Talía Malagón1, Aaron MacCosham1, Ann N Burchell2,3, Mariam El-Zein1, Pierre Paul Tellier4, François Coutlée5,6, Eduardo L Franco1. 1. Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, Canada. 2. Department of Family and Community Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. 3. Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 4. Department of Family Medicine, McGill University, Montreal, Canada. 5. Service de Biologie moléculaire du département de Médecine de laboratoire et Service d'infectiologie du département de Médecine, Centre Hospitalier de l'Université de Montréal, Montréal, Canadaand. 6. Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Canada.
Abstract
BACKGROUND: Infections with human papillomaviruses (HPVs) may enter a latent state, and eventually become reactivated following loss of immune control. It is unclear what proportion of incident HPV detections are reactivations of previous latent infections vs new transmissions. METHODS: The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) cohort study prospectively followed young newly formed heterosexual partners recruited between 2005 and 2011 in Montréal, Canada. We calculated the fraction of incident HPV detections nonattributable to sexual transmission risk factors with a Bayesian Markov model. Results are the median (2.5th-97.5th percentiles) of the estimated posterior distribution. RESULTS: A total of 544 type-specific incident HPV detection events occurred in 849 participants; 33% of incident HPV detections occurred in participants whose HITCH partners were negative for that HPV type and who reported no other sex partners over follow-up. We estimate that 43% (38%-48%) of all incident HPV detections in this population were not attributable to recent sexual transmission and might be potentially reactivation of latent infections. CONCLUSIONS: A positive HPV test result in many cases may be a reactivated past infection, rather than a new infection from recent sexual behaviors or partner infidelity. The potential for reactivation of latent infections in previously HPV-negative women should be considered in the context of cervical cancer screening.
BACKGROUND: Infections with human papillomaviruses (HPVs) may enter a latent state, and eventually become reactivated following loss of immune control. It is unclear what proportion of incident HPV detections are reactivations of previous latent infections vs new transmissions. METHODS: The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) cohort study prospectively followed young newly formed heterosexual partners recruited between 2005 and 2011 in Montréal, Canada. We calculated the fraction of incident HPV detections nonattributable to sexual transmission risk factors with a Bayesian Markov model. Results are the median (2.5th-97.5th percentiles) of the estimated posterior distribution. RESULTS: A total of 544 type-specific incident HPV detection events occurred in 849 participants; 33% of incident HPV detections occurred in participants whose HITCH partners were negative for that HPV type and who reported no other sex partners over follow-up. We estimate that 43% (38%-48%) of all incident HPV detections in this population were not attributable to recent sexual transmission and might be potentially reactivation of latent infections. CONCLUSIONS: A positive HPV test result in many cases may be a reactivated past infection, rather than a new infection from recent sexual behaviors or partner infidelity. The potential for reactivation of latent infections in previously HPV-negative women should be considered in the context of cervical cancer screening.
Authors: Philip E Castle; Patti E Gravitt; Diane Solomon; Cosette M Wheeler; Mark Schiffman Journal: J Clin Microbiol Date: 2007-11-07 Impact factor: 5.948
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Authors: Ann N Burchell; Pierre-Paul Tellier; James Hanley; François Coutlée; Eduardo L Franco Journal: Sex Transm Dis Date: 2010-01 Impact factor: 2.830