Natural history of persistent high-risk human papillomavirus infections in Korean women

• Published in: Gynecologic oncology Vol. 115; no. 1; pp. 75 - 80
• Main Authors: Bae, Jaeman, Seo, Sang-Soo, Park, Young-Soo, Dong, Seung-Myung, Kang, Sokbom, Myung, Seung-Kwon, Park, Sang-Yoon
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2009
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Cervical cancer screening; Cervical Intraepithelial Neoplasia - epidemiology; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; CIN; Clearance; DNA, Viral - analysis; Female; Hematology, Oncology and Palliative Medicine; Human papillomavirus; Humans; Korea - epidemiology; Mass Screening; Middle Aged; Obstetrics and Gynecology; Papanicolaou Test; Papillomaviridae - genetics; Papillomavirus Infections - epidemiology; Papillomavirus Infections - pathology; Papillomavirus Infections - virology; Prevalence; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Vaginal Smears; Viral Load; Korea; CIN; Human papillomavirus; Cervical cancer screening; Prevalence; Clearance; Viral load
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2009.06.016

Abstract Objective This prospective study was performed to evaluate the clearance of high-risk human papillomavirus (HPV) infection and incidence of cytologic abnormality and cervical intraepithelial neoplasia (CIN) during the follow-up of persistent infection in Korean women. Methods A total of 4170 women who were screened for cervical cancer, were aged 30 years or older, had no abnormal last Pap smear results for 3 years, had no history of treatment for cervical neoplastic disease, and were not pregnant were analyzed for high-risk HPV prevalence using the Hybrid capture (HC) II assay. The 224 women with normal cytology but positive for high-risk HPV DNA using the HC-II assay were analyzed for their clearance of HPV infection. Results The median time to clearance in women with initially normal cytology was 7.5 months from initial detection (95% CI, 5.2–9.8 months). There were significant differences in the median time to clearance (4.5 vs. 14.5 months, p < 0.001) of high-risk HPV infection between women with the initial relative light unit/cutoff (RLU/CO) ratio values < 10.0 and ≥ 10.0, as determined by the HC-II assay. In Kaplan–Meier analysis, probability of development of cytologic abnormalities, CIN and high-grade CIN was 38.2%, 21.7% and 8.5% respectively at 24 months of persistent high-risk HPV infection. Conclusion The prevalence and clearance of high-risk infection in Korean women was similar to that in Western countries. Persistent high-risk HPV infection was associated with high viral load.