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Co-factors of high-risk human papillomavirus infections display unique profiles in incident CIN1, CIN2 and CIN3.

Authors
  • Syrjänen, K
  • Shabalova, I
  • Naud, P
  • Derchain, S
  • Sarian, L
  • Kozachenko, V
  • Zakharchenko, S
  • Roteli-Martins, C
  • Nerovjna, R
  • Longatto-Filho, A
  • Kljukina, L
  • Tatti, S
  • Branovskaja, M
  • Branca, M
  • Grunjberga, V
  • Erzen, M
  • Juschenko, A
  • Hammes, L Serpa
  • Costa, S
  • Podistov, J
  • And 4 more
Type
Published Article
Journal
International Journal of STD & AIDS
Publisher
SAGE Publications
Publication Date
April 2011
Volume
22
Issue
5
Pages
263–272
Identifiers
DOI: 10.1258/ijsa.2009.009280
PMID: 21571974
Source
Medline
License
Unknown

Abstract

In addition to oncogenic 'high-risk' human papillomaviruses (HR-HPV), several co-factors are needed in cervical carcinogenesis, but it is poorly understood whether these HPV co-factors associated with incident cervical intraepithelial neoplasia (CIN) grade 1 are different from those required for progression to CIN2 and CIN3. To gain further insights into the true biological differences between CIN1, CIN2 and CIN3, we assessed HPV co-factors increasing the risk of incident CIN1, CIN2 and CIN3. Data from the New Independent States of the Former Soviet Union (NIS) Cohort (n = 3187) and the Latin American Screening (LAMS) Study (n = 12,114) were combined, and co-factors associated with progression to CIN1, CIN2 and CIN3 were analysed using multinomial logistic regression models with all covariates recorded at baseline. HR-HPV-positive women (n = 1105) represented a subcohort of all 1865 women prospectively followed up in both studies. Altogether, 90 (4.8%), 39 (2.1%) and 14 (1.4%) cases progressed to CIN1, CIN2 and CIN3, respectively. Baseline HR-HPV was the single most powerful predictor of incident CIN1, CIN2 and CIN3. When controlled for residual HPV confounding by analysing HR-HPV-positive women only, the risk profiles of incident CIN1, CIN2 and CIN3 were unique. Completely different HPV co-factors were associated with progression to CIN1, CIN2 and CIN3 in univariate and multivariate analyses, irrespective of whether non-progression, CIN1 or CIN2 was used as the reference outcome. HPV co-factors associated with progression to CIN1, CIN2 and CIN3 display unique profiles, implicating genuine biological differences between the three CIN grades, which prompts us to re-visit the concept of combining CIN2 with CIN3 or CIN1.

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