NATURAL-HISTORY OF CERVICOVAGINAL PAPILLOMAVIRUS INFECTION IN YOUNG-WOMEN

Background Genital human papillomavirus (HPV) infection is highly prev alent in sexually active young women. However, precise risk factors fo r HPV infection and its incidence and duration are not well known. Met hods We followed 608 college women at six-month intervals for three ye ars. At each visit, we collected information about lifestyle and sexua l behavior and obtained cervicovaginal-lavage samples for the detectio n of HPV DNA by polymerase chain reaction and Southern blot hybridizat ion. Pap smears were obtained annually. Results The cumulative 36-mont h incidence of HPV infection was 43 percent (95 percent confidence int erval, 36 to 49 percent). An increased risk of HPV infection was signi ficantly associated with younger age, Hispanic ethnicity, black race, an increased number of vaginal-sex partners, high frequencies of vagin al sex and alcohol consumption, anal sex, and certain characteristics of partners (regular partners having an increased number of lifetime p artners and not being in school). The median duration of new infection s was 8 months (95 percent confidence interval, 7 to 10 months). The p ersistence of HPV for greater than or equal to 6 months was related to older age, types of HPV associated with cervical cancer, and infectio n with multiple types of HPV but not with smoking. The risk of an abno rmal Pap smear increased with persistent HPV infection, particularly w ith high-risk types (relative risk, 37.2; 95 percent confidence interv al, 14.6 to 94.8). Conclusions The incidence of HPV infection in sexua lly active young college women is high. The short duration of most HPV infections in these women suggests that the associated cervical dyspl asia should be managed conservatively. (C) 1998, Massachusetts Medical Society.