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Combined Oral Contraceptive Use Increases HPV Persistence but Not New HPV Detection in a Cohort of Women From Thailand

机译:联合口服避孕药可提高泰国女性队列中的HPV持续性但不能检测到新的HPV

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摘要

>Background. Women diagnosed with cervical cancer report longer duration and more recent use of combined oral contraceptives (COCs). It is unclear how COC use impacts risk of cervical carcinogenesis.>Methods. We estimated the risk of new human papillomavirus (HPV) DNA detection and persistence among 1135 human immunodeficiency virus (HIV)–negative women aged 20–37 years from Thailand who were followed for 18 months at 6-month intervals. Type-specific HPV DNA, demographic information, hormonal contraceptive use, sexual behavior, genital tract coinfection, and Papanicolaou test results were assessed at baseline and each follow-up.>Results. Women who reported current COC use during follow-up were less likely to clear HPV infection compared with nonusers, independent of sexual behavior, and Papanicolaou test diagnosis (AHR: 0.67 [95% CI: .49–.93]). Similar associations were not observed among women reporting current use of depomedroxyprogesterone acetate (DMPA). Neither COC nor DMPA use was significantly associated with new HPV DNA detection.>Conclusions. These data do not support the hypothesis that contraceptive use is associated with cervical cancer risk via increased risk of HPV acquisition. The increased risk of HPV persistence observed among current COC users suggests a possible influence of female sex hormones on host response to HPV infection.
机译:>背景。被诊断患有宫颈癌的妇女报告病程更长,并且最近使用复合口服避孕药(COC)。尚不清楚COC的使用如何影响子宫颈癌的风险。>方法。我们估计了1135名人类免疫缺陷病毒(HIV)阴性的20岁以下女性中新的人类乳头瘤病毒(HPV)DNA检测和持久性的风险。来自泰国37年,每6个月随访18个月。在基线和每次随访时评估特定类型的HPV DNA,人口统计信息,激素避孕药的使用,性行为,生殖道合并感染和帕潘尼古拉测试结果。>结果。在报告期间当前使用COC的妇女与非使用者相比,独立于性行为和帕潘尼古拉试验诊断,随访更不可能清除HPV感染(AHR:0.67 [95%CI:.49–.93])。在报告目前使用醋酸去甲孕酮(DMPA)的女性中未观察到类似的关联。新的HPV DNA检测与COC和DMPA的使用均无显着相关。>结论。这些数据不支持以下假设:使用避孕药会增加HPV感染的风险与宫颈癌风险有关。在目前的COC使用者中观察到的HPV持续性风险增加表明,女性性激素可能会对宿主对HPV感染的反应产生影响。

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