Details

Autor(en) / Beteiligte

• Syrjänen, K
• Kulmala, S M
• Shabalova, I
• Petrovichev, N
• Kozachenko, V
• Zakharova, T
• Pajanidi, J
• Podistov, J
• Chemeris, G
• Sozaeva, L
• Lipova, E
• Tsidaeva, I
• Ivanchenko, O
• Pshepurko, A
• Zakharenko, S
• Nerovjna, R
• Kljukina, L
• Erokhina, O
• Branovskaja, M
• Nikitina, M
• Grunjberga, V
• Grunjberg, A
• Juschenko, A
• Santopietro, R
• Cintorino, M
• Tosi, P
• Syrjänen, S

Titel

Epidemiological, clinical and viral determinants of the increased prevalence of high-risk human papillomavirus (HPV) infections in elderly women

Ist Teil von

• European journal of gynaecological oncology, 2008, Vol.29 (2), p.114-122

Ort / Verlag

Italy

Erscheinungsjahr

2008

Quelle

MEDLINE

Beschreibungen/Notizen

• Population-based studies have reported a second peak of human papillomavirus (HPV) prevalence among women > 55 years, but reasons for this U-shaped HPV prevalence curve are poorly understood. To analyse determinants of high-risk HPV (HR-HPV) infections among postmenopausal women. A cohort of 3,187 women was stratified into three age categories: i) youngest age group < 25 years (n = 1.103); ii) women between 26-55 years (n = 2.004), and iii) women > 55 years (n = 80), analysed for epidemiological, clinical and virological determinants of their HR-HPV infections. Real-time PCR was used for HPV genotyping, analysis of viral loads for HPV16, 18/45, 31, 33/52/58, 35 and 39, and load of integrated HPV16. Age-standardised prevalence of HR-HPV infections showed a second peak among women > 55 years, with a perfect U-shaped curve (R2 = 0.966). The factors explaining this increased HR-HPV prevalence among older women include: i) cohort effect, ii) higher viral loads for HR-HPV types with cubic model curve (R2 = 0.714) for HPV 16, iii) distinct shift (p = 0.0001) from multiple-type infections to single HR-HPV types, iv) transition from episomal to integrated HPV16 (p = 0.009), v) higher load of integrated HPV16 (p = 0.009), and, vi) higher proportion of incident infections, higher rate of viral persistence, and lower rate of HR-HPV clearance. These data suggest that in women who fail to eradicate their HR-HPV infection until menopause, selection of integrated viral clone has taken place, driving the process towards progressing disease. Consequent to this, most of the HR-HPV infections in women > 55 years were associated with high-grade CIN or invasive carcinoma.