Synergistic Effect of Viral Load and Alcohol Consumption on the Risk of Persistent High-Risk Human Papillomavirus Infection

• Published in: PloS one Vol. 9; no. 8; p. e104374
• Main Authors: Oh, Hea Young, Seo, Sang-Soo, Kim, Mi Kyung, Lee, Dong Ock, Chung, Youn Kyung, Lim, Myong Cheol, Kim, Joo-Young, Lee, Chan Wha, Park, Sang-Yoon
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20.08.2014; Public Library of Science (PLoS)
• Subjects: Adult; Alcohol Drinking; Alcohol use; Alcoholic beverages; Alcohols; Cancer; Cervical cancer; Cervix; Confidence intervals; Drinking behavior; Female; Follow-Up Studies; Health risk assessment; Health risks; Human papillomavirus; Humans; Infections; Lesions; Medicine and Health Sciences; Middle Aged; Papillomaviridae - isolation & purification; Papillomavirus Infections - virology; Prospective Studies; Recurrence; Regression analysis; Risk Factors; Statistical analysis; Synergistic effect; Viral Load; Womens health; Italy
• DOI: 10.1371/journal.pone.0104374
• ISSN: 1932-6203

This prospective study aimed to examine the combined effect of viral load and alcohol consumption on the risk of persistent high-risk (HR) human papillomavirus (HPV) infection. Among women undergoing health screening between 2002 and 2011 at the National Cancer Center, 284 and 122 women with HR-HPV infection and cytological findings of low-grade squamous intraepithelial or lower-grade lesions were followed up for 1 and 2 years, respectively. Multivariate logistic regression analysis was performed, and the relative excess risk due to interaction (RERI) and synergy index (S) were calculated. Among drinkers, the risks of 1-year (odds ratio [OR] 4.09, 95% confidence interval [CI] 2.05-8.18) and 2-year persistence (OR 8.08, CI 2.36-27.6) were significantly higher for high HPV loads than for low HPV loads; this association was not seen for non-drinkers. The risks for 1-year (OR 4.14, CI 1.89-9.05) and 2-year persistence (OR 6.61, CI 2.09-20.9) were significantly higher in subjects with a high HPV load who were also drinkers than in those who were non-drinkers. A high HPV load together with a longer drinking duration or higher alcohol consumption was associated with increased risks of 1-year (OR 3.07, CI 1.40-6.75 or OR 2.05, CI 0.87-4.83) and 2-year persistence (OR 6.40, CI 1.72-23.8 or OR 4.14, CI 1.18-14.6). The synergistic effect of alcohol consumption and HR-HPV load was stronger on the risk of 2-year persistence (RERI = 3.26, S = 2.38) than on the risk of 1-year persistence (RERI = 1.21, S = 1.63). The synergistic effect of HR-HPV load and alcohol consumption was associated with the risk of HR-HPV persistence and was stronger for longer-term HR-HPV infection. Limiting alcohol consumption might be an important measure to prevent the development of cervical cancer in women with a high HR-HPV load.