BACKGROUND: Cohort effects, new sex partnerships, and human papillomavirus (HPV) reactivation have been posited as explanations for the bimodal age-specific HPV prevalence observed in some populations; no studies have systematically evaluated the reasons for the lack of a second peak in the United States. METHODS: A cohort of 843 women aged 35-60 years were enrolled into a 2-year, semiannual follow-up study. Age-specific HPV prevalence was estimated in strata defined by a lower risk of prior infection (<5 self-reported lifetime sex partners) and a higher risk of prior infection (≥ 5 lifetime sex partners). The interaction between age and lifetime sex partners was tested using likelihood ratio statistics. Population attributable risk (PAR) was estimated using Levin's formula. RESULTS: The age-specific prevalence of 14 high-risk HPV genotypes (HR-HPV) declined with age among women with <5 lifetime sex partners but not among women with ≥ 5 lifetime sex partners (P = .01 for interaction). The PAR for HR-HPV due to ≥ 5 lifetime sex partners was higher among older women (87.2%), compared with younger women (28.0%). In contrast, the PAR associated with a new sex partner was 28% among women aged 35-49 years and 7.7% among women aged 50-60 years. CONCLUSIONS: A lower cumulative probability of HPV infection among women with a sexual debut before the sexual revolution may be masking an age-related increase in HPV reactivation in the United States.
BACKGROUND: Cohort effects, new sex partnerships, and human papillomavirus (HPV) reactivation have been posited as explanations for the bimodal age-specific HPV prevalence observed in some populations; no studies have systematically evaluated the reasons for the lack of a second peak in the United States. METHODS: A cohort of 843 women aged 35-60 years were enrolled into a 2-year, semiannual follow-up study. Age-specific HPV prevalence was estimated in strata defined by a lower risk of prior infection (<5 self-reported lifetime sex partners) and a higher risk of prior infection (≥ 5 lifetime sex partners). The interaction between age and lifetime sex partners was tested using likelihood ratio statistics. Population attributable risk (PAR) was estimated using Levin's formula. RESULTS: The age-specific prevalence of 14 high-risk HPV genotypes (HR-HPV) declined with age among women with <5 lifetime sex partners but not among women with ≥ 5 lifetime sex partners (P = .01 for interaction). The PAR for HR-HPV due to ≥ 5 lifetime sex partners was higher among older women (87.2%), compared with younger women (28.0%). In contrast, the PAR associated with a new sex partner was 28% among women aged 35-49 years and 7.7% among women aged 50-60 years. CONCLUSIONS: A lower cumulative probability of HPV infection among women with a sexual debut before the sexual revolution may be masking an age-related increase in HPV reactivation in the United States.
Authors: P E Gravitt; C L Peyton; T Q Alessi; C M Wheeler; F Coutlée; A Hildesheim; M H Schiffman; D R Scott; R J Apple Journal: J Clin Microbiol Date: 2000-01 Impact factor: 5.948
Authors: Morgan A Marks; Raphael P Viscidi; Kathryn Chang; Michelle Silver; Anne Burke; Roslyn Howard; Patti E Gravitt Journal: Cytokine Date: 2011-10-19 Impact factor: 3.861
Authors: Sarika Desai; Ruth Chapman; Mark Jit; Tom Nichols; Ray Borrow; Michael Wilding; Christina Linford; Catherine M Lowndes; Anthony Nardone; Richard Pebody; Kate Soldan Journal: Sex Transm Dis Date: 2011-07 Impact factor: 2.830
Authors: Susan Hariri; Elizabeth R Unger; Maya Sternberg; Eileen F Dunne; David Swan; Sonya Patel; Lauri E Markowitz Journal: J Infect Dis Date: 2011-08-15 Impact factor: 5.226
Authors: Mona Saraiya; Meg Watson; Xiaocheng Wu; Jessica B King; Vivien W Chen; Jennifer S Smith; Anna R Giuliano Journal: Cancer Date: 2008-11-15 Impact factor: 6.860
Authors: Djenaba A Joseph; Jacqueline W Miller; Xiaocheng Wu; Vivien W Chen; Cyllene R Morris; Marc T Goodman; Jose M Villalon-Gomez; Melanie A Williams; Rosemary D Cress Journal: Cancer Date: 2008-11-15 Impact factor: 6.860
Authors: Anne F Rositch; Michelle I Silver; Anne Burke; Raphael Viscidi; Kathryn Chang; Cindy M P Duke; Wen Shen; Patti E Gravitt Journal: J Low Genit Tract Dis Date: 2013-01 Impact factor: 1.925
Authors: S Deblina Datta; Laura A Koutsky; Sylvie Ratelle; Elizabeth R Unger; Judith Shlay; Tracie McClain; Beth Weaver; Peter Kerndt; Jonathan Zenilman; Michael Hagensee; Cristen J Suhr; Hillard Weinstock Journal: Ann Intern Med Date: 2008-04-01 Impact factor: 25.391
Authors: Hannah P Yang; Rosemary E Zuna; Mark Schiffman; Joan L Walker; Mark E Sherman; Lisa M Landrum; Katherine Moxley; Michael A Gold; S Terence Dunn; Richard A Allen; Roy Zhang; Rodney Long; Sophia S Wang; Nicolas Wentzensen Journal: PLoS One Date: 2012-01-13 Impact factor: 3.240
Authors: Lauren Wilson; Michael Pawlita; Phillip E Castle; Tim Waterboer; Vikrant Sahasrabuddhe; Patti E Gravitt; Mark Schiffman; Nicolas Wentzensen Journal: J Infect Dis Date: 2014-02-25 Impact factor: 5.226
Authors: Gary Goldenberg; Maida Taylor; Brian Berman; Mark Kaufmann; William Abramovits; Joshua Zeichner Journal: J Clin Aesthet Dermatol Date: 2016-03-01
Authors: Mary K Grabowski; Ronald H Gray; David Serwadda; Godfrey Kigozi; Patti E Gravitt; Fred Nalugoda; Steven J Reynolds; Maria J Wawer; Stephen Watya; Thomas C Quinn; Aaron A R Tobian Journal: Sex Transm Infect Date: 2014-01-30 Impact factor: 3.519
Authors: Mary K Grabowski; Xiangrong Kong; Ronald H Gray; David Serwadda; Godfrey Kigozi; Patti E Gravitt; Fred Nalugoda; Steven J Reynolds; Maria J Wawer; Andrew D Redd; Stephen Watya; Thomas C Quinn; Aaron A R Tobian Journal: J Infect Dis Date: 2015-11-23 Impact factor: 5.226
Authors: Marcia L Shew; Aaron C Ermel; Bree A Weaver; Yan Tong; Wanzhu Tu; Laura M Kester; Cheryl Denski; J D Fortenberry; Darron R Brown Journal: J Infect Dis Date: 2013-08-02 Impact factor: 5.226
Authors: Sarah Feldman; Erin Cook; Michelle Davis; Susan T Gershman; Amresh Hanchate; Jennifer S Haas; Rebecca B Perkins Journal: J Low Genit Tract Dis Date: 2018-10 Impact factor: 1.925