Proportion of Incident Genital Human Papillomavirus Detections not Attributable to Transmission and Potentially Attributable to Latent Infections: Implications for Cervical Cancer Screening.

BACKGROUND

Infections with human papillomaviruses (HPVs) may enter a latent state, and eventually become reactivated following loss of immune control. It is unclear what proportion of incident HPV detections are reactivations of previous latent infections vs new transmissions.

METHODS

The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) cohort study prospectively followed young newly formed heterosexual partners recruited between 2005 and 2011 in Montréal, Canada. We calculated the fraction of incident HPV detections nonattributable to sexual transmission risk factors with a Bayesian Markov model. Results are the median (2.5th-97.5th percentiles) of the estimated posterior distribution.

RESULTS

A total of 544 type-specific incident HPV detection events occurred in 849 participants; 33% of incident HPV detections occurred in participants whose HITCH partners were negative for that HPV type and who reported no other sex partners over follow-up. We estimate that 43% (38%-48%) of all incident HPV detections in this population were not attributable to recent sexual transmission and might be potentially reactivation of latent infections.

CONCLUSIONS

A positive HPV test result in many cases may be a reactivated past infection, rather than a new infection from recent sexual behaviors or partner infidelity. The potential for reactivation of latent infections in previously HPV-negative women should be considered in the context of cervical cancer screening.

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [e-mail].

Déclaration de conflit d'intérêts

Potential conflicts of interests. F. C. reports grants paid to his institution from Becton Dickinson, Roche Molecular systems, and Merk Sharp and Dome outside of the submitted work, as well as from Canadian Institutes of Health Research (CIHR), CANFAR and the Fonds de la recherche en Santé du Québec. E. L. F. reports grants to his institution from CIHR, the National Institutes of Health, and Merck during the conduct of the study; and personal fees from Merck. M. Z. and E. L. F. hold a patent related to the discovery “DNA methylation markers for early detection of cervical cancer” registered at the Office of Innovation and Partnerships, McGill University, Montreal, Quebec, Canada. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.