HCP Live
Contagion LiveCGT LiveNeurology LiveHCP LiveOncology LiveContemporary PediatricsContemporary OBGYNEndocrinology NetworkPractical CardiologyRheumatology Netowrk

Persistent HPV may put women at risk for other HPV infections

Human papillomavirus virus (HPV) infections that persist for a long time appear to leave women more susceptible to other HPV infections, especially longer-term ones, than infections that clear up, a recent study suggests.

Human papillomavirus virus (HPV) infections that persist for a long time appear to leave women more susceptible to other HPV infections, especially longer-term ones, than infections that clear up, a recent study suggests.

Researchers investigated long-term persistence of HPV without apparent cervical precancer and cancer in a subset of 810 Costa Rican women with 1,403 prevalently detected HPV infections from a large population-based study. The women underwent 3 or more years of active follow-up and 3 or more screening visits. Cervical specimens were tested using polymerase chain reaction. Fifty-eight of the 810 women had 72 long-term HPV infections (5%) that persisted until the end of the follow-up period (median, 7 years). A logistic regression model showed that women with long-term HPV were more likely than women whose infections cleared to have another newly-detected HPV infection when assessed at 3 or more office visits (odds ratio, 2.6).

The study was published in the Journal of Infectious Diseases (2011;203(6):814-822).

“The clinical implications and best patient management for the approximately 1 in 20 HPV-positive women who, by our definition, will have long-term viral persistence without evidence of cervical disease among those with an index-positive HPV test are uncertain,” the authors note.

The authors observe that although immediate excision of cervical tissue “provides the greatest safety, almost 90% of women would be overtreated” with this approach. An alternative approach would be “a more aggressive colposcopic exam, including 4-quadrant microbiopsies and endocervical curettage to maximize disease ascertainment without excision,” they write.

Women with long-term persistence of HPV infection were older than women with other outcomes, the researchers found (mean age, 54.4 years [median, 58.5 years] vs mean age, 35.8 years [median, 32.0 years]). They speculate that some older women may not be able to clear HPV infection because of age-related immunologic decline.