Browsing by Author "Snijders, Peter J."

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    High-risk HPV infection after five years in a population-based cohort of Chilean women
    (2011) Ferreccio Readi, Catterina; Van De Wyngard, Vanessa; Domínguez, M. A.; Puschel Illanes, Klaus; Corvalán R., Alejandro; Olcay, Fabiola; Franceschi, Silvia; Snijders, Peter J.; Ferreccio Readi, Catterina; Van De Wyngard, Vanessa; Domínguez, M. A.; Puschel Illanes, Klaus; Corvalán R., Alejandro; Olcay, Fabiola; Franceschi, Silvia; Snijders, Peter J.
    Abstract Background The need to review cervical cancer prevention strategies has been triggered by the availability of new prevention tools linked to human papillomavirus (HPV): vaccines and screening tests. To consider these innovations, information on HPV type distribution and natural history is necessary. This is a five-year follow-up study of gynecological high-risk (HR) HPV infection among a Chilean population-based cohort of women. Findings A population-based random sample of 969 women from Santiago, Chile aged 17 years or older was enrolled in 2001 and revisited in 2006. At both visits they answered a survey on demographics and sexual history and provided a cervical sample for HPV DNA detection (GP5+/6+ primer-mediated PCR and Reverse line blot genotyping). Follow-up was completed by 576 (59.4%) women; 45 (4.6%) refused participation; most losses to follow-up were women who were unreachable, no longer eligible or had missing samples. HR-HPV prevalence increased by 43%. Incidence was highest in women < 20 years of age (19.4%) and lowest in women > 70 (0%); it was three times higher among women HR-HPV positive versus HPV negative at baseline (25.5% and 8.3%; OR 3.8, 95% CI 1.8-8.0). Type-specific persistence was 35.3%; it increased with age, from 0% in women < 30 years of age to 100% in women > 70. An enrollment Pap result ASCUS or worse was the only risk factor for being HR-HPV positive at both visits. Conclusions HR-HPV prevalence increased in the study population. All HR-HPV infections in women < 30 years old cleared, supporting the current recommendation of HR-HPV screening for women > 30 years.
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    Serological prevalence and persistence of high-risk human papillomavirus infection among women in Santiago, Chile
    (2014) Castro, Felipe A.; Dominguez, Angélica; Puschel Illanes, Klaus; Van De Wyngard, Vanessa; Snijders, Peter J.; Franceschi, Silvia; Pawlita, Michael; Ferreccio Readi, Catterina; Castro, Felipe A.; Dominguez, Angélica; Puschel Illanes, Klaus; Van De Wyngard, Vanessa; Snijders, Peter J.; Franceschi, Silvia; Pawlita, Michael; Ferreccio Readi, Catterina
    Abstract Background Human papillomavirus (HPV) serology is a main factor for designing vaccination programs and surveillance strategies; nevertheless, there are few reports of HPV seroprevalence in the general population, especially in Latin America. This study aimed to describe high-risk HPV serological prevalence, persistence, and association with concurrent cervical infection, in Chilean women. Methods 1021 women from the general population, aged 15–85 years, were studied in 2001 of whom 600 were reexamined in 2006. The assessments at both time points included cervical HPV DNA testing, HPV antibody testing, cervical cytology and a sociodemographic/behavioral questionnaire. HPV DNA and antibodies against L1 protein of types 16, 18, 31, 33, 35, 45, 52, and 58 were assessed by reverse line blot and multiplex serology, respectively. Results Seropositivity was high at both baseline (43.2%) and follow-up (50.2%) and increased with age (p < 0.001); corresponding DNA prevalences were 6.7% and 8.7%. DNA and seroprevalence were associated at baseline (p = 0.01 for any HPV). Early age at first sexual intercourse and having had two or more sexual partners were independently associated with seropositivity. Most (82.0%) initially seropositive women remained seropositive at follow-up; 21.6% of initially seronegative women seroconverted, reaching 17.5% among women older than 60 years of age. ASCUS or worse cytology was correlated with HPV DNA positivity but not with HPV seropositivity. Conclusion HPV seroprevalence studies are a useful tool for learning about the dynamics of HPV infection in a community. This study contributes to understanding the natural history of HPV infection and provides a baseline assessment before the incorporation of HPV vaccination into a national program.