Detection and Clearance of Type-Specific and Phylogenetically Related Genital Human Papillomavirus Infections in Young Women in New Heterosexual Relationships

• Published in: The Journal of infectious diseases Vol. 229; no. 3; pp. 691 - 706
• Main Authors: Arthur, Andrew W, El-Zein, Mariam, Burchell, Ann N, Tellier, Pierre-Paul, Coutlée, François, Franco, Eduardo L
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 14-03-2024
• Subjects: Female; Genitalia; Heterosexuality; Humans; Incidence; Major; Papillomaviridae - genetics; Papillomavirus Infections; Phylogeny; Prospective Studies; Risk Factors; Sexually Transmitted Diseases; Uterine Cervical Neoplasms - epidemiology; sexually transmitted infection; genital infection; prospective cohort study; human papillomavirus; Papillomaviridae; clearance; persistence; incidence; natural history; cervical cancer
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiad450

Abstract
Background
Understanding the natural history of human papillomavirus (HPV) infections is essential to cervical cancer prevention planning. We estimated HPV type-specific infection detection and clearance in young women.
Methods
The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) study is a prospective cohort of 502 college-age women who recently initiated a heterosexual relationship. We tested vaginal samples collected at 6 clinical visits over 24 months for 36 HPV types. Using rates and Kaplan-Meier analysis, we estimated time-to-event statistics with 95% confidence intervals (CIs) for detection of incident infections and clearance of incident and present-at-baseline infections (separately). We conducted analyses at the woman- and HPV-levels, with HPV types grouped by phylogenetic relatedness.
Results
By 24 months, we detected incident infections in 40.4% (CI, 33.4%–48.4%) of women. Incident subgenus 1 (43.4; CI, 33.6–56.4), 2 (47.1; CI, 39.9–55.5), and 3 (46.6; CI, 37.7–57.7) infections cleared at similar rates per 1000 infection-months. We observed similar homogeny in HPV-level clearance rates among present-at-baseline infections.
Conclusions
Our analyses provide type-specific infection natural history estimates for cervical cancer prevention planning. HPV-level analyses did not clearly indicate that high oncogenic risk subgenus 2 infections persist longer than their low oncogenic risk subgenera 1 and 3 counterparts.
Using rates and Kaplan-Meier analyses, we characterized the natural history of human papillomavirus (HPV) infections in college-age women in new heterosexual relationships. Our HPV type-specific analyses indicated homogenous detection and clearance rates for infections grouped by Alphapapillomavirus subgenera.