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Factors predicting persistence of high-risk human papillomavirus (HPV) infections in women prospectively followed-up in three New Independent States (NIS)* of the former Soviet Union

  • S. Syrjanen1
  • I. Shabalova2,3
  • N. Petrovichev2
  • V. Kozachenko2
  • T. Zakharova2
  • J. Pajanidi2
  • J. Podistov2
  • G. Chemeris2
  • L. Sozaeva3
  • E. Lipova3
  • I. Tsidaeva4
  • O. Ivanchenko4
  • A. Pshepurko4
  • S. Zakharenko5
  • R. Nerovjna6
  • L. Kljukina7
  • O. Erokhina7
  • M. Branovskaja8
  • M. Nikitina9
  • V. Grunberga9
  • A. Grunberg9
  • A. Juschenko9
  • M. Cintorino10
  • R. S antopietro10
  • P. Tosi10
  • K. SyrjJ anen10,11,*,

1Department of Oral Pathology, Institute of Dentistry, and MedIcity Research Laboratory, University of Turku,Turku, Finland

2N.N. Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia

3Russian Academy of Post-Graduate Medical Education, Moscow, Russia

4Novgorod Clinical Regional Hospital, Centralised Cytology Laboratory, Novgorod, Russia

5Novgorod Municipal Dermato-venereological Dispensary, Department of Gynaecology, Novgorod, Russia

6Novgorod Female Consultative Outpatient Hospital, Department of Gynaecology, Novgorod, Russia

7Research Institute of Oncology and Medical Radiology, Republican Centre of Clinical Cytology, Minsk, Belarus

8Minsk State Medical Institute, Department of Gynaecology and Obstetrics, Minsk, Belarus

9Latvian Cancer Centre, Department of Gynaecology, & Laboratory of Cytology, Riga, Latvia

10Department of Pathology, University of Siena, Siena, Italy

11Department of Oncology & Radiotherapy, Turku University Central Hospital, Turku, Finland

DOI: 10.12892/ejgo200505491 Vol.26,Issue 5,September 2005 pp.491-498

Published: 10 September 2005

*Corresponding Author(s): K. SyrjJ anen E-mail:

Abstract

Background: We completed an analysis of the factors predicting the persistence of high risk (HR) HPV infections in women participating in a multicenter screening trial in three NIS countries.

Methods: The 543 baseline HR HPV-positive women included in this analysis are derived from a sub-cohort of 887 women who were prospectively followed-up for a mean of 21.6 months (range: 0.5-42.9) as a part of a multi-center screening study in three NIS countries (the NIS cohort study; n = 3,187 women). Of these 543 women, 273 showed persistent HR-HPV in serial Hybrid Capture II (HCII) testing during the follow-up (Group 1), whereas 270 women cleared their infection (Group 2). These two groups were compared with their epidemiological, clinical, and virological data (HCII, PCR) to disclose the factors predicting persistent HR-HPV infection.

Results: Women with persistent HR-HPV infections were significantly younger (27.3 yrs) than those who cleared their infection (29.1 yrs) (p = 0.006), and their follow-up time was shorter; 14.1 and 21 months, respectively (p = 0.0001). Both variables were treated as confounders in the multivariate analyses. Of the 66 recorded epidemiological variables, only being a current smoker proved to be an independent predictor (OR 1.693; 95% CI 1.114-2.573; p=0.014). Baseline colposcopy, biopsy or Pap smear did not predict HPV persistence, whereas an incident or persistent abnormal Pap during the follow-up were independent predictors in a multivariate model (p = 0.005), together with the high viral load (HCII RLU/CO at 100 pg/ml cut-off), and HR HPV positive PCR test (p = 0.0001). When all significant variables were entered in the regression model, only the follow-up time (OR 0.950, 95% CI 0.924-0.976; p = 0.0001) and HR-HPV positive PCR (OR 4.169, 95% CI 1.741-9.987; p = 0.001), remained independent predictors.

Conclusions: While several factors were related to HR-HPV persistence in univariate analysis and when adjusted for age and follow-up time as confounders, the only independent predictors in the multivariate regression model were follow-up time and HR-HPV positive PCR. Clearly more data are needed on type-specific persistence and HPV integration as its predictors.

Keywords

High-risk HPV; Persistent infection; Virus clearance; Predictors; Screening; Hybrid Capture Ⅱ

Cite and Share

S. Syrjanen,I. Shabalova,N. Petrovichev,V. Kozachenko,T. Zakharova,J. Pajanidi,J. Podistov,G. Chemeris,L. Sozaeva,E. Lipova,I. Tsidaeva,O. Ivanchenko,A. Pshepurko,S. Zakharenko,R. Nerovjna,L. Kljukina,O. Erokhina,M. Branovskaja,M. Nikitina,V. Grunberga,A. Grunberg,A. Juschenko,M. Cintorino,R. S antopietro,P. Tosi,K. SyrjJ anen. Factors predicting persistence of high-risk human papillomavirus (HPV) infections in women prospectively followed-up in three New Independent States (NIS)* of the former Soviet Union. European Journal of Gynaecological Oncology. 2005. 26(5);491-498.

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