A prospective study on the risk of cervical intra-epithelial neoplasia among healthy subjects with serum antibodies to HPV compared with HPV DNA in cervical smears.
To estimate the risk of developing cervical intra-epithelial neoplasia (CIN) among women exposed to human papillomavirus (HPV) type 16, we performed a prospective study in a population-based cohort of more than 15,000 women followed for 34.9 months.
Seventy-four women developed CIN during follow-up and were matched for age, time of sampling and area of residence with 148 women who remained CIN-free during follow-up.
The blood samples taken at enrollment were tested for serum antibodies to HPV types 16,18 and 33 capsids.
Cervical smears or biopsies were analyzed for the presence of HPV DNA by nested PCR using HPV general primers and by HPV 16-and 18-type-specific PCR.
HPV serology and HPV-PCR were in good agreement, particularly when the blood sample and the Pap smear were taken less than 6 months apart.
HPV DNA was found in 88% of cases and 4% of controls, whereas HPV 16 DNA was present in 44% of cases and in 1 of 141 controls.
HPV-16-seropositive women had a 3-fold increased risk of developing CIN.
The risk was highest among women younger than 35 years of age, of whom an estimated 3.4% of HPV-16-seropositive and 0.5% of seronegative women developed CIN.
Since the risk associated with HPV-16 seropositivity (a measure of past or present infection) was 35-fold lower than that of HPV DNA (present infection), most infections appear to be eliminated before CIN develops. (...)
Mots-clés Pascal : Dysplasie col utérus, Cancer in situ, Carcinome, Facteur risque, Epidémiologie, Sérologie, Papillomavirus humain, Papillomavirus, Papovaviridae, Virus, DNA, Frottis cervical, Réaction chaîne polymérase, Etude comparative, Prospective, Etude cohorte, Suède, Europe, Homme, Appareil génital femelle pathologie, Col utérus pathologie, Lésion précancéreuse, Tumeur maligne, Biologie moléculaire
Mots-clés Pascal anglais : Cervical dysplasia, Carcinoma in situ, Carcinoma, Risk factor, Epidemiology, Serology, Human papillomavirus, Papillomavirus, Papovaviridae, Virus, DNA, Cervical smear, Polymerase chain reaction, Comparative study, Prospective, Cohort study, Sweden, Europe, Human, Female genital diseases, Uterine cervix diseases, Premalignant lesion, Malignant tumor, Molecular biology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0475211
Code Inist : 002B20C02. Création : 10/04/1997.