2.74 per 100 person-years), HPV-51 (2.70), HPV-52 (1.66), HPV-66 (1.14), and HPV-18 (1.09). Increased infection risk was associated with more lifetime sexual partners, being single, Chlamydia trachomatis history, and duration of hormone use. CIN1+ and CIN2+ lesions were most commonly associated with HPV-16, with an overall incidence rate of 1.87 and 1.07 per 100 person-years, respectively. Previous cervical HPV infection was most strongly associated with CIN development. Conclusions: More than 25{\%} of women were infected with HPV within 1 year of beginning sexual activity. Without underestimating the value of vaccination at older ages, our findings emphasize its importance before sexual initiation.",
keywords = "CIN, HPV, Risk, Sexual intercourse, Time",
author = "{HPV PATRICIA Study Group} and Xavier Castellsagu{\'e} and Jorma Paavonen and Unnop Jaisamrarn and Wheeler, {Cosette M.} and Skinner, {S. Rachel} and Matti Lehtinen and Paulo Naud and Chow, {Song Nan} and {Del Rosario-Raymundo}, {Maria Rowena} and Teixeira, {Julio C.} and Johanna Palmroth and {De Carvalho}, {Newton S.} and Germar, {Maria Julieta V.} and Klaus Peters and Garland, {Suzanne M.} and Anne Szarewski and Poppe, {Willy A.J.} and Barbara Romanowski and Schwarz, {Tino F.} and Tjalma, {Wiebren A.A.} and Bosch, {F. Xavier} and Bozonnat, {Marie Cecile} and Frank Struyf and Gary Dubin and Dominique Rosillon and Laurence Baril and I. Denham and Garland, {S. M.} and A. Mindel and Skinner, {S. R.} and {De Sutter}, P. and Poppe, {W. A.J.} and W. Tjalma and {De Carvalho}, {N. S.} and P. Naud and Teixeira, {J. C.} and Aoki, {F. Y.} and F. Diaz-Mitoma and M. Dionne and L. Ferguson and M. Miller and K. Papp and B. Ramjattan and B. Romanowski and Orr, {P. H.} and R. Somani and D. Apter and T. Karppa and N. Kudjoi and Ferris, {Daron Gale}",
year = "2014",
month = "1",
day = "1",
doi = "10.1186/s12879-014-0551-y",
language = "English (US)",
volume = "14",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity

T2 - Analysis of women in the control arm of the randomized, controlled PATRICIA trial

AU - HPV PATRICIA Study Group

AU - Castellsagué, Xavier

AU - Paavonen, Jorma

AU - Jaisamrarn, Unnop

AU - Wheeler, Cosette M.

AU - Skinner, S. Rachel

AU - Lehtinen, Matti

AU - Naud, Paulo

AU - Chow, Song Nan

AU - Del Rosario-Raymundo, Maria Rowena

AU - Teixeira, Julio C.

AU - Palmroth, Johanna

AU - De Carvalho, Newton S.

AU - Germar, Maria Julieta V.

AU - Peters, Klaus

AU - Garland, Suzanne M.

AU - Szarewski, Anne

AU - Poppe, Willy A.J.

AU - Romanowski, Barbara

AU - Schwarz, Tino F.

AU - Tjalma, Wiebren A.A.

AU - Bosch, F. Xavier

AU - Bozonnat, Marie Cecile

AU - Struyf, Frank

AU - Dubin, Gary

AU - Rosillon, Dominique

AU - Baril, Laurence

AU - Denham, I.

AU - Garland, S. M.

AU - Mindel, A.

AU - Skinner, S. R.

AU - De Sutter, P.

AU - Poppe, W. A.J.

AU - Tjalma, W.

AU - De Carvalho, N. S.

AU - Naud, P.

AU - Teixeira, J. C.

AU - Aoki, F. Y.

AU - Diaz-Mitoma, F.

AU - Dionne, M.

AU - Ferguson, L.

AU - Miller, M.

AU - Papp, K.

AU - Ramjattan, B.

AU - Romanowski, B.

AU - Orr, P. H.

AU - Somani, R.

AU - Apter, D.

AU - Karppa, T.

AU - Kudjoi, N.

AU - Ferris, Daron Gale

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: More information is needed about time between sexual initiation and human papillomavirus (HPV) infection and development of cervical precancer. Methods: The objectives were to investigate the time between first sexual activity and detection of first cervical HPV infection or development of first cervical intraepithelial neoplasia (CIN), and associated factors in women from the double-blind, multinational, 4-year PATRICIA trial. PATRICIA enroled women aged 15-25 years with no more than 6 lifetime sexual partners. Women were randomized 1:1 to the HPV-16/18 AS04-adjuvanted vaccine or to control, but only women from the control arm who began sexual intercourse during the study or within 6 months before enrolment, and had no HPV infection detected before the recorded date of their first sexual intercourse, were included in the present analysis. The time between onset of sexual activity and detection of the first cervical HPV infection or development of the first CIN lesion was analyzed using Kaplan-Meier and univariate and multivariable Cox proportional-hazards models. Results: A total of 9337 women were enroled in the control arm of PATRICIA of whom 982 fulfilled the required inclusion criteria for analysis. A cumulative total of 28%, 44%, and 62% of the subjects had HPV infection within 12, 24, and 48 months, respectively. The overall incidence rate was 27.08 per 100 person-years. The most common oncogenic types associated with 6-month persistent infection were HPV-16 (incidence rate: 2.74 per 100 person-years), HPV-51 (2.70), HPV-52 (1.66), HPV-66 (1.14), and HPV-18 (1.09). Increased infection risk was associated with more lifetime sexual partners, being single, Chlamydia trachomatis history, and duration of hormone use. CIN1+ and CIN2+ lesions were most commonly associated with HPV-16, with an overall incidence rate of 1.87 and 1.07 per 100 person-years, respectively. Previous cervical HPV infection was most strongly associated with CIN development. Conclusions: More than 25% of women were infected with HPV within 1 year of beginning sexual activity. Without underestimating the value of vaccination at older ages, our findings emphasize its importance before sexual initiation.

AB - Background: More information is needed about time between sexual initiation and human papillomavirus (HPV) infection and development of cervical precancer. Methods: The objectives were to investigate the time between first sexual activity and detection of first cervical HPV infection or development of first cervical intraepithelial neoplasia (CIN), and associated factors in women from the double-blind, multinational, 4-year PATRICIA trial. PATRICIA enroled women aged 15-25 years with no more than 6 lifetime sexual partners. Women were randomized 1:1 to the HPV-16/18 AS04-adjuvanted vaccine or to control, but only women from the control arm who began sexual intercourse during the study or within 6 months before enrolment, and had no HPV infection detected before the recorded date of their first sexual intercourse, were included in the present analysis. The time between onset of sexual activity and detection of the first cervical HPV infection or development of the first CIN lesion was analyzed using Kaplan-Meier and univariate and multivariable Cox proportional-hazards models. Results: A total of 9337 women were enroled in the control arm of PATRICIA of whom 982 fulfilled the required inclusion criteria for analysis. A cumulative total of 28%, 44%, and 62% of the subjects had HPV infection within 12, 24, and 48 months, respectively. The overall incidence rate was 27.08 per 100 person-years. The most common oncogenic types associated with 6-month persistent infection were HPV-16 (incidence rate: 2.74 per 100 person-years), HPV-51 (2.70), HPV-52 (1.66), HPV-66 (1.14), and HPV-18 (1.09). Increased infection risk was associated with more lifetime sexual partners, being single, Chlamydia trachomatis history, and duration of hormone use. CIN1+ and CIN2+ lesions were most commonly associated with HPV-16, with an overall incidence rate of 1.87 and 1.07 per 100 person-years, respectively. Previous cervical HPV infection was most strongly associated with CIN development. Conclusions: More than 25% of women were infected with HPV within 1 year of beginning sexual activity. Without underestimating the value of vaccination at older ages, our findings emphasize its importance before sexual initiation.

KW - CIN

KW - HPV

KW - Risk

KW - Sexual intercourse

KW - Time

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U2 - 10.1186/s12879-014-0551-y

DO - 10.1186/s12879-014-0551-y

M3 - Article

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JO - BMC Infectious Diseases

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