Molano Monica, Van den Brule Adriaan, Plummer Martyn, Weiderpass Elisabete, Posso Hector, Arslan Annie, Meijer Chris J L M, Muñoz Nubia, Franceschi Silvia
Department of Pathology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.
Am J Epidemiol. 2003 Sep 1;158(5):486-94. doi: 10.1093/aje/kwg171.
Little is known about the factors that influence clearance of human papillomavirus (HPV), the primary cause of cervical carcinoma. A total of 227 women cytologically normal and HPV positive at baseline were identified from a population-based cohort of 1,995 Bogota, Colombia, women aged 13-85 years followed between 1993 and 2000 (mean follow-up, 5.3 years). HPV DNA detection and viral load determination were based on a GP5+/GP6+ polymerase chain reaction enzyme immunoassay. Rate ratio estimates for HPV clearance were calculated by using methods for interval-censored survival time data. Analyses were based on 316 type-specific HPV infections. HPV 16 had a significantly lower clearance rate than infections with low-risk types (rate ratio (RR) = 0.47, 95% confidence interval (CI): 0.32, 0.72), HPV types related to HPV 16 (types 31, 33, 35, 52, 58) had intermediate clearance rates (RR = 0.62, 95% CI: 0.47, 0.94), and other high-risk types did not show evidence of slower clearance compared with low-risk types. Infections with single and multiple HPV types had similar clearance rates. There was no evidence of a dose-response relation between clearance and viral load. Observed was slower clearance in parous women (RR = 0.64, 95% CI: 0.47, 0.89) and faster clearance in ever users of oral contraceptives (RR = 1.38, 95% CI: 1.07, 1.77).
关于影响人乳头瘤病毒（HPV，宫颈癌的主要病因）清除的因素，人们了解甚少。从哥伦比亚波哥大的1995名年龄在13 - 85岁之间的女性人群队列中，识别出了227名在基线时细胞学正常且HPV呈阳性的女性，该队列在1993年至2000年期间进行随访（平均随访时间为5.3年）。HPV DNA检测和病毒载量测定基于GP5 + / GP6 +聚合酶链反应酶免疫测定法。HPV清除率的比率估计值通过使用区间删失生存时间数据的方法来计算。分析基于316种型特异性HPV感染。HPV 16的清除率显著低于低风险型感染（比率比（RR）= 0.47，95%置信区间（CI）：0.32，0.72），与HPV 16相关的HPV型（31、33、35、52、58型）清除率中等（RR = 0.62，95% CI：0.47，0.94），并且与低风险型相比，其他高风险型未显示出清除较慢的证据。单一和多种HPV型感染的清除率相似。在清除率与病毒载量之间没有剂量反应关系的证据。观察到经产妇清除较慢（RR = 0.64，95% CI：0.47，0.89），而口服避孕药使用者清除较快（RR = 1.38，95% CI：1.07，1.77）。
