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Abstract

Title: The Natural History of Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia Among Young Women in the Guanacaste Cohort Shortly After Initiation of Sexual Life.
Author: Rodriguez AC, Burk R, Herrero R, Hildesheim A, Bratti C, Sherman ME, Solomon D, Guillen D, Alfaro M, Viscidi R, Morales J, Hutchinson M, Wacholder S, Schiffman M
Journal: Sex Transm Dis 34(7):494-502
Year: 2007
Month: July

Abstract: OBJECTIVE:: Cross-sectional analyses of our 10,000-woman, population-based Guanacaste cohort suggest a lag of >/=10 years between the peak of human papillomavirus (HPV) infection and the later peak of cervical intraepithelial neoplasia grade 3 (CIN 3). We wanted to explore early HPV natural history and CIN 3 prospectively. STUDY DESIGN:: As part of the Guanacaste cohort, we followed 206 initially virginal women aged 18 to 26 semiannually for a median of 3.6 years after initiation of sexual life. RESULTS:: A total of 53.4% of women tested positive during the study for >/=1 HPV type. Very few infections persisted for >1 to 2 years. Three women had histologically confirmed CIN 3, of which 2 showed persistent HPV 16. The other had serologic evidence of HPV 31. CONCLUSIONS:: HPV infection occurs frequently and clears rapidly in most young women initiating sexual intercourse. Persistent HPV 16 can cause early CIN 3. The peak age for CIN 3 will decline with the increased screening intensity and sensitivity typical of longitudinal studies.