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Human Papillomavirus 16: Prevalence, Incidence, and Behavioral Risk Factors

Human Papillomavirus 16: Prevalence, Incidence, and Behavioral Risk Factors. Deborah L. Thompson, MD, MSPH March 10, 2004. Background. HPV is common viral STD > 30 HPV types infecting genital region Classified based on oncogenic potential Difficulties with HPV testing. Goals of study.

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Human Papillomavirus 16: Prevalence, Incidence, and Behavioral Risk Factors

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  1. Human Papillomavirus 16: Prevalence, Incidence, and Behavioral Risk Factors Deborah L. Thompson, MD, MSPH March 10, 2004

  2. Background • HPV is common viral STD • > 30 HPV types infecting genital region • Classified based on oncogenic potential • Difficulties with HPV testing

  3. Goals of study • Characterize prevalence, persistence, and incidence of serologically determined HPV-16 • Improve understanding of demographic and behavioral risk factors for seropositivity

  4. Methods • Study design • Cross-sectional for seroprevalence • Retrospective cohort for antibody persistence and seroincidence

  5. Methods • Population • Project RESPECT - STD Clinics • PR study participants were 5758 heterosexual pts aged 14 yrs or older • 1595 patients used in current study

  6. Study population

  7. Methods • Questionnaire data • Interviews at 0, 3, 6, 9, and 12 months • Data for sera • Serum collected at 0, 6, and 12 months • IgG antibodies to HPV-16 by ELISA using virus-like particles

  8. Outcome Definition • Prevalent infection: seropositive at baseline • Persistent infection: seropositive at baseline and at 6 and 12 months • Incident infection: seronegative at baseline with subsequent seropositive result at 6 and/or 12 months

  9. Statistical analysis • Point prevalence and incidence density • Simple logistic regression • Multiple logistic regression

  10. Study Population (n=1595)

  11. Study Population (n=1595)

  12. Results: HPV-16 Seroprevalence • Overall, 24.5% (95% CI 22.4, 26.6) • Higher among women (30.2%) than men (18.7%, OR 2.1, 95% CI 1.6, 2.8)

  13. Results: HPV-16 Seroprevalence *Adjusted for race/ethnicity, education, income, and study site.

  14. Results: HPV-16 Seroincidence • Overall incidence 20.2 cases per 100 person-years (95% CI 17.9, 22.5) • Women: 25.4 cases per 100 person-years (95% CI 21.8, 29.0) • Men: 15.7 cases per 100 person-years (95% CI 12.9, 18.5)

  15. Results: HPV-16 Seroincidence *Adjusted for race/ethnicity, arm, study site, and income.

  16. Study limitations • No gold standard • Potential for misclassification • Limited generalizability

  17. Conclusions • Seroprevalence and seroincidence higher among women than men • Age > 20 years independently associated with seroprevalence and seroincidence • Recent sexual behavior was stronger predictor than lifetime sexual behavior

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