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Published in: BMC Infectious Diseases 1/2011

Open Access 01-12-2011 | Research article

Incident cervical infections with high- and low-risk human papillomavirus (HPV) infections among mothers in the prospective Finnish Family HPV Study

Published in: BMC Infectious Diseases | Issue 1/2011

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Abstract

Background

The knowledge on type specificity and factors that increase or decrease the risk of incident HPV-infections is important to better understand the dynamics of HPV-infections.

Methods

A series of 329 pregnant women were enrolled in Finnish Family HPV Study at 3rd trimester of pregnancy and followed-up for 6 years, during which 203 baseline HPV-negative women acquired incident HPV infection. Incidence times and incidence rates (IR) were calculated for 24 low-and high-risk HPV-types detected by Multiplex-HPV-genotyping at each visit. Poison regression was used to estimate predictors of incident HPV infections of species 7 and 9 HPV-genotypes.

Results

HPV16 was the most frequent (47.8%) incident genotype followed by multiple-type infections (25.1%), and single infection with HPV18, 70, 6 and 45. Actuarial mean times to incident event were longest for HPV31 (34.5 months) and HPV45 (32.8 months), while crude mean times were longest for HPV56 (42.4 months) and HPV16 (23.1 months). Actuarial IR was highest for HPV16 and multiple-type infections. Independent protective factors against incident infections were 1) > 2 life-time sexual partners (p = 0.014), 2) later initiation of oral contraceptives (age > 20 years) (p = 0.017) and 3) pregnancy at FU visit (p = 0.0001).

Conclusions

Among newly delivered mothers, higher number of life-time sexual partners, initiation of OC use after age 20 and becoming pregnant during FU decreased the risk for incident species 7/9 HPV infections.
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Literature
1.
go back to reference De Villiers EM: Classification of papillomaviruses. Virology. 2004, 324: 17-27. 10.1016/j.virol.2004.03.033.CrossRefPubMed De Villiers EM: Classification of papillomaviruses. Virology. 2004, 324: 17-27. 10.1016/j.virol.2004.03.033.CrossRefPubMed
2.
go back to reference Muñoz N, Bosch FX, de Sanjosé S, Herrero R, Castellsagué X, Shah KV, Snijders PJ, Meijer CJ, International Agency for Research on Cancer Multicenter Cervical Cancer Study Group: Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003, 348: 518-27. 10.1056/NEJMoa021641.CrossRefPubMed Muñoz N, Bosch FX, de Sanjosé S, Herrero R, Castellsagué X, Shah KV, Snijders PJ, Meijer CJ, International Agency for Research on Cancer Multicenter Cervical Cancer Study Group: Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003, 348: 518-27. 10.1056/NEJMoa021641.CrossRefPubMed
3.
go back to reference Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, Tortolero-Luna G, Kjaer SK, Muñoz N: Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine. 2008, 26: K1-16.CrossRefPubMed Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, Tortolero-Luna G, Kjaer SK, Muñoz N: Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine. 2008, 26: K1-16.CrossRefPubMed
4.
go back to reference Moscicki AB, Hills N, Shiboski S, Powell K, Jay N, Hanson E, Miller S, Clayton L, Farhat S, Broering J, Darragh T, Palefsky J: Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. JAMA. 2001, 285: 2995-3002. 10.1001/jama.285.23.2995.CrossRefPubMed Moscicki AB, Hills N, Shiboski S, Powell K, Jay N, Hanson E, Miller S, Clayton L, Farhat S, Broering J, Darragh T, Palefsky J: Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. JAMA. 2001, 285: 2995-3002. 10.1001/jama.285.23.2995.CrossRefPubMed
5.
go back to reference Sellors JW, Karwalajtys TL, Kaczorowski J, Mahony JB, Lytwyn A, Chong S, Sparrow J, Lorincz A, Survey of HPV in Ontario Women Group: Incidence, clearance and predictors of human papillomavirus infection in women. CMAJ. 2003, 168: 421-5.PubMedPubMedCentral Sellors JW, Karwalajtys TL, Kaczorowski J, Mahony JB, Lytwyn A, Chong S, Sparrow J, Lorincz A, Survey of HPV in Ontario Women Group: Incidence, clearance and predictors of human papillomavirus infection in women. CMAJ. 2003, 168: 421-5.PubMedPubMedCentral
6.
go back to reference Syrjänen S, Shabalova I, Petrovichev N, Kozachenko V, Zakharova T, Pajanidi J, Podistov J, Chemeris G, Sozaeva L, Lipova E, Tsidaeva I, Ivanchenko O, Pshepurko A, Zakharenko S, Nerovjna R, Kljukina L, Erokhina O, Branovskaja M, Nikitina M, Grunberga V, Grunberg A, Juschenko A, Tosi P, Cintorino M, Santopietro R, Syrjänen K: Acquisition of high-risk human papillomavirus infections and pap smear abnormalities among women in the New Independent States of the Former Soviet Union. J Clin Microbiol. 2004, 42: 505-11. 10.1128/JCM.42.2.505-511.2004.CrossRefPubMedPubMedCentral Syrjänen S, Shabalova I, Petrovichev N, Kozachenko V, Zakharova T, Pajanidi J, Podistov J, Chemeris G, Sozaeva L, Lipova E, Tsidaeva I, Ivanchenko O, Pshepurko A, Zakharenko S, Nerovjna R, Kljukina L, Erokhina O, Branovskaja M, Nikitina M, Grunberga V, Grunberg A, Juschenko A, Tosi P, Cintorino M, Santopietro R, Syrjänen K: Acquisition of high-risk human papillomavirus infections and pap smear abnormalities among women in the New Independent States of the Former Soviet Union. J Clin Microbiol. 2004, 42: 505-11. 10.1128/JCM.42.2.505-511.2004.CrossRefPubMedPubMedCentral
7.
go back to reference Syrjänen S, Shabalova I, Petrovichev N, Podistov J, Ivanchenko O, Zakharenko S, Nerovjna R, Kljukina L, Branovskaja M, Juschenko A, Tosi P, Syrjänen K, NIS Cohort Study Group: Age-specific incidence and clearance of high-risk human papillomavirus infections in women in the former Soviet Union. Int J STD AIDS. 2005, 16: 217-23. 10.1258/0956462053420211.CrossRefPubMed Syrjänen S, Shabalova I, Petrovichev N, Podistov J, Ivanchenko O, Zakharenko S, Nerovjna R, Kljukina L, Branovskaja M, Juschenko A, Tosi P, Syrjänen K, NIS Cohort Study Group: Age-specific incidence and clearance of high-risk human papillomavirus infections in women in the former Soviet Union. Int J STD AIDS. 2005, 16: 217-23. 10.1258/0956462053420211.CrossRefPubMed
8.
go back to reference Franco EL, Villa LL, Sobrinho JP, Prado JM, Rousseau MC, Désy M, Rohan TE: Epidemiology of acquisition and clearance of cervical human papillomavirus infection in women from a high-risk area for cervical cancer. J Infect Dis. 1999, 180: 1415-23. 10.1086/315086.CrossRefPubMed Franco EL, Villa LL, Sobrinho JP, Prado JM, Rousseau MC, Désy M, Rohan TE: Epidemiology of acquisition and clearance of cervical human papillomavirus infection in women from a high-risk area for cervical cancer. J Infect Dis. 1999, 180: 1415-23. 10.1086/315086.CrossRefPubMed
9.
go back to reference Giuliano AR, Harris R, Sedjo RL, Baldwin S, Roe D, Papenfuss MR, Abrahamsen M, Inserra P, Olvera S, Hatch K: Incidence, prevalence, and clearance of type-specific human papillomavirus infections: The Young Women's Health Study. J Infect Dis. 2002, 186: 462-9. 10.1086/341782.CrossRefPubMed Giuliano AR, Harris R, Sedjo RL, Baldwin S, Roe D, Papenfuss MR, Abrahamsen M, Inserra P, Olvera S, Hatch K: Incidence, prevalence, and clearance of type-specific human papillomavirus infections: The Young Women's Health Study. J Infect Dis. 2002, 186: 462-9. 10.1086/341782.CrossRefPubMed
10.
go back to reference Muñoz N, Méndez F, Posso H, Molano M, van den Brule AJ, Ronderos M, Meijer C, Muñoz A, Instituto Nacional de Cancerologia HPV Study Group: Incidence, duration, and determinants of cervical human papillomavirus infection in a cohort of Colombian women with normal cytological results. J Infect Dis. 2004, 190: 2077-87. 10.1086/425907.CrossRefPubMed Muñoz N, Méndez F, Posso H, Molano M, van den Brule AJ, Ronderos M, Meijer C, Muñoz A, Instituto Nacional de Cancerologia HPV Study Group: Incidence, duration, and determinants of cervical human papillomavirus infection in a cohort of Colombian women with normal cytological results. J Infect Dis. 2004, 190: 2077-87. 10.1086/425907.CrossRefPubMed
11.
go back to reference Winer RL, Lee SK, Hughes JP, Adam DE, Kiviat NB, Koutsky LA: Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. Am J Epidemiol. 2003, 157: 218-26. 10.1093/aje/kwf180.CrossRefPubMed Winer RL, Lee SK, Hughes JP, Adam DE, Kiviat NB, Koutsky LA: Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. Am J Epidemiol. 2003, 157: 218-26. 10.1093/aje/kwf180.CrossRefPubMed
12.
go back to reference Chao A, Chang CJ, Lai CH, Chao FY, Hsu YH, Chou HH, Huang HJ, Jung SM, Lin CT, Cheng HH, Huang CC, Yang JE, Chang TC: Incidence and outcome of acquisition of human papillomavirus infection in women with normal cytology--a population-based cohort study from Taiwan. Int J Cancer. 2010, 126: 191-8. 10.1002/ijc.24717.CrossRefPubMed Chao A, Chang CJ, Lai CH, Chao FY, Hsu YH, Chou HH, Huang HJ, Jung SM, Lin CT, Cheng HH, Huang CC, Yang JE, Chang TC: Incidence and outcome of acquisition of human papillomavirus infection in women with normal cytology--a population-based cohort study from Taiwan. Int J Cancer. 2010, 126: 191-8. 10.1002/ijc.24717.CrossRefPubMed
13.
go back to reference Nielsen A, Iftner T, Munk C, Kjaer SK: Acquisition of high-risk human papillomavirus infection in a population-based cohort of Danish women. Sex Transm Dis. 2009, 36: 609-15. 10.1097/OLQ.0b013e3181a96d0e.CrossRefPubMedPubMedCentral Nielsen A, Iftner T, Munk C, Kjaer SK: Acquisition of high-risk human papillomavirus infection in a population-based cohort of Danish women. Sex Transm Dis. 2009, 36: 609-15. 10.1097/OLQ.0b013e3181a96d0e.CrossRefPubMedPubMedCentral
14.
go back to reference Fukuchi E, Sawaya GF, Chirenje M, Magure T, Tuveson J, Ma Y, Shiboski S, Da Costa M, Palefsky J, Moscicki AB, Makunike-Mutasa R, Chipato T, Smith-McCune KK: Cervical human papillomavirus incidence and persistence in a cohort of HIV-negative women in Zimbabwe. Sex Transm Dis. 2009, 36: 305-11. 10.1097/OLQ.0b013e318194eb76.CrossRefPubMed Fukuchi E, Sawaya GF, Chirenje M, Magure T, Tuveson J, Ma Y, Shiboski S, Da Costa M, Palefsky J, Moscicki AB, Makunike-Mutasa R, Chipato T, Smith-McCune KK: Cervical human papillomavirus incidence and persistence in a cohort of HIV-negative women in Zimbabwe. Sex Transm Dis. 2009, 36: 305-11. 10.1097/OLQ.0b013e318194eb76.CrossRefPubMed
15.
go back to reference Oh JK, Ju YH, Franceschi S, Quint W, Shin HR: Acquisition of new infection and clearance of type-specific human papillomavirus infections in female students in Busan, South Korea: a follow-up study. BMC Infect Dis. 2008, 8: 13-10.1186/1471-2334-8-13.CrossRefPubMedPubMedCentral Oh JK, Ju YH, Franceschi S, Quint W, Shin HR: Acquisition of new infection and clearance of type-specific human papillomavirus infections in female students in Busan, South Korea: a follow-up study. BMC Infect Dis. 2008, 8: 13-10.1186/1471-2334-8-13.CrossRefPubMedPubMedCentral
16.
go back to reference Goodman MT, Shvetsov YB, McDuffie K, Wilkens LR, Zhu X, Thompson PJ, Ning L, Killeen J, Kamemoto L, Hernandez BY: Prevalence, acquisition, and clearance of cervical human papillomavirus infection among women with normal cytology: Hawaii Human Papillomavirus Cohort Study. Cancer Res. 2008, 68: 8813-24. 10.1158/0008-5472.CAN-08-1380.CrossRefPubMedPubMedCentral Goodman MT, Shvetsov YB, McDuffie K, Wilkens LR, Zhu X, Thompson PJ, Ning L, Killeen J, Kamemoto L, Hernandez BY: Prevalence, acquisition, and clearance of cervical human papillomavirus infection among women with normal cytology: Hawaii Human Papillomavirus Cohort Study. Cancer Res. 2008, 68: 8813-24. 10.1158/0008-5472.CAN-08-1380.CrossRefPubMedPubMedCentral
17.
go back to reference Richardson H, Kelsall G, Tellier P, Voyer H, Abrahamowicz M, Ferenczy A, Coutlée F, Franco EL: The natural history of type-specific human papillomavirus infections in female university students. Cancer Epidemiol Biomarkers Prev. 2003, 12: 485-90.PubMed Richardson H, Kelsall G, Tellier P, Voyer H, Abrahamowicz M, Ferenczy A, Coutlée F, Franco EL: The natural history of type-specific human papillomavirus infections in female university students. Cancer Epidemiol Biomarkers Prev. 2003, 12: 485-90.PubMed
18.
go back to reference Rintala MA, Grénman SE, Puranen MH, Isolauri E, Ekblad U, Kero PO, Syrjänen SM: Transmission of high risk HPV between parents and infants: a prospective HPV Family Study in Finland. J Clin Microbiol. 2005, 43: 376-81. 10.1128/JCM.43.1.376-381.2005.CrossRefPubMedPubMedCentral Rintala MA, Grénman SE, Puranen MH, Isolauri E, Ekblad U, Kero PO, Syrjänen SM: Transmission of high risk HPV between parents and infants: a prospective HPV Family Study in Finland. J Clin Microbiol. 2005, 43: 376-81. 10.1128/JCM.43.1.376-381.2005.CrossRefPubMedPubMedCentral
19.
go back to reference Rintala MA, Grénman SE, Järvenkylä ME, Syrjänen KJ, Syrjänen SM: High-risk types of human papillomavirus (HPV) DNA in oral and genital mucosa of infants during their first 3 years of life: experience from the Finnish HPV Family Study. Clin Infect Dis. 2005, 41: 1728-33. 10.1086/498114.CrossRefPubMed Rintala MA, Grénman SE, Järvenkylä ME, Syrjänen KJ, Syrjänen SM: High-risk types of human papillomavirus (HPV) DNA in oral and genital mucosa of infants during their first 3 years of life: experience from the Finnish HPV Family Study. Clin Infect Dis. 2005, 41: 1728-33. 10.1086/498114.CrossRefPubMed
20.
go back to reference Louvanto K, Syrjänen KJ, Rintala MA, Grénman SE, Syrjänen SM: Genotype-specific clearance of genital human papillomavirus (HPV) infections among mothers in the Finnish family HPV study. J Clin Microbiol. 2010, 48: 2665-71. 10.1128/JCM.00783-10.CrossRefPubMedPubMedCentral Louvanto K, Syrjänen KJ, Rintala MA, Grénman SE, Syrjänen SM: Genotype-specific clearance of genital human papillomavirus (HPV) infections among mothers in the Finnish family HPV study. J Clin Microbiol. 2010, 48: 2665-71. 10.1128/JCM.00783-10.CrossRefPubMedPubMedCentral
21.
go back to reference Schmitt M, Bravo IG, Snijders PJ, Gissmann L, Pawlita M, Waterboer T: Bead-based multiplex genotyping of human papillomaviruses. J Clin Microbiol. 2006, 44: 504-12. 10.1128/JCM.44.2.504-512.2006.CrossRefPubMedPubMedCentral Schmitt M, Bravo IG, Snijders PJ, Gissmann L, Pawlita M, Waterboer T: Bead-based multiplex genotyping of human papillomaviruses. J Clin Microbiol. 2006, 44: 504-12. 10.1128/JCM.44.2.504-512.2006.CrossRefPubMedPubMedCentral
22.
go back to reference Snijders PJF, van den Brule AJC, Schrijnemakers HFJ, Snow G, Meijer CJLM, Walboomers JMM: The use of general primers in the polymerase chain reaction permits the detection of a broad spectrum of human papillomavirus genotypes. J Gen Virol. 1990, 71: 173-181. 10.1099/0022-1317-71-1-173.CrossRefPubMed Snijders PJF, van den Brule AJC, Schrijnemakers HFJ, Snow G, Meijer CJLM, Walboomers JMM: The use of general primers in the polymerase chain reaction permits the detection of a broad spectrum of human papillomavirus genotypes. J Gen Virol. 1990, 71: 173-181. 10.1099/0022-1317-71-1-173.CrossRefPubMed
23.
go back to reference Miller SA, Dykes DD, Polesky HF: A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res. 1988, 16: 1215-10.1093/nar/16.3.1215.CrossRefPubMedPubMedCentral Miller SA, Dykes DD, Polesky HF: A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res. 1988, 16: 1215-10.1093/nar/16.3.1215.CrossRefPubMedPubMedCentral
24.
go back to reference Anttila M, Syrjänen S, Ji H, Saarikoski S, Syrjänen K: Failure to demonstrate human papillomavirus DNA in epithelial ovarian cancer by general primer PCR. Gynecol Oncol. 1999, 72: 337-341. 10.1006/gyno.1998.5264.CrossRefPubMed Anttila M, Syrjänen S, Ji H, Saarikoski S, Syrjänen K: Failure to demonstrate human papillomavirus DNA in epithelial ovarian cancer by general primer PCR. Gynecol Oncol. 1999, 72: 337-341. 10.1006/gyno.1998.5264.CrossRefPubMed
25.
go back to reference Syrjänen S, Waterboer T, Sarkola M, Michael K, Rintala M, Syrjänen K, Grenman S, Pawlita M: Dynamics of human papillomavirus serology in women followed up for 36 months after pregnancy. J Gen Virol. 2009, 90: 1515-26. 10.1099/vir.0.007823-0.CrossRefPubMed Syrjänen S, Waterboer T, Sarkola M, Michael K, Rintala M, Syrjänen K, Grenman S, Pawlita M: Dynamics of human papillomavirus serology in women followed up for 36 months after pregnancy. J Gen Virol. 2009, 90: 1515-26. 10.1099/vir.0.007823-0.CrossRefPubMed
26.
go back to reference Diggle PJ, Liang KY, Zeger SL: Analysis of longitudinal data. 1994, Oxford: Oxford University Press, 1 Diggle PJ, Liang KY, Zeger SL: Analysis of longitudinal data. 1994, Oxford: Oxford University Press, 1
27.
go back to reference Hardin J, Hilbe JM: Generalized estimating equations. 2003, Boca Raton, FL: Chapman & Hall Hardin J, Hilbe JM: Generalized estimating equations. 2003, Boca Raton, FL: Chapman & Hall
28.
go back to reference Kulmala SM, Shabalova IP, Petrovitchev N, Syrjänen KJ, Gyllensten UB, Johansson BC, Syrjänen SM, New Independent States of the former Soviet Union Cohort Study Group: Type-specific persistence of high-risk human papillomavirus infections in the New Independent States of the former Soviet Union Cohort Study. Cancer Epidemiol Biomarkers Prev. 2007, 16: 17-22. 10.1158/1055-9965.EPI-06-0649.CrossRefPubMed Kulmala SM, Shabalova IP, Petrovitchev N, Syrjänen KJ, Gyllensten UB, Johansson BC, Syrjänen SM, New Independent States of the former Soviet Union Cohort Study Group: Type-specific persistence of high-risk human papillomavirus infections in the New Independent States of the former Soviet Union Cohort Study. Cancer Epidemiol Biomarkers Prev. 2007, 16: 17-22. 10.1158/1055-9965.EPI-06-0649.CrossRefPubMed
29.
go back to reference Ho GY, Studentsov YY, Bierman R, Burk RD: Natural history of human papillomavirus type 16 virus-like particle antibodies in young women. Cancer Epidemiol Biomarkers Prev. 2004, 13 (1): 110-6. 10.1158/1055-9965.EPI-03-0191.CrossRefPubMed Ho GY, Studentsov YY, Bierman R, Burk RD: Natural history of human papillomavirus type 16 virus-like particle antibodies in young women. Cancer Epidemiol Biomarkers Prev. 2004, 13 (1): 110-6. 10.1158/1055-9965.EPI-03-0191.CrossRefPubMed
30.
go back to reference Carter JJ, Koutsky LA, Hughes JP, Lee SK, Kuypers J, Kiviat N, Galloway DA: Comparison of human papillomavirus types 16, 18, and 6 capsid antibody responses following incident infection. J Infect Dis. 2000, 181 (6): 1911-9. 10.1086/315498.CrossRefPubMed Carter JJ, Koutsky LA, Hughes JP, Lee SK, Kuypers J, Kiviat N, Galloway DA: Comparison of human papillomavirus types 16, 18, and 6 capsid antibody responses following incident infection. J Infect Dis. 2000, 181 (6): 1911-9. 10.1086/315498.CrossRefPubMed
31.
go back to reference Louvanto K, Rintala M, Syrjänen K, Grenman S, Syrjänen S: Genotype-specific persistence of genital human papillomavirus (HPV) infections in women followed for 6 years in the Finnish Family HPV Study. J Infect Dis. 2010, 202: 436-44. 10.1086/653826.CrossRefPubMed Louvanto K, Rintala M, Syrjänen K, Grenman S, Syrjänen S: Genotype-specific persistence of genital human papillomavirus (HPV) infections in women followed for 6 years in the Finnish Family HPV Study. J Infect Dis. 2010, 202: 436-44. 10.1086/653826.CrossRefPubMed
32.
go back to reference Sarkola ME, Grenman SE, Rintala MA, Syrjanen KJ, Syrjanen SM: Effect of second pregnancy on maternal carriage and outcome of high-risk human papillomavirus (HPV): experience from the prospective finnish family HPV study. Gynecol Obstet Invest. 2009, 67: 208-216. 10.1159/000209204.CrossRefPubMed Sarkola ME, Grenman SE, Rintala MA, Syrjanen KJ, Syrjanen SM: Effect of second pregnancy on maternal carriage and outcome of high-risk human papillomavirus (HPV): experience from the prospective finnish family HPV study. Gynecol Obstet Invest. 2009, 67: 208-216. 10.1159/000209204.CrossRefPubMed
Metadata
Title
Incident cervical infections with high- and low-risk human papillomavirus (HPV) infections among mothers in the prospective Finnish Family HPV Study
Publication date
01-12-2011
Published in
BMC Infectious Diseases / Issue 1/2011
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-11-179

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