Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/96110
Title: Natural history of progression of HPV infection to cervical lesion or clearance: analysis of the control arm of the large, randomised PATRICIA study
Author: Jaisamrarn, Unnop
Castellsagué, Xavier
Garland, Suzanne M.
Naud, Paulo
Palmroth, Johanna
Rosario Raymundo, María Rowena
Wheeler, Cossette M.
Salmerón, Jorge
Chow, Song-Nan
Apter, Dan
Teixeira, Julio C.
Skinner, S Rachel
Hedrick, James
Szarewski, Anne
Romanowski, Barbara
Aoki, Fred Y.
Schwarz, Tino F.
Poppe, Willy A. J.
Bosch Aparici, Francisco Javier
Carvalho, Newton S.
Germar, Maria Julieta
Peters, Klaus
Paavonen, Jorma
Bozonnat, Marie Cecile
Descamps, Dominique
Struyf, Frank
Dubin, Gary O.
Rosillon, Dominique
Baril, Laurence
Keywords: Papil·lomavirus
Carcinogènesi
Càncer
Papillomaviruses
Carcinogenesis
Cancer
Issue Date: 19-Nov-2013
Publisher: Public Library of Science (PLoS)
Abstract: Background: The control arm of PATRICIA (PApillomaTRIal against Cancer In young Adults, NCT00122681) was used to investigate the risk of progression from cervical HPV infection to cervical intraepithelial neoplasia (CIN) or clearance of infection, and associated determinants. Methods and Findings: Women aged 15-25 years were enrolled. A 6-month persistent HPV infection (6MPI) was defined as detection of the same HPV type at two consecutive evaluations over 6 months and clearance as ≥2 type-specific HPV negative samples taken at two consecutive intervals of approximately 6 months following a positive sample. The primary endpoint was CIN grade 2 or greater (CIN2+) associated with the same HPV type as a 6MPI. Secondary endpoints were CIN1+/CIN3+ associated with the same HPV type as a 6MPI; CIN1+/CIN2+/CIN3+ associated with an infection of any duration; and clearance of infection. The analyses included 4825 women with 16,785 infections (3363 womenwith 6902 6MPIs). Risk of developing a CIN1+/CIN2+/CIN3+ associated with same HPV type as a 6MPI varied with HPV type and was significantly higher for oncogenic versus non-oncogenic types. Hazard ratios for development of CIN2+ were 10.44 (95% CI: 6.96-15.65), 9.65 (5.97-15.60), 5.68 (3.50-9.21), 5.38 (2.87-10.06) and 3.87 (2.38-6.30) for HPV-16, HPV-33, HPV-31, HPV-45 and HPV-18, respectively. HPV-16 or HPV-33 6MPIs had ~25-fold higher risk for progression to CIN3+. Previous or concomitant HPV infection or CIN1+ associated with a different HPV type increased risk. Of the different oncogenic HPV types, HPV-16 and HPV-31 infections were least likely to clear. Conclusions: Cervical infections with oncogenic HPV types increased the risk of CIN2+ and CIN3+. Previous or concomitant infection or CIN1+ also increased the risk. HPV-16 and HPV-33 have by far the highest risk of progression to CIN3+, and HPV-16 and HPV-31 have the lowest chance of clearance.
Note: Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0079260
It is part of: PLoS One, 2013, vol. 8, num. 11, p. e79260
Related resource: http://dx.doi.org/10.1371/journal.pone.0079260
URI: http://hdl.handle.net/2445/96110
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Fonaments Clínics)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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