Division of Cancer Epidemiology, Gerald Bronfman Department of Oncology, McGill University, Montréal, Canada.
Département de Médecine Sociale et Préventive, Université de Montréal, Montréal, Canada.
J Infect Dis. 2023 Aug 16;228(4):402-411. doi: 10.1093/infdis/jiad043.
We assessed the incidence and risk factors for first detection and redetection with the same human papillomavirus (HPV) genotype, and prevalence of cytological lesions during HPV redetections.
The Ludwig-McGill cohort study followed women aged 18-60 years from São Paulo, Brazil in 1993-1997 for up to 10 years. Women provided cervical samples for cytology testing and HPV DNA testing at each visit. A redetection was defined as a recurring genotype-specific HPV positive result after 1 or more intervening negative visits. Predictors of genotype-specific redetection were assessed using adjusted hazard ratios (aHR) with Cox regression modeling.
In total, 2184 women contributed 2368 incident HPV genotype-specific first detections and 308 genotype-specific redetections over a median follow-up of 6.5 years. The cumulative incidence of redetection with the same genotype was 6.6% at 1 year and 14.8% at 5 years after the loss of positivity of the first detection. Neither age (aHR 0.90; 95% confidence interval [CI], .54-1.47 for ≥45 years vs < 25 years) nor new sexual partner acquisition (aHR 0.98; 95% CI, .70-1.35) were statistically associated with genotype-specific redetection. High-grade squamous intraepithelial lesion prevalence was similar during first HPV detections (2.9%) and redetection (3.2%).
Our findings suggest many HPV redetections were likely reactivations of latent recurring infections.
我们评估了首次检测和同型 HPV 再次检测的发生率和危险因素，以及 HPV 再次检测时细胞学病变的流行情况。
Ludwig-McGill 队列研究于 1993 年至 1997 年期间对巴西圣保罗的 18-60 岁女性进行了随访，随访时间长达 10 年。女性在每次就诊时提供宫颈样本进行细胞学检测和 HPV DNA 检测。HPV 再次检测定义为在 1 次或多次阴性随访后再次出现特定 HPV 基因型阳性结果。采用 Cox 回归模型评估调整后的风险比（aHR），评估特定 HPV 基因型再次检测的预测因素。
在中位随访 6.5 年期间，共有 2184 名女性提供了 2368 例首次 HPV 基因型特异性检测的首次检测结果和 308 例 HPV 基因型特异性再次检测结果。首次检测结果转为阳性 1 年后和 5 年后，同一基因型的再次检测累积发生率分别为 6.6%和 14.8%。年龄（aHR 0.90；95%置信区间[CI]，≥45 岁 vs < 25 岁为 0.54-1.47）和新性伴侣的获得（aHR 0.98；95%CI，0.70-1.35）均与特定 HPV 基因型的再次检测无统计学关联。首次 HPV 检测时（2.9%）和再次检测时（3.2%）高级别鳞状上皮内病变的患病率相似。
我们的研究结果表明，许多 HPV 再次检测可能是潜伏性复发性感染的再激活。
