Epidemiologic Profile of Type‐Specific Human Papillomavirus Infection and Cervical Neoplasia in Guanacaste, Costa Rica
Abstract
Background Detailed epidemiologic studies of cervical type-specific human papillomavirus (HPV) infection in large populations are scarce. Methods We recruited a population-based cohort in Guanacaste, Costa Rica. Participants were interviewed, screened for cervical neoplasia, and tested for >40 HPV types by use of MY09/11 L1 consensus primer polymerase chain reaction. We estimated the risk factors for infection and the associations between type-specific HPV infections and cervical intraepithelial neoplasia (CIN) and cancer in 8514 sexually active women who had not undergone a hysterectomy. Results The overall HPV prevalence was 26.5%. The most common type was HPV-16 (3.6% of the population). HPV prevalence showed a U-shaped age-specific curve. Sexual behaviors were the main determinants of oncogenic and nononcogenic infections; age at first sexual intercourse was not independently associated with infection. Barrier contraceptive use was somewhat protective against infection. Oncogenic infections were strongly associated with risk of all grades of CIN and of cancer. Types 16, 18, and 58 were the most common in women diagnosed with CIN3 and cancer. Except for those that included HPV-16, multiple-type infections were associated with an increased risk (compared with that for single-type infections) of all grades of CIN and of cancer. Conclusions We confirmed the bimodal age pattern of HPV infection in Guanacaste and the sexually transmitted nature of both oncogenic and nononcogeni…
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The increase in HPV infection and multiple types with age is explained by cumulative lifetime exposure, relative incompetency in viral clearance, and insufficient adaptive immune responses at menopausal transition, contributing to HPV persistence or reactivation.
“The frequency of HPV infection and multiple types increases with age explains cumulative lifetime exposure [33], relative incompetency in viral clearance and insufficient adaptive immune responses at this age caused by hormonal changes at menopausal transition, contributing to HPV persistence or reactivation of latent HPV infections [34, 35].”
From HPV Genotypes distribution in Indian women with and without cervical carcinoma: Implication for HPV vaccination program in Odisha, Eastern India (2017) · cites this paper as [34]
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Senapati, R., Nayak, B., Kar, S. K., & Dwibedi, B. (2017) · BMC Infectious Diseases · doi:10.1186/s12879-016-2136-4 · Cited by 95 · see citing works
“The frequency of HPV infection and multiple types increases with age explains cumulative lifetime exposure [33], relative incompetency in viral clearance and insufficient adaptive immune responses at this age caused by hormonal changes at menopausal transition, contributing to HPV persistence or reactivation of latent…”
BackgroundMachalek, D. A., Grulich, A. E., Jin, F., Templeton, D. J., & Poynten, I. M. (2012) · Sexual Health · doi:10.1071/sh12043 · Cited by 59 · see citing works
- Authors
- Herrero, R., Castle, P. E., Schiffman, M., Bratti, M. C., Hildesheim, A., Morales, J., Alfaro, M., Sherman, M. E., Wacholder, S., Chen, S., Rodriguez, A. C., & Burk, R. D.
- Affiliations
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (CR)
- National Institutes of Health (US)
- Information Management Services (US)
- Albert Einstein College of Medicine (US)
- ORCID
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-06
- Volume
- 191
- Issue
- 11
- Pages
- 1796-1807
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2162602627
- Cited by
- 377
- References
- 0
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 9 · 2023: 9 · 2022: 13 · 2021: 9 · 2020: 6 · 2019: 11 · 2018: 12 · 2017: 19 · 2016: 10 · 2015: 18 · 2014: 9 · 2013: 25 · 2012: 25
- FWCI
- 21.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- human papillomavirus, HPV genotype distribution, cervical intraepithelial neoplasia, cervical cancer, HPV16, HPV 18, HPV58, multiple HPV infection, sexual behavior, sexually transmitted infections, Guanacaste
- MeSH terms
- Adult, Age Factors, Aged, Uterine Cervical Neoplasms, Costa Rica, Female, Humans, Middle Aged, Risk Factors, Prevalence, Papillomaviridae, Papillomavirus Infections
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