Natural History Of Human Papillomavirus Type 52/58 Infection In A Cohort Of Women Aged 18-45 Years

Objectives Based on a prospective cohort of women(aged 18-45 years)residing in Yangcheng County,Shanxi Province and Xinmi City,Henan Province to investigate the prevalence,incidence,clearance,recurrence of HPV52/58 infection and compare the incidence of type-specific related cervical intraepithelial neoplasia in HPV 52/58 positive women and negative women at baseline during the 3.5-year follow-up.Methods Women(aged 18-45 years)were recruited from the general population from December 2012 to March 2013,underwent cytologic testing and PCR-based testing of cervical swab samples for HPV DNA at 5?12-month intervals(0m/7m/12m/18m/14m/30m/42m)for up to 3.5 years.Results Totally,2124 volunteers were enrolled at baseline,and 2096(98.7%)of 2124 with at least one subsequent cervical swab specimen available were eligible to contribute person-time to each type-specific analysis.The baseline characteristics of the prospective subcohort of 2096 women were very similar to those of the entire study population.1 The overall prevalence of HPV52 infection at enrollment was 4.14%(95%CI 3.30-4.99),and the HPV58 was 1.08%(95%CI 0.64-1.52),the infection rate is higher in type 52 than that of type 58.The prevalence of HPV 52 and 58 related precancerous lesions(CIN1+)and CIN2+ were 23.5/10,000 persons and 9.4/10,000 persons,respectively.No statistical differences were found in the distribution of HPV52 and 58 prevalence between age and region.2 The new infection rate of HPV52 was 1.4/1000 person-months(95%CI 1.2-1.7)and 0.6/1000 person-months(95%CI 0.4-0.8)of HPV58.About 70%of new infections were eliminated during the follow-up.The median clearance time was 18.5 months(95%CI 13.9-23.1)and 18.0 months(95%CI 11.8-24.2).The risk of cervical infection reappearance within?3.5 years following a period of nondetection was 2.0/1000 person-months and 13.4/1000 person-months for HPV52 and 58,respectively.3 The annual cumulative incidence of cervical precancerous lesions in women with HPV52 infection at baseline were significantly higher than those negative women,risk ratios were 47.2 and 24.7,respectively.Similarly,the incidence of cervical precancerous lesions related to type 58 infection were also significantly higher in DNA positive women than those with negative detection,risk ratios were 85.1 and 120.4,respectively.Conclusions The incidence of HPV52/58 infection was remarkable and was mostly transient,its tight connection with the occurrence of cervical lesions cannot be ignored in China yet,the development of new vaccines that cover more oncogenic types or in great harmony with indigenous HPV infection pattern is necessary.