Koshiol Jill, Schroeder Jane, Jamieson Denise J, Marshall Stephen W, Duerr Ann, Heilig Charles M, Shah Keerti V, Klein Robert S, Cu-Uvin Susan, Schuman Paula, Celentano David, Smith Jennifer S
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, USA.
Am J Epidemiol. 2006 Jul 15;164(2):176-83. doi: 10.1093/aje/kwj165. Epub 2006 Jun 14.
Persistent human papillomavirus (HPV) infection seems central to cervical carcinogenesis. Smoking is associated with cervical cancer in HPV DNA-positive women, but its association with HPV persistence is unclear, particularly with respect to human immunodeficiency virus (HIV) serostatus. The authors evaluated smoking and HPV clearance by HIV serostatus among 801 women from the HIV Epidemiology Research Study (United States, 1993-2000). Type-specific HPV duration was defined as the interval between initial MY09/11 polymerase chain reaction positivity and the first of two consecutive HPV-negative study visits. Hazard ratios adjusted for study site and risk behaviors (sexual activity or injection drug use) were estimated using Cox regression. This analysis included 522 HIV-seropositive and 279 HIV-seronegative women (median follow-up, 4.4 years). Ever smoking was associated with reduced clearance of high-risk HPV in HIV-seronegative women (hazard ratio (HR) = 0.51, 95% confidence interval (CI): 0.30, 0.88) but not in HIV-seropositive women (HR = 0.96, 95% CI: 0.65, 1.42); similar results were found for current smoking. Current smoking was not associated with clearance of any type-specific HPV in HIV-seropositive (HR = 0.99, 95% CI: 0.82, 1.20) or HIV-seronegative (HR = 0.93, 95% CI: 0.68, 1.26) women. HPV clearance did not appear to vary by amount or duration of smoking. Smoking did not modify overall clearance but was associated with lower high-risk HPV clearance in HIV-seronegative women.
持续性人乳头瘤病毒（HPV）感染似乎是宫颈癌发生的核心因素。吸烟与HPV DNA阳性女性的宫颈癌有关，但其与HPV持续性的关联尚不清楚，尤其是在人类免疫缺陷病毒（HIV）血清学状态方面。作者在来自HIV流行病学研究（美国，1993 - 2000年）的801名女性中，按HIV血清学状态评估了吸烟情况和HPV清除情况。特定类型HPV持续时间定义为初始MY09/11聚合酶链反应阳性与连续两次HPV阴性研究访视中首次阴性访视之间的间隔时间。使用Cox回归估计经研究地点和风险行为（性活动或注射吸毒）调整后的风险比。该分析纳入了522名HIV血清阳性和279名HIV血清阴性女性（中位随访时间为4.4年）。曾经吸烟与HIV血清阴性女性中高危HPV清除率降低有关（风险比（HR）= 0.51，95%置信区间（CI）：0.30，0.88），但在HIV血清阳性女性中无此关联（HR = 0.96，95% CI：0.65，1.42）；当前吸烟情况也得到类似结果。当前吸烟与HIV血清阳性（HR = 0.99，95% CI：0.82，1.20）或HIV血清阴性（HR = 0.93，95% CI：0.68，1.26）女性中任何特定类型HPV的清除均无关联。HPV清除情况似乎不因吸烟量或吸烟持续时间而有所不同。吸烟并未改变总体清除情况，但与HIV血清阴性女性中较低的高危HPV清除率有关。
