TY - JOUR
T1 - Incidence and persistence of carcinogenic genital human papillomavirus infections in young women with or without Chlamydia trachomatis co-infection
AU - Medical Microbiological Laboratories and the CSI group
AU - Vriend, Henrike J
AU - Bogaards, Johannes A
AU - van Bergen, Jan E A M
AU - Brink, Antoinette A T P
AU - van den Broek, Ingrid V F
AU - Hoebe, Christian J P A
AU - King, Audrey J
AU - van der Sande, Marianne A B
AU - Wolffs, Petra F G
AU - de Melker, Hester E
N1 - © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2015
Y1 - 2015
N2 - We assessed whether infection with chlamydia increases the incidence of carcinogenic human papillomavirus (HPV) infections and if HPV persistence is affected by chlamydia co-infection. For 1982 women (16-29 years-old) participating in two consecutive rounds of a chlamydia screening implementation trial, swabs were polymerase chain reaction tested to detect chlamydia and 14 carcinogenic HPV genotypes. HPV type-specific incidence and persistence rates were stratified for chlamydia positivity at follow-up. Associations were assessed by multilevel logistic regression analyses with correction for sexual risk factors. HPV type-specific incidence ranged from 1.4% to 8.9% and persistence from 22.7% to 59.4% after a median follow-up of 11 months (interquartile range: 11-12). Differences in 1-year HPV persistence rates between chlamydia -infected and noninfected women were less distinct than differences in HPV incidence rates (pooled adjusted odds ratios of 1.17 [95% CI: 0.69-1.96] and 1.84 [95% CI: 1.36-2.47], respectively). The effect of chlamydia co-infection on HPV-infection risk did not significantly differ by HPV genotype. In conclusion, infection with chlamydia increases the risk of infection by carcinogenic HPV types and may enhance persistence of some HPV types. Although these findings could reflect residual confounding through unobserved risk factors, our results do give reason to explore more fully the association between chlamydia and HPV type-specific acquisition and persistence.
AB - We assessed whether infection with chlamydia increases the incidence of carcinogenic human papillomavirus (HPV) infections and if HPV persistence is affected by chlamydia co-infection. For 1982 women (16-29 years-old) participating in two consecutive rounds of a chlamydia screening implementation trial, swabs were polymerase chain reaction tested to detect chlamydia and 14 carcinogenic HPV genotypes. HPV type-specific incidence and persistence rates were stratified for chlamydia positivity at follow-up. Associations were assessed by multilevel logistic regression analyses with correction for sexual risk factors. HPV type-specific incidence ranged from 1.4% to 8.9% and persistence from 22.7% to 59.4% after a median follow-up of 11 months (interquartile range: 11-12). Differences in 1-year HPV persistence rates between chlamydia -infected and noninfected women were less distinct than differences in HPV incidence rates (pooled adjusted odds ratios of 1.17 [95% CI: 0.69-1.96] and 1.84 [95% CI: 1.36-2.47], respectively). The effect of chlamydia co-infection on HPV-infection risk did not significantly differ by HPV genotype. In conclusion, infection with chlamydia increases the risk of infection by carcinogenic HPV types and may enhance persistence of some HPV types. Although these findings could reflect residual confounding through unobserved risk factors, our results do give reason to explore more fully the association between chlamydia and HPV type-specific acquisition and persistence.
KW - Adolescent
KW - Adult
KW - Alphapapillomavirus/genetics
KW - Carcinogenesis
KW - Chlamydia Infections/epidemiology
KW - Chlamydia trachomatis/isolation & purification
KW - Coinfection/epidemiology
KW - Female
KW - Humans
KW - Incidence
KW - Netherlands/epidemiology
KW - Papillomavirus Infections/complications
KW - Polymerase Chain Reaction
KW - Risk Factors
KW - Uterine Cervical Neoplasms/epidemiology
KW - Vaginal Smears
KW - Young Adult
U2 - 10.1002/cam4.496
DO - 10.1002/cam4.496
M3 - A1: Web of Science-article
C2 - 26194784
VL - 4
SP - 1589
EP - 1598
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 10
ER -