Persistent Human Papillomavirus Infection as a Predictor of Cervical Intraepithelial Neoplasia

Abstract

Human papillomavirus (HPV) infection is believed to be the central cause of cervical cancer, although most of the epidemiological evidence has come from retrospective, case-control studies,¹ which do not provide information on the dynamics of cumulative or persistent exposure to cervical HPV infection. The social and economic implications of cervical cancer for public health programs worldwide and the recent interest in the development of HPV vaccines have compelled the initiation of prospective, long-term multidisciplinary studies of the natural history of cervical cancer to investigate the role of HPV infection in the development of preinvasive cervical lesions. To date, several studies have reported results on the prospective relationship between HPV infection and the incidence of squamous intraepithelial lesions (SILs)^2-9; however, only 2 of these studies have reported on HPV persistence and subsequent SIL incidence over an extended period of time.^8,9