Frequency and risk factors for prevalent, incident, and persistent genital carcinogenic human papillomavirus infection in sexually active women: community based cohort study

Objective To investigate frequency and risk factors for prevalent, incident, and persistent carcinogenic human papillomavirus (HPV) in young women before the introduction of immunisation against HPV types 16 and 18 for schoolgirls.Design Cohort studySetting 20 London universities and further educati...

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Bibliographic Details
Published in:BMJ (Online) 2012-06, Vol.344 (7864), p.17-17
Main Authors: Oakeshott, Pippa, Aghaizu, Adamma, Reid, Fiona, Howell-Jones, Rebecca, Hay, Phillip E, Sadiq, S Tariq, Lacey, Charles J, Beddows, Simon, Soldan, Kate
Format: Article
Language:English
Subjects:
Adolescent
Adult
Cervical cancer
Chlamydia Infections - epidemiology
Chlamydia trachomatis
Cohort Studies
Epidemiologic Studies
Ethnic Studies
Female
Follow-Up Studies
Genitalia
Genotypes
Human papillomavirus 16
Human papillomavirus 18
Humans
Immunology (Including Allergy)
Incidence
Infections
Infectious Diseases
London - epidemiology
Nursing students
Ophthalmology
Papillomaviridae
Papillomavirus Infections - epidemiology
Papillomavirus Infections - ethnology
Predisposing factors
Prevalence
Reproductive Tract Infections - epidemiology
Reproductive Tract Infections - ethnology
Risk Factors
Screening (Epidemiology)
Screening (Public Health)
Sexual Behavior - statistics & numerical data
Sexual Health
Sexual Partners
Sexually Transmitted Diseases - epidemiology
Sexually Transmitted Diseases - ethnology
Uterine Cervical Neoplasms - ethnology
Uterine Cervical Neoplasms - etiology
Vaginosis, Bacterial - epidemiology
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Summary:Objective To investigate frequency and risk factors for prevalent, incident, and persistent carcinogenic human papillomavirus (HPV) in young women before the introduction of immunisation against HPV types 16 and 18 for schoolgirls.Design Cohort studySetting 20 London universities and further education colleges.Participants 2185 sexually active female students, mean age 21 years (range 16-27), 38% from ethnic minorities, who took part in the POPI (prevention of pelvic infection) chlamydia screening trial in 2004-08 and who provided duplicate, self taken vaginal swabs and completed questionnaires at baseline. At follow-up, a median of 16 months later, 821 women (38%) returned repeat vaginal swabs by post. In 2009-10, stored samples were tested for HPV.Results Samples from 404/2185 (18.5% (95% CI 16.9% to 20.2%)) of the cohort were positive for carcinogenic HPV at baseline, including 15.0% (327) positive for non-vaccine carcinogenic genotypes. Reporting two or more sexual partners in the previous year and concurrent Chlamydia trachomatis or bacterial vaginosis were independent risk factors for prevalent vaginal HPV infection. Infection with one or more new HPV types was found in 17.7% (145/821) of follow-up samples, giving an estimated annual incidence of carcinogenic HPV infection of 12.9% (95% CI 11.0% to 15.0%). Incident infection was more common in women reporting two or more partners in the previous year, aged
ISSN:0959-8138
1756-1833
1756-1833
DOI:10.1136/bmj.e4168