Human papillomavirus infection and cervical intraepithelial neoplasia in a cohort of low-risk women

This study was a prospective examination of the incidence of human papillomavirus (HPV) infection in a low-risk female population and an assessment of the risk of development of LSIL with HPV infection. In a longitudinal study, women aged 19–60 years – non-smokers, and married or living with a constant partner, who presented for cervical cancer screening at an outpatient clinic – were invited to participate in a prospective study of cervical HPV infection, and were examined every 3 months. Of the 464 women at risk, 20 presented with HPV infections during the follow-up. Low-grade squamous intraepithelial lesions (LSIL) event developed in 18 women. Among these women, 13 were HPV-positive (10 high-risk and 3 low-risk types). The average duration of new LSIL was 20.1 months (95% CI: 13.9–26.3) and 55.3 months (95% CI: 45.7–64.9) in the HPV-positive and negative groups, respectively, the difference was statistically significant ( p < 0.001). With the use of Cox proportional hazard regression, we estimated the relative risk as 90.0 for a first instance of LSIL among women testing positive for HPV as compared with women testing negative for HPV. This study has provided evidence that HPV infection is associated with an increased risk of LSIL.