TY - JOUR
T1 - A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica
AU - Castle, Philip E.
AU - Schiffman, Mark
AU - Herrero, Rolando
AU - Hildesheim, Allan
AU - Rodriguez, Ana Cecilia
AU - Bratti, M. Concepcion
AU - Sherman, Mark E.
AU - Wacholder, Sholom
AU - Tarone, Robert
AU - Burk, Robert D.
N1 - Funding Information:
Financial support: Public Health Service (contracts N01CP21081 and N01CP31061 between the National Cancer Institute [NCI], the National Institutes of Health, the Department of Health and Human Services, and the Costa Rican Foundation for Training in Health Sciences [FUCODOCSA], Costa Rica); NCI (contracts NO1-CP-21081, NO1-CP-33061, NO1-CP-40542, NO1-CP-50535, and NO1-CP-81023 with FUCODOCSA; grant CA78527 to R.D.B.).
PY - 2005/6/1
Y1 - 2005/6/1
N2 - Background. Cross-sectional human papillomavirus (HPV) DNA prevalence peaks at young ages, reflecting sexual acquisition and typically rapid clearance. In some populations, HPV prevalence demonstrates a second peak in older women. Longitudinal data may help to explain this second peak. Methods. We followed a population-based cohort of 7237 women in Guanacaste, Costa Rica, in which we had previously observed a second peak in the baseline HPV prevalence in older women. We tested for >40 HPV types by polyrnerase chain reaction. We analyzed age-specific patterns of acquisition and persistence 5-7 years after enrollment for individual HPV types. Results. At enrollment and follow-up, cross-sectional data revealed U-shaped age-specific HPV prevalence curves for virtually every type, with higher prevalences in the younger and older women than in the middle-aged women. Prospectively, acquisition of types decreased significantly as women aged (PTrend<.05, for both), with the highest peak in young women and a secondary minor peak in older women. Type-specific persistence of HPV increased with age (PTrend<.0001). Overall, HPV acquisition predominated at younger ages, whereas persistent infections gradually became more prominent with age (PTrend<.0001). Conclusions. Newly apparent infections decreased, whereas persistence increased, with age; this latter tendency supports the utility of HPV screening in older women.
AB - Background. Cross-sectional human papillomavirus (HPV) DNA prevalence peaks at young ages, reflecting sexual acquisition and typically rapid clearance. In some populations, HPV prevalence demonstrates a second peak in older women. Longitudinal data may help to explain this second peak. Methods. We followed a population-based cohort of 7237 women in Guanacaste, Costa Rica, in which we had previously observed a second peak in the baseline HPV prevalence in older women. We tested for >40 HPV types by polyrnerase chain reaction. We analyzed age-specific patterns of acquisition and persistence 5-7 years after enrollment for individual HPV types. Results. At enrollment and follow-up, cross-sectional data revealed U-shaped age-specific HPV prevalence curves for virtually every type, with higher prevalences in the younger and older women than in the middle-aged women. Prospectively, acquisition of types decreased significantly as women aged (PTrend<.05, for both), with the highest peak in young women and a secondary minor peak in older women. Type-specific persistence of HPV increased with age (PTrend<.0001). Overall, HPV acquisition predominated at younger ages, whereas persistent infections gradually became more prominent with age (PTrend<.0001). Conclusions. Newly apparent infections decreased, whereas persistence increased, with age; this latter tendency supports the utility of HPV screening in older women.
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U2 - 10.1086/428779
DO - 10.1086/428779
M3 - Article
C2 - 15871112
AN - SCOPUS:21044453904
SN - 0022-1899
VL - 191
SP - 1808
EP - 1816
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 11
ER -
