RESUMO
Coinfection with multiple types of human papillomavirus (HPV) and its implications for the development of efficacious HPV vaccines is a subject of great interest. To describe the occurrence of concurrent infection with multiple HPV types and to determine whether genital HPV infection modifies the risk of acquiring a new HPV infection with another HPV type, 1610 subjects were monitored for an average of 4.1 years in Bogota, Colombia. Information on risk factors for HPV infection and cervical cells was collected for detection of HPV DNA of 36 types at study entry and at 6 consecutive 6-month follow-up visits. Clustering or the concurrent acquisition of multiple types occurred more often than would be expected by chance. Subjects with incident HPV-16 or -18 infection had 5-7 times higher odds of acquiring a subsequent HPV-58 infection than subjects not infected with HPV-16 or -18. This might affect the protection conferred by effective HPV vaccines.
Assuntos
Papillomaviridae/classificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero/prevenção & controle , Vacinas Virais/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Razão de Chances , Papillomaviridae/genética , Papillomaviridae/imunologia , Papillomaviridae/patogenicidade , Fatores de Risco , Especificidade da Espécie , Vacinas Virais/imunologiaRESUMO
Data on the incidence and determinants of human papillomavirus (HPV) infection in women >30 years old are scarce. To address this, a cohort of 1610 women--15-85 years old, HPV negative, and with normal cytological results at baseline--was monitored every 6 months for an average of 4.1 years. Information on risk factors and cervical samples for cytological testing and detection and typing of HPV DNA were obtained at each visit. The incidence of high-risk types was higher than that of low-risk types (5.0 vs. 2.0 cases/100 woman-years). The age-specific incidence curve for high-risk types was bimodal, whereas the incidence of low-risk types gradually decreased with age. Infections with high-risk types lasted longer than infections with low-risk types (14.8 vs. 11.1 months). In this cohort of cytologically normal women, the incidence of cervical HPV infection was high, and the epidemiological profile of high-risk HPV types was different from that of low-risk types.