Natural History of HPV Infections in Mid-adult Women

中成年女性 HPV 感染的自然史

基本信息

批准号：
7937461
负责人：
RACHEL L. WINER
金额：
$ 107.11万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-17 至 2011-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7937461
关键词：
Adolescence Adult Age Age-Years Antibodies Atypical Squamous Cell Biopsy Cervical Cervical Cancer Screening Clinical Collection Counseling Cytology DNA Data Detection Development Disease Employee Enrollment Epidemiology Exposure to Faculty Female Frequencies Genotype Guidelines HPV-High Risk Health Human Papilloma Virus Vaccine Human Papillomavirus Immunosuppressive Agents Individual Infection Interview Longitudinal Studies Malignant neoplasm of cervix uteri Measures Medical Menopause Natural History Nurse Practitioners Pap smear Patients Pharmacologic Substance Population Prevention Prevention strategy Probability Recommendation Recording of previous events Reporting Risk Sampling Screening procedure Serological Serum Sex Behavior Sexual Partners Smoking Specimen Students Test Result Testing Universities Vaccinated Vaccination Vaccines Vagina Viral Viral Load result Visit Washington Woman Women&apos s Group age group aged condoms consistent condom use design diaries follow-up high risk innovation interest older women prophylactic protective effect sexually active viral DNA young adult

项目摘要

While much is now known about the acquisition and early natural history of HPV infections in sexually active young women, little is known about HPV infections in mid-adult women. In particular, the risk of acquiring new high-risk (HR) HPV infections from new sex partners is undefined and the frequency of reactivating HR HPV infections that were acquired in adolescence or young adulthood is unknown. Furthermore, the risk of abnormal cytology associated with new versus reactivated infections is undefined. We will enroll 1,000 women between the ages of 30 to 50 who are faculty, staff, or students at the University of Washington andfollow them with bi-annual clinical visits for two years. At each visit, a nurse practitioner will conduct a faceto-face medical and sexual behavior interview (supplemented with bi-weekly online sexual behavior diaries) and collect cervical specimens for Pap testing and for HPV genotyping and viral load testing. Serum for HPV antibody testing will be collected at the enrollment and exit visits. Women will also self-collect vaginal samples for HPV DNA testing at each visit, and a subset of 200 women will be selected to do monthly selfcollections between the month 6 and month 12 visits. The specific aims of this longitudinal study are to 1) define rates and determinants of newly acquired and reactivated type-specific HR HPV infections in midadult women; 2) define the probability and determinants of reactivation in a subset of 200 women (with serologic evidence of prior infection and no recent new sex partners) followed with monthly vaginal selfcollections for HPV testing for 6 months; and 3) compare the probability of abnormal cytology (atypical squamous cells of undetermined significance or greater [ASC-US+]) associated with newly acquired versus re-activated type-specific HR HPV infections. Findings from this project will inform clinician/patient interactions and development of prophylactic vaccine implementation and cervical cancer screening guidelines in populations of mid-adult women.

虽然现在对性活跃的年轻女性 HPV 感染的获得和早期自然史了解很多，但对中年女性 HPV 感染知之甚少。特别是，从新的性伴侣处获得新的高危 (HR) HPV 感染的风险尚不清楚，并且在青春期或成年早期获得的 HR HPV 感染重新激活的频率尚不清楚。此外，与新感染和再激活感染相关的细胞学异常风险尚不清楚。我们将招募 1,000 名年龄在 30 岁至 50 岁之间的女性，她们是华盛顿大学的教职员工或学生，并对她们进行为期两年的每两年一次的临床访视。每次就诊时，执业护士都会进行面对面的医疗和性行为访谈（辅以每两周一次的在线性行为日记），并收集宫颈标本进行巴氏涂片检查、HPV 基因分型和病毒载量检测。用于 HPV 抗体检测的血清将在入组和出院访视时收集。女性还将在每次就诊时自行采集阴道样本进行 HPV DNA 检测，并且将选择 200 名女性的子集在第 6 个月至第 12 个月的就诊期间每月进行自我采集。这项纵向研究的具体目的是 1) 确定中成年女性新获得和重新激活的特定型 HR HPV 感染的比率和决定因素； 2) 确定 200 名女性（有既往感染的血清学证据且最近没有新的性伴侣）的重新激活的概率和决定因素，随后每月进行阴道自我采集以进行 HPV 检测，持续 6 个月； 3) 比较与新获得和重新激活的特异性 HR HPV 感染相关的异常细胞学（意义未定或更大的非典型鳞状细胞 [ASC-US+]）的概率。该项目的研究结果将为临床医生/患者的互动以及中成年女性预防性疫苗实施和宫颈癌筛查指南的制定提供信息。