Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity: analysis of women in the control arm of the randomized, controlled PATRICIA trial
Identifieur interne : 000A73 ( Pmc/Curation ); précédent : 000A72; suivant : 000A74Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity: analysis of women in the control arm of the randomized, controlled PATRICIA trial
Auteurs : Xavier Castellsagué ; Jorma Paavonen [Finlande] ; Unnop Jaisamrarn [Thaïlande] ; Cosette M. Wheeler [États-Unis] ; S Rachel Skinner [Australie] ; Matti Lehtinen [Finlande] ; Paulo Naud [Brésil] ; Song-Nan Chow [Taïwan] ; Maria Rowena Del Rosario-Raymundo [Philippines] ; Julio C. Teixeira ; Johanna Palmroth [Finlande] ; Newton S. De Carvalho ; Maria Julieta V. Germar [Philippines] ; Klaus Peters [Allemagne] ; Suzanne M. Garland [Australie] ; Anne Szarewski [Royaume-Uni] ; Willy Aj Poppe [Belgique] ; Barbara Romanowski ; Tino F. Schwarz [Allemagne] ; Wiebren Aa Tjalma [Belgique] ; F Xavier Bosch [Espagne] ; Marie-Cecile Bozonnat [France] ; Frank Struyf [Belgique] ; Gary Dubin [États-Unis] ; Dominique Rosillon [Belgique] ; Laurence Baril [Belgique]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2014.
Abstract
More information is needed about time between sexual initiation and human papillomavirus (HPV) infection and development of cervical precancer.
The objectives were to investigate the time between first sexual activity and detection of first cervical HPV infection or development of first cervical intraepithelial neoplasia (CIN), and associated factors in women from the double-blind, multinational, 4-year PATRICIA trial. PATRICIA enroled women aged 15-25 years with no more than 6 lifetime sexual partners. Women were randomized 1:1 to the HPV-16/18 AS04-adjuvanted vaccine or to control, but only women from the control arm who began sexual intercourse during the study or within 6 months before enrolment, and had no HPV infection detected before the recorded date of their first sexual intercourse, were included in the present analysis. The time between onset of sexual activity and detection of the first cervical HPV infection or development of the first CIN lesion was analyzed using Kaplan-Meier and univariate and multivariable Cox proportional-hazards models.
A total of 9337 women were enroled in the control arm of PATRICIA of whom 982 fulfilled the required inclusion criteria for analysis. A cumulative total of 28%, 44%, and 62% of the subjects had HPV infection within 12, 24, and 48 months, respectively. The overall incidence rate was 27.08 per 100 person-years. The most common oncogenic types associated with 6-month persistent infection were HPV-16 (incidence rate: 2.74 per 100 person-years), HPV-51 (2.70), HPV-52 (1.66), HPV-66 (1.14), and HPV-18 (1.09). Increased infection risk was associated with more lifetime sexual partners, being single,
More than 25% of women were infected with HPV within 1 year of beginning sexual activity. Without underestimating the value of vaccination at older ages, our findings emphasize its importance before sexual initiation.
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The online version of this article (doi:10.1186/s12879-014-0551-y) contains supplementary material, which is available to authorized users.
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DOI: 10.1186/s12879-014-0551-y
PubMed: 25927224
PubMed Central: 4251672
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Xavier Castellsagué<affiliation><nlm:aff id="Aff1">Unit of Infections and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L'Hospitalet de Llobregat, Avda. Gran via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Catalonia Spain</nlm:aff><wicri:noCountry code="subfield">Catalonia Spain</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff10">Departamento de Tocoginecologia da Unicamp, University of Campinas, Campinas, Sao Paulo Brazil</nlm:aff><wicri:noCountry code="subfield">Sao Paulo Brazil</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff12">Department of Gynecology and Obstetrics, Infectious Diseases in Gynecology and Obstetrics Sector, Federal University of Paraná, Curitiba, Parana Brazil</nlm:aff><wicri:noCountry code="subfield">Parana Brazil</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff18">Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB Canada</nlm:aff><wicri:noCountry code="subfield">AB Canada</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1">Unit of Infections and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L'Hospitalet de Llobregat, Avda. Gran via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Catalonia Spain</nlm:aff><wicri:noCountry code="subfield">Catalonia Spain</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff21">Network on Cooperative Cancer Research, RTICC, Catalonia, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Network on Cooperative Cancer Research, RTICC, Catalonia</wicri:regionArea></affiliation>Le document en format XML
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Gran via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Catalonia Spain</nlm:aff><wicri:noCountry code="subfield">Catalonia Spain</wicri:noCountry></affiliation></author><author><name sortKey="Paavonen, Jorma" sort="Paavonen, Jorma" uniqKey="Paavonen J" first="Jorma" last="Paavonen">Jorma Paavonen</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki</wicri:regionArea></affiliation></author><author><name sortKey="Jaisamrarn, Unnop" sort="Jaisamrarn, Unnop" uniqKey="Jaisamrarn U" first="Unnop" last="Jaisamrarn">Unnop Jaisamrarn</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok</wicri:regionArea></affiliation></author><author><name sortKey="Wheeler, Cosette M" sort="Wheeler, Cosette M" uniqKey="Wheeler C" first="Cosette M" last="Wheeler">Cosette M. 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Teixeira</name><affiliation><nlm:aff id="Aff10">Departamento de Tocoginecologia da Unicamp, University of Campinas, Campinas, Sao Paulo Brazil</nlm:aff><wicri:noCountry code="subfield">Sao Paulo Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Palmroth, Johanna" sort="Palmroth, Johanna" uniqKey="Palmroth J" first="Johanna" last="Palmroth">Johanna Palmroth</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Department of Obstetrics and Gynecology, Central Hospital of North Carelian, Joensuu, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Obstetrics and Gynecology, Central Hospital of North Carelian, Joensuu</wicri:regionArea></affiliation></author><author><name sortKey="De Carvalho, Newton S" sort="De Carvalho, Newton S" uniqKey="De Carvalho N" first="Newton S" last="De Carvalho">Newton S. De Carvalho</name><affiliation><nlm:aff id="Aff12">Department of Gynecology and Obstetrics, Infectious Diseases in Gynecology and Obstetrics Sector, Federal University of Paraná, Curitiba, Parana Brazil</nlm:aff><wicri:noCountry code="subfield">Parana Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Germar, Maria Julieta V" sort="Germar, Maria Julieta V" uniqKey="Germar M" first="Maria Julieta V" last="Germar">Maria Julieta V. Germar</name><affiliation wicri:level="1"><nlm:aff id="Aff13">Department of Obstetrics and Gynaecology, University of the Philippines College of Medicine, Philippines General Hospital, Manila, Philippines</nlm:aff><country xml:lang="fr">Philippines</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University of the Philippines College of Medicine, Philippines General Hospital, Manila</wicri:regionArea></affiliation></author><author><name sortKey="Peters, Klaus" sort="Peters, Klaus" uniqKey="Peters K" first="Klaus" last="Peters">Klaus Peters</name><affiliation wicri:level="1"><nlm:aff id="Aff14">Facharzt für Frauenheilkunde und Geburtshilfe, Hamburg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Facharzt für Frauenheilkunde und Geburtshilfe, Hamburg</wicri:regionArea></affiliation></author><author><name sortKey="Garland, Suzanne M" sort="Garland, Suzanne M" uniqKey="Garland S" first="Suzanne M" last="Garland">Suzanne M. Garland</name><affiliation wicri:level="4"><nlm:aff id="Aff15">Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Parkville/Department of Microbiology, The Royal Children's Hospital, Parkville/Murdoch Children's Research Institute, Parkville/Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria Australia</nlm:aff><orgName type="university">Université de Melbourne</orgName><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Szarewski, Anne" sort="Szarewski, Anne" uniqKey="Szarewski A" first="Anne" last="Szarewski">Anne Szarewski</name><affiliation wicri:level="1"><nlm:aff id="Aff16">Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London</wicri:regionArea></affiliation></author><author><name sortKey="Poppe, Willy Aj" sort="Poppe, Willy Aj" uniqKey="Poppe W" first="Willy Aj" last="Poppe">Willy Aj Poppe</name><affiliation wicri:level="1"><nlm:aff id="Aff17">Department of Gynaecology, University Hospital KU Leuven Gasthuisberg, Leuven, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Gynaecology, University Hospital KU Leuven Gasthuisberg, Leuven</wicri:regionArea></affiliation></author><author><name sortKey="Romanowski, Barbara" sort="Romanowski, Barbara" uniqKey="Romanowski B" first="Barbara" last="Romanowski">Barbara Romanowski</name><affiliation><nlm:aff id="Aff18">Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB Canada</nlm:aff><wicri:noCountry code="subfield">AB Canada</wicri:noCountry></affiliation></author><author><name sortKey="Schwarz, Tino F" sort="Schwarz, Tino F" uniqKey="Schwarz T" first="Tino F" last="Schwarz">Tino F. Schwarz</name><affiliation wicri:level="1"><nlm:aff id="Aff19">Central Laboratory and Vaccination Centre, Stiftung Juliusspital, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Central Laboratory and Vaccination Centre, Stiftung Juliusspital, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg</wicri:regionArea></affiliation></author><author><name sortKey="Tjalma, Wiebren Aa" sort="Tjalma, Wiebren Aa" uniqKey="Tjalma W" first="Wiebren Aa" last="Tjalma">Wiebren Aa Tjalma</name><affiliation wicri:level="1"><nlm:aff id="Aff20">Multidisciplinary Breast Clinic and Gynaecological Oncology, Antwerp University Hospital, University of Antwerp, Antwerpen, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Multidisciplinary Breast Clinic and Gynaecological Oncology, Antwerp University Hospital, University of Antwerp, Antwerpen</wicri:regionArea></affiliation></author><author><name sortKey="Bosch, F Xavier" sort="Bosch, F Xavier" uniqKey="Bosch F" first="F Xavier" last="Bosch">F Xavier Bosch</name><affiliation><nlm:aff id="Aff1">Unit of Infections and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L'Hospitalet de Llobregat, Avda. Gran via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Catalonia Spain</nlm:aff><wicri:noCountry code="subfield">Catalonia Spain</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff21">Network on Cooperative Cancer Research, RTICC, Catalonia, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Network on Cooperative Cancer Research, RTICC, Catalonia</wicri:regionArea></affiliation></author><author><name sortKey="Bozonnat, Marie Cecile" sort="Bozonnat, Marie Cecile" uniqKey="Bozonnat M" first="Marie-Cecile" last="Bozonnat">Marie-Cecile Bozonnat</name><affiliation wicri:level="1"><nlm:aff id="Aff22">4Clinics, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>4Clinics, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Struyf, Frank" sort="Struyf, Frank" uniqKey="Struyf F" first="Frank" last="Struyf">Frank Struyf</name><affiliation wicri:level="1"><nlm:aff id="Aff23">GlaxoSmithKline Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GlaxoSmithKline Vaccines, Wavre</wicri:regionArea></affiliation></author><author><name sortKey="Dubin, Gary" sort="Dubin, Gary" uniqKey="Dubin G" first="Gary" last="Dubin">Gary Dubin</name><affiliation wicri:level="2"><nlm:aff id="Aff24">GlaxoSmithKline Vaccines, King of Prussia, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>GlaxoSmithKline Vaccines, King of Prussia</wicri:cityArea></affiliation></author><author><name sortKey="Rosillon, Dominique" sort="Rosillon, Dominique" uniqKey="Rosillon D" first="Dominique" last="Rosillon">Dominique Rosillon</name><affiliation wicri:level="1"><nlm:aff id="Aff23">GlaxoSmithKline Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GlaxoSmithKline Vaccines, Wavre</wicri:regionArea></affiliation></author><author><name sortKey="Baril, Laurence" sort="Baril, Laurence" uniqKey="Baril L" first="Laurence" last="Baril">Laurence Baril</name><affiliation wicri:level="1"><nlm:aff id="Aff23">GlaxoSmithKline Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GlaxoSmithKline Vaccines, Wavre</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25927224</idno><idno type="pmc">4251672</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251672</idno><idno type="RBID">PMC:4251672</idno><idno type="doi">10.1186/s12879-014-0551-y</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000A96</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000A96</idno><idno type="wicri:Area/Pmc/Curation">000A73</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000A73</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity: analysis of women in the control arm of the randomized, controlled PATRICIA trial</title><author><name sortKey="Castellsague, Xavier" sort="Castellsague, Xavier" uniqKey="Castellsague X" first="Xavier" last="Castellsagué">Xavier Castellsagué</name><affiliation><nlm:aff id="Aff1">Unit of Infections and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L'Hospitalet de Llobregat, Avda. Gran via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Catalonia Spain</nlm:aff><wicri:noCountry code="subfield">Catalonia Spain</wicri:noCountry></affiliation></author><author><name sortKey="Paavonen, Jorma" sort="Paavonen, Jorma" uniqKey="Paavonen J" first="Jorma" last="Paavonen">Jorma Paavonen</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki</wicri:regionArea></affiliation></author><author><name sortKey="Jaisamrarn, Unnop" sort="Jaisamrarn, Unnop" uniqKey="Jaisamrarn U" first="Unnop" last="Jaisamrarn">Unnop Jaisamrarn</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand</nlm:aff><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok</wicri:regionArea></affiliation></author><author><name sortKey="Wheeler, Cosette M" sort="Wheeler, Cosette M" uniqKey="Wheeler C" first="Cosette M" last="Wheeler">Cosette M. Wheeler</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Departments of Pathology and Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Nouveau-Mexique</region></placeName><wicri:cityArea>Departments of Pathology and Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque</wicri:cityArea></affiliation></author><author><name sortKey="Skinner, S Rachel" sort="Skinner, S Rachel" uniqKey="Skinner S" first="S Rachel" last="Skinner">S Rachel Skinner</name><affiliation wicri:level="2"><nlm:aff id="Aff5">Vaccines Trials Group, Telethon Institute for Child Health Research, Perth, WA and Sydney University Discipline of Paediatrics and Child Health, Children's Hospital Westmead, Sydney, NSW Australia</nlm:aff><country>Australie</country><placeName><region type="state">Nouvelle-Galles du Sud</region></placeName><wicri:cityArea>Vaccines Trials Group, Telethon Institute for Child Health Research, Perth, WA and Sydney University Discipline of Paediatrics and Child Health, Children's Hospital Westmead, Sydney</wicri:cityArea></affiliation></author><author><name sortKey="Lehtinen, Matti" sort="Lehtinen, Matti" uniqKey="Lehtinen M" first="Matti" last="Lehtinen">Matti Lehtinen</name><affiliation wicri:level="1"><nlm:aff id="Aff6">University of Tampere, School of Public Health, Tampere, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>University of Tampere, School of Public Health, Tampere</wicri:regionArea></affiliation></author><author><name sortKey="Naud, Paulo" sort="Naud, Paulo" uniqKey="Naud P" first="Paulo" last="Naud">Paulo Naud</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Department of Gynecology & Obstetrics Federal University of Rio Grande do Sul - UFRGS/HCPA, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Gynecology & Obstetrics Federal University of Rio Grande do Sul - UFRGS/HCPA, Hospital de Clínicas de Porto Alegre, Porto Alegre</wicri:regionArea></affiliation></author><author><name sortKey="Chow, Song Nan" sort="Chow, Song Nan" uniqKey="Chow S" first="Song-Nan" last="Chow">Song-Nan Chow</name><affiliation wicri:level="1"><nlm:aff id="Aff8">Department of Obstetrics and Gynecology, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Obstetrics and Gynecology, College of Medicine and the Hospital, National Taiwan University, Taipei</wicri:regionArea></affiliation></author><author><name sortKey="Del Rosario Raymundo, Maria Rowena" sort="Del Rosario Raymundo, Maria Rowena" uniqKey="Del Rosario Raymundo M" first="Maria Rowena" last="Del Rosario-Raymundo">Maria Rowena Del Rosario-Raymundo</name><affiliation wicri:level="1"><nlm:aff id="Aff9">San Pablo Colleges Medical Center, San Pablo City, Laguna, Philippines</nlm:aff><country xml:lang="fr">Philippines</country><wicri:regionArea>San Pablo Colleges Medical Center, San Pablo City, Laguna</wicri:regionArea></affiliation></author><author><name sortKey="Teixeira, Julio C" sort="Teixeira, Julio C" uniqKey="Teixeira J" first="Julio C" last="Teixeira">Julio C. Teixeira</name><affiliation><nlm:aff id="Aff10">Departamento de Tocoginecologia da Unicamp, University of Campinas, Campinas, Sao Paulo Brazil</nlm:aff><wicri:noCountry code="subfield">Sao Paulo Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Palmroth, Johanna" sort="Palmroth, Johanna" uniqKey="Palmroth J" first="Johanna" last="Palmroth">Johanna Palmroth</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Department of Obstetrics and Gynecology, Central Hospital of North Carelian, Joensuu, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Obstetrics and Gynecology, Central Hospital of North Carelian, Joensuu</wicri:regionArea></affiliation></author><author><name sortKey="De Carvalho, Newton S" sort="De Carvalho, Newton S" uniqKey="De Carvalho N" first="Newton S" last="De Carvalho">Newton S. De Carvalho</name><affiliation><nlm:aff id="Aff12">Department of Gynecology and Obstetrics, Infectious Diseases in Gynecology and Obstetrics Sector, Federal University of Paraná, Curitiba, Parana Brazil</nlm:aff><wicri:noCountry code="subfield">Parana Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Germar, Maria Julieta V" sort="Germar, Maria Julieta V" uniqKey="Germar M" first="Maria Julieta V" last="Germar">Maria Julieta V. Germar</name><affiliation wicri:level="1"><nlm:aff id="Aff13">Department of Obstetrics and Gynaecology, University of the Philippines College of Medicine, Philippines General Hospital, Manila, Philippines</nlm:aff><country xml:lang="fr">Philippines</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University of the Philippines College of Medicine, Philippines General Hospital, Manila</wicri:regionArea></affiliation></author><author><name sortKey="Peters, Klaus" sort="Peters, Klaus" uniqKey="Peters K" first="Klaus" last="Peters">Klaus Peters</name><affiliation wicri:level="1"><nlm:aff id="Aff14">Facharzt für Frauenheilkunde und Geburtshilfe, Hamburg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Facharzt für Frauenheilkunde und Geburtshilfe, Hamburg</wicri:regionArea></affiliation></author><author><name sortKey="Garland, Suzanne M" sort="Garland, Suzanne M" uniqKey="Garland S" first="Suzanne M" last="Garland">Suzanne M. Garland</name><affiliation wicri:level="4"><nlm:aff id="Aff15">Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Parkville/Department of Microbiology, The Royal Children's Hospital, Parkville/Murdoch Children's Research Institute, Parkville/Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria Australia</nlm:aff><orgName type="university">Université de Melbourne</orgName><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Szarewski, Anne" sort="Szarewski, Anne" uniqKey="Szarewski A" first="Anne" last="Szarewski">Anne Szarewski</name><affiliation wicri:level="1"><nlm:aff id="Aff16">Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London</wicri:regionArea></affiliation></author><author><name sortKey="Poppe, Willy Aj" sort="Poppe, Willy Aj" uniqKey="Poppe W" first="Willy Aj" last="Poppe">Willy Aj Poppe</name><affiliation wicri:level="1"><nlm:aff id="Aff17">Department of Gynaecology, University Hospital KU Leuven Gasthuisberg, Leuven, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Gynaecology, University Hospital KU Leuven Gasthuisberg, Leuven</wicri:regionArea></affiliation></author><author><name sortKey="Romanowski, Barbara" sort="Romanowski, Barbara" uniqKey="Romanowski B" first="Barbara" last="Romanowski">Barbara Romanowski</name><affiliation><nlm:aff id="Aff18">Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB Canada</nlm:aff><wicri:noCountry code="subfield">AB Canada</wicri:noCountry></affiliation></author><author><name sortKey="Schwarz, Tino F" sort="Schwarz, Tino F" uniqKey="Schwarz T" first="Tino F" last="Schwarz">Tino F. Schwarz</name><affiliation wicri:level="1"><nlm:aff id="Aff19">Central Laboratory and Vaccination Centre, Stiftung Juliusspital, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Central Laboratory and Vaccination Centre, Stiftung Juliusspital, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg</wicri:regionArea></affiliation></author><author><name sortKey="Tjalma, Wiebren Aa" sort="Tjalma, Wiebren Aa" uniqKey="Tjalma W" first="Wiebren Aa" last="Tjalma">Wiebren Aa Tjalma</name><affiliation wicri:level="1"><nlm:aff id="Aff20">Multidisciplinary Breast Clinic and Gynaecological Oncology, Antwerp University Hospital, University of Antwerp, Antwerpen, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Multidisciplinary Breast Clinic and Gynaecological Oncology, Antwerp University Hospital, University of Antwerp, Antwerpen</wicri:regionArea></affiliation></author><author><name sortKey="Bosch, F Xavier" sort="Bosch, F Xavier" uniqKey="Bosch F" first="F Xavier" last="Bosch">F Xavier Bosch</name><affiliation><nlm:aff id="Aff1">Unit of Infections and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L'Hospitalet de Llobregat, Avda. Gran via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Catalonia Spain</nlm:aff><wicri:noCountry code="subfield">Catalonia Spain</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff21">Network on Cooperative Cancer Research, RTICC, Catalonia, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Network on Cooperative Cancer Research, RTICC, Catalonia</wicri:regionArea></affiliation></author><author><name sortKey="Bozonnat, Marie Cecile" sort="Bozonnat, Marie Cecile" uniqKey="Bozonnat M" first="Marie-Cecile" last="Bozonnat">Marie-Cecile Bozonnat</name><affiliation wicri:level="1"><nlm:aff id="Aff22">4Clinics, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>4Clinics, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Struyf, Frank" sort="Struyf, Frank" uniqKey="Struyf F" first="Frank" last="Struyf">Frank Struyf</name><affiliation wicri:level="1"><nlm:aff id="Aff23">GlaxoSmithKline Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GlaxoSmithKline Vaccines, Wavre</wicri:regionArea></affiliation></author><author><name sortKey="Dubin, Gary" sort="Dubin, Gary" uniqKey="Dubin G" first="Gary" last="Dubin">Gary Dubin</name><affiliation wicri:level="2"><nlm:aff id="Aff24">GlaxoSmithKline Vaccines, King of Prussia, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>GlaxoSmithKline Vaccines, King of Prussia</wicri:cityArea></affiliation></author><author><name sortKey="Rosillon, Dominique" sort="Rosillon, Dominique" uniqKey="Rosillon D" first="Dominique" last="Rosillon">Dominique Rosillon</name><affiliation wicri:level="1"><nlm:aff id="Aff23">GlaxoSmithKline Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GlaxoSmithKline Vaccines, Wavre</wicri:regionArea></affiliation></author><author><name sortKey="Baril, Laurence" sort="Baril, Laurence" uniqKey="Baril L" first="Laurence" last="Baril">Laurence Baril</name><affiliation wicri:level="1"><nlm:aff id="Aff23">GlaxoSmithKline Vaccines, Wavre, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>GlaxoSmithKline Vaccines, Wavre</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>More information is needed about time between sexual initiation and human papillomavirus (HPV) infection and development of cervical precancer.</p></sec><sec><title>Methods</title><p>The objectives were to investigate the time between first sexual activity and detection of first cervical HPV infection or development of first cervical intraepithelial neoplasia (CIN), and associated factors in women from the double-blind, multinational, 4-year PATRICIA trial. PATRICIA enroled women aged 15-25 years with no more than 6 lifetime sexual partners. Women were randomized 1:1 to the HPV-16/18 AS04-adjuvanted vaccine or to control, but only women from the control arm who began sexual intercourse during the study or within 6 months before enrolment, and had no HPV infection detected before the recorded date of their first sexual intercourse, were included in the present analysis. The time between onset of sexual activity and detection of the first cervical HPV infection or development of the first CIN lesion was analyzed using Kaplan-Meier and univariate and multivariable Cox proportional-hazards models.</p></sec><sec><title>Results</title><p>A total of 9337 women were enroled in the control arm of PATRICIA of whom 982 fulfilled the required inclusion criteria for analysis. A cumulative total of 28%, 44%, and 62% of the subjects had HPV infection within 12, 24, and 48 months, respectively. The overall incidence rate was 27.08 per 100 person-years. The most common oncogenic types associated with 6-month persistent infection were HPV-16 (incidence rate: 2.74 per 100 person-years), HPV-51 (2.70), HPV-52 (1.66), HPV-66 (1.14), and HPV-18 (1.09). Increased infection risk was associated with more lifetime sexual partners, being single, <italic>Chlamydia trachomatis</italic> history, and duration of hormone use. CIN1+ and CIN2+ lesions were most commonly associated with HPV-16, with an overall incidence rate of 1.87 and 1.07 per 100 person-years, respectively. Previous cervical HPV infection was most strongly associated with CIN development.</p></sec><sec><title>Conclusions</title><p>More than 25% of women were infected with HPV within 1 year of beginning sexual activity. Without underestimating the value of vaccination at older ages, our findings emphasize its importance before sexual initiation.</p></sec><sec><title>Trial registration</title><p>clinicaltrials.gov: <ext-link ext-link-type="uri" xlink:href="http://www.NCT00122681">NCT00122681</ext-link>.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12879-014-0551-y) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Koshiol, J" uniqKey="Koshiol J">J Koshiol</name></author><author><name sortKey="Lindsey, L" uniqKey="Lindsey L">L Lindsey</name></author><author><name sortKey="Pimenta, Jm" uniqKey="Pimenta J">JM Pimenta</name></author><author><name sortKey="Poole, C" uniqKey="Poole C">C Poole</name></author><author><name sortKey="Jenkins, D" uniqKey="Jenkins D">D 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id><journal-title-group><journal-title>BMC Infectious Diseases</journal-title></journal-title-group><issn pub-type="epub">1471-2334</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25927224</article-id><article-id pub-id-type="pmc">4251672</article-id><article-id pub-id-type="publisher-id">551</article-id><article-id pub-id-type="doi">10.1186/s12879-014-0551-y</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity: analysis of women in the control arm of the randomized, controlled PATRICIA trial</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" deceased="no" equal-contrib="no"><name><surname>Castellsagué</surname><given-names>Xavier</given-names></name><address><email>xcastellsague@iconcologia.net</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Paavonen</surname><given-names>Jorma</given-names></name><address><email>Jorma.Paavonen@hus.fi</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Jaisamrarn</surname><given-names>Unnop</given-names></name><address><email>dr.unnop@yahoo.com</email></address><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Wheeler</surname><given-names>Cosette M</given-names></name><address><email>CWheeler@salud.unm.edu</email></address><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Skinner</surname><given-names>S Rachel</given-names></name><address><email>rachels5@chw.edu.au</email></address><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Lehtinen</surname><given-names>Matti</given-names></name><address><email>matti.lehtinen@uta.fi</email></address><xref ref-type="aff" rid="Aff6"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Naud</surname><given-names>Paulo</given-names></name><address><email>cacontrol@hcpa.ufrgs.br</email></address><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Chow</surname><given-names>Song-Nan</given-names></name><address><email>snchow@ntu.edu.tw</email></address><xref ref-type="aff" rid="Aff8"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Del Rosario-Raymundo</surname><given-names>Maria Rowena</given-names></name><address><email>runnymeadow@yahoo.com</email></address><xref ref-type="aff" rid="Aff9"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Teixeira</surname><given-names>Julio C</given-names></name><address><email>juliotex@uol.com.br</email></address><xref ref-type="aff" rid="Aff10"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Palmroth</surname><given-names>Johanna</given-names></name><address><email>johanna.palmroth@dnainternet.net</email></address><xref ref-type="aff" rid="Aff11"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>de Carvalho</surname><given-names>Newton S</given-names></name><address><email>infectogin@ufpr.br</email></address><xref ref-type="aff" rid="Aff12"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Germar</surname><given-names>Maria Julieta V</given-names></name><address><email>jvgermar@yahoo.com</email></address><xref ref-type="aff" rid="Aff13"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Peters</surname><given-names>Klaus</given-names></name><address><email>klaus@dr-peters.net</email></address><xref ref-type="aff" rid="Aff14"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Garland</surname><given-names>Suzanne M</given-names></name><address><email>suzanne.garland@thewomens.org.au</email></address><xref ref-type="aff" rid="Aff15"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Szarewski</surname><given-names>Anne</given-names></name><xref ref-type="aff" rid="Aff16"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Poppe</surname><given-names>Willy AJ</given-names></name><address><email>willy.Poppe@uz.kuleuven.ac.be</email></address><xref ref-type="aff" rid="Aff17"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Romanowski</surname><given-names>Barbara</given-names></name><address><email>broman@docromanowski.com</email></address><xref ref-type="aff" rid="Aff18"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Schwarz</surname><given-names>Tino F</given-names></name><address><email>t.schwarz@juliusspital.de</email></address><xref ref-type="aff" rid="Aff19"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Tjalma</surname><given-names>Wiebren AA</given-names></name><address><email>wiebren.tjalma@uza.be</email></address><xref ref-type="aff" rid="Aff20"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Bosch</surname><given-names>F Xavier</given-names></name><address><email>x.bosch@iconcologia.net</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff21"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Bozonnat</surname><given-names>Marie-Cecile</given-names></name><address><email>mcbozonnat@4clinics.com</email></address><xref ref-type="aff" rid="Aff22"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Struyf</surname><given-names>Frank</given-names></name><address><email>FRANK.STRUYF@GSK.COM</email></address><xref ref-type="aff" rid="Aff23"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Dubin</surname><given-names>Gary</given-names></name><address><email>Gary.O.Dubin@gsk.com</email></address><xref ref-type="aff" rid="Aff24"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Rosillon</surname><given-names>Dominique</given-names></name><address><email>DOMINIQUE.X.ROSILLON@GSK.COM</email></address><xref ref-type="aff" rid="Aff23"></xref></contrib><contrib contrib-type="author" deceased="no" equal-contrib="no"><name><surname>Baril</surname><given-names>Laurence</given-names></name><address><email>LAURENCE.X.BARIL@GSK.COM</email></address><xref ref-type="aff" rid="Aff23"></xref></contrib><contrib contrib-type="author"><collab>for the HPV PATRICIA Study Group</collab></contrib><aff id="Aff1"><label></label>Unit of Infections and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia (ICO), IDIBELL, CIBER-ESP, L'Hospitalet de Llobregat, Avda. Gran via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Catalonia Spain</aff><aff id="Aff2"><label></label>Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Finland</aff><aff id="Aff3"><label></label>Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand</aff><aff id="Aff4"><label></label>Departments of Pathology and Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM USA</aff><aff id="Aff5"><label></label>Vaccines Trials Group, Telethon Institute for Child Health Research, Perth, WA and Sydney University Discipline of Paediatrics and Child Health, Children's Hospital Westmead, Sydney, NSW Australia</aff><aff id="Aff6"><label></label>University of Tampere, School of Public Health, Tampere, Finland</aff><aff id="Aff7"><label></label>Department of Gynecology & Obstetrics Federal University of Rio Grande do Sul - UFRGS/HCPA, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil</aff><aff id="Aff8"><label></label>Department of Obstetrics and Gynecology, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan</aff><aff id="Aff9"><label></label>San Pablo Colleges Medical Center, San Pablo City, Laguna, Philippines</aff><aff id="Aff10"><label></label>Departamento de Tocoginecologia da Unicamp, University of Campinas, Campinas, Sao Paulo Brazil</aff><aff id="Aff11"><label></label>Department of Obstetrics and Gynecology, Central Hospital of North Carelian, Joensuu, Finland</aff><aff id="Aff12"><label></label>Department of Gynecology and Obstetrics, Infectious Diseases in Gynecology and Obstetrics Sector, Federal University of Paraná, Curitiba, Parana Brazil</aff><aff id="Aff13"><label></label>Department of Obstetrics and Gynaecology, University of the Philippines College of Medicine, Philippines General Hospital, Manila, Philippines</aff><aff id="Aff14"><label></label>Facharzt für Frauenheilkunde und Geburtshilfe, Hamburg, Germany</aff><aff id="Aff15"><label></label>Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Parkville/Department of Microbiology, The Royal Children's Hospital, Parkville/Murdoch Children's Research Institute, Parkville/Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria Australia</aff><aff id="Aff16"><label></label>Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK</aff><aff id="Aff17"><label></label>Department of Gynaecology, University Hospital KU Leuven Gasthuisberg, Leuven, Belgium</aff><aff id="Aff18"><label></label>Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB Canada</aff><aff id="Aff19"><label></label>Central Laboratory and Vaccination Centre, Stiftung Juliusspital, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany</aff><aff id="Aff20"><label></label>Multidisciplinary Breast Clinic and Gynaecological Oncology, Antwerp University Hospital, University of Antwerp, Antwerpen, Belgium</aff><aff id="Aff21"><label></label>Network on Cooperative Cancer Research, RTICC, Catalonia, Spain</aff><aff id="Aff22"><label></label>4Clinics, Paris, France</aff><aff id="Aff23"><label></label>GlaxoSmithKline Vaccines, Wavre, Belgium</aff><aff id="Aff24"><label></label>GlaxoSmithKline Vaccines, King of Prussia, PA USA</aff></contrib-group><pub-date pub-type="epub"><day>30</day><month>10</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>30</day><month>10</month><year>2014</year></pub-date><pub-date pub-type="collection"><year>2014</year></pub-date><volume>14</volume><elocation-id>551</elocation-id><history><date date-type="received"><day>24</day><month>4</month><year>2014</year></date><date date-type="accepted"><day>9</day><month>10</month><year>2014</year></date></history><permissions><copyright-statement>© Castellsagué et al.; licensee BioMed Central Ltd. 2014</copyright-statement><license license-type="open-access"><license-p>This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>More information is needed about time between sexual initiation and human papillomavirus (HPV) infection and development of cervical precancer.</p></sec><sec><title>Methods</title><p>The objectives were to investigate the time between first sexual activity and detection of first cervical HPV infection or development of first cervical intraepithelial neoplasia (CIN), and associated factors in women from the double-blind, multinational, 4-year PATRICIA trial. PATRICIA enroled women aged 15-25 years with no more than 6 lifetime sexual partners. Women were randomized 1:1 to the HPV-16/18 AS04-adjuvanted vaccine or to control, but only women from the control arm who began sexual intercourse during the study or within 6 months before enrolment, and had no HPV infection detected before the recorded date of their first sexual intercourse, were included in the present analysis. The time between onset of sexual activity and detection of the first cervical HPV infection or development of the first CIN lesion was analyzed using Kaplan-Meier and univariate and multivariable Cox proportional-hazards models.</p></sec><sec><title>Results</title><p>A total of 9337 women were enroled in the control arm of PATRICIA of whom 982 fulfilled the required inclusion criteria for analysis. A cumulative total of 28%, 44%, and 62% of the subjects had HPV infection within 12, 24, and 48 months, respectively. The overall incidence rate was 27.08 per 100 person-years. The most common oncogenic types associated with 6-month persistent infection were HPV-16 (incidence rate: 2.74 per 100 person-years), HPV-51 (2.70), HPV-52 (1.66), HPV-66 (1.14), and HPV-18 (1.09). Increased infection risk was associated with more lifetime sexual partners, being single, <italic>Chlamydia trachomatis</italic> history, and duration of hormone use. CIN1+ and CIN2+ lesions were most commonly associated with HPV-16, with an overall incidence rate of 1.87 and 1.07 per 100 person-years, respectively. Previous cervical HPV infection was most strongly associated with CIN development.</p></sec><sec><title>Conclusions</title><p>More than 25% of women were infected with HPV within 1 year of beginning sexual activity. Without underestimating the value of vaccination at older ages, our findings emphasize its importance before sexual initiation.</p></sec><sec><title>Trial registration</title><p>clinicaltrials.gov: <ext-link ext-link-type="uri" xlink:href="http://www.NCT00122681">NCT00122681</ext-link>.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12879-014-0551-y) contains supplementary material, which is available to authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>HPV</kwd><kwd>CIN</kwd><kwd>Sexual intercourse</kwd><kwd>Time</kwd><kwd>Risk</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2014</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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