By Bree Weaver MD, Marcia Shew MD, Brahim Qadadri BS, Wanzhu Tu PhD, Yang Tong PhD, Cheryl Denski BG, J. Dennis Fortenberry MD, Darron Brown MD
The aim of the study was to better characterize the natural history of human papillomavirus (HPV) infections in female adolescents.
Female adolescents were enrolled in a longitudinal study. Self-vaginal samples were obtained every 3 months and tested for HPV. No participants received HPV vaccination. The findings for 40 female adolescents with the longest follow-up are reported in this study.
Average age at the time of enrollment was 15.2 years (range: 14–17; SD: .97). Mean duration of follow-up was 6.7 years (range: 4.4–9.2; SD: 1.2). In all, 32 participants (80%) reported being involved in sexual activity before their enrollment in the study; all reported being involved in sexual activity before enrollment; all reported being involved in sexual activity during follow-up. Baseline and cumulative prevalence of HPV among participants was 55% and 100%, respectively. During the study, each participant tested positive for a mean of 14 HPV types. Cumulatively, HPV 16 was detected in 29 of 40 participants (72.5%). Mean duration of high- and low-risk infections was 655.9 (median: 433) and 524.1 days (median: 334), respectively.
With prolonged follow-up, HPV infections with multiple types were found in all participants. Most had infection with HPV-16 or HPV-18, the oncogenic types represented in current vaccines, as well as infection with other oncogenic types. These data reinforce the importance of vaccine and non-vaccine strategies for prevention of HPV infections.