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. 2016 May 15;138(10):2428-38.
doi: 10.1002/ijc.29971.

Progression of HPV infection to detectable cervical lesions or clearance in adult women: Analysis of the control arm of the VIVIANE study

S Rachel Skinner  1 , Cosette M Wheeler  2 , Barbara Romanowski  3 , Xavier Castellsagué  4 , Eduardo Lazcano-Ponce  5 , M Rowena Del Rosario-Raymundo  6 , Carlos Vallejos  7 , Galina Minkina  8 , Daniel Pereira Da Silva  9 , Shelly McNeil  10 , Vera Prilepskaya  11 , Irina Gogotadze  12 , Deborah Money  13 , Suzanne M Garland  14 , Viktor Romanenko  15 , Diane M Harper  16 , Myron J Levin  17 , Archana Chatterjee  18 , Brecht Geeraerts  19 , Frank Struyf  19 , Gary Dubin  20 , Marie-Cécile Bozonnat  21 , Dominique Rosillon  19 , Laurence Baril  19 ; VIVIANE Study Group
Collaborators, Affiliations

Progression of HPV infection to detectable cervical lesions or clearance in adult women: Analysis of the control arm of the VIVIANE study

S Rachel Skinner et al. Int J Cancer. .

Abstract

The control arm of the phase III VIVIANE (Human PapillomaVIrus: Vaccine Immunogenicity ANd Efficacy; NCT00294047) study in women >25 years was studied to assess risk of progression from cervical HPV infection to detectable cervical intraepithelial neoplasia (CIN). The risk of detecting CIN associated with the same HPV type as the reference infection was analysed using Kaplan-Meier and multivariable Cox models. Infections were categorised depending upon persistence as 6-month persistent infection (6MPI) or infection of any duration. The 4-year interim analysis included 2,838 women, of whom 1,073 (37.8%) experienced 2,615 infections of any duration and 708 (24.9%) experienced 1,130 6MPIs. Infection with oncogenic HPV types significantly increased the risk of detecting CIN grade 2 or greater (CIN2+) versus non-oncogenic types. For 6MPI, the highest risk was associated with HPV-33 (hazard ratio [HR]: 31.9 [8.3-122.2, p < 0.0001]). The next highest risk was with HPV-16 (21.1 [6.3-70.0], p < 0.0001). Similar findings were seen for infections of any duration. Significant risk was also observed for HPV-18, HPV-31, and HPV-45. Concomitant HPV infection or CIN grade 1 or greater associated with a different oncogenic HPV type increased risk. Most women (79.3%) with an HPV infection at baseline cleared detectable infections of any duration, and 69.9% cleared a 6MPI. The risk of progression of HPV infection to CIN2+ in women >25 years in this study was similar to that in women 15-25 years in PATRICIA.

Keywords: CIN; HPV; VIVIANE; adult women; natural history.

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Figures

Figure 1
Figure 1
Study flow chart: detection of HPV infections and CIN. A. Throughout study. B. Prevalent infection at baseline. C. Infection first detected during follow‐up. 1Infection detected at baseline and subsequently identified as being a 6MPI or 12MPI. 12MPI: 12‐month persistent infection; 6MPI: 6‐month persistent infection; CIN: cervical intraepithelial neoplasia; HPV: human papillomavirus; TVC: total vaccinated cohort.
Figure 2
Figure 2
Chance of clearance of an HPV infection of any duration according to HPV type. HPV: human papillomavirus; HPVI: HPV infection of any duration.
See this image and copyright information in PMC

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