Cancer Epidemiology Biomarkers & Prevention, Vol 4, Issue 4 373-380, Copyright © 1995 by American Association for Cancer Research

ARTICLES

A longitudinal analysis of human papillomavirus 16 infection, nutritional status, and cervical dysplasia progression

T Liu, SJ Soong, RD Alvarez and CE Butterworth Jr
Biostatistics Unit, University of Alabama at Birmingham 35294-3300, USA.

To evaluate the effect of potential risk factors, especially human papillomavirus type 16 (HPV-16) infection and nutritional status on the course of cervical dysplasia, we analyzed data from an intervention trial conducted from 1985 to 1990, in Birmingham, Alabama. With the use of data of four repeated evaluations of dysplasia at an interval of 2 months, specific relationships between HPV-16 infection, plasma retinol and zinc levels, and dysplasia progression were evaluated through longitudinal data analysis of generalized estimating equations. Repeated assessments of nutritional status from blood samples, HPV-16 infection, and dysplasia diagnosis were available from 206 women. Dysplasia diagnosis was confirmed by both Papanicolaou smear and colposcopy examinations and was classified as normal, low, or high grade squamous intraepithelial lesions according to the Bethesda system and assigned a score of 0, 1, or 2, respectively. Generalized estimating equation analyses were performed with assumptions of variance of Poisson and link of logarithm. Separate analyses were also conducted for HPV-16-positive and HPV-16-negative women. By multivariate modeling with adjustment for age, race, smoking, oral contraceptive use, and plasma levels of nutrients, HPV-16 infection was found to be related to the progression of cervical dysplasia, with a relative risk of 1.19 and a 95% confidence interval of 1.03-1.38. High plasma levels of retinol were related to the regression of cervical dysplasia, especially in HPV-16-positive women. A protective effect was also observed for high levels of zinc.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				J. J. Kim, K. M. Kuntz, N. K. Stout, S. Mahmud, L. L. Villa, E. L. Franco, and S. J. Goldie Multiparameter Calibration of a Natural History Model of Cervical Cancer Am. J. Epidemiol., July 15, 2007; 166(2): 137 - 150. [Abstract] [Full Text] [PDF]

				B. C Tohill, C. M Heilig, R. S Klein, A. Rompalo, S. Cu-Uvin, E. G Piwoz, D. J Jamieson, and A. Duerr Nutritional biomarkers associated with gynecological conditions among US women with or at risk of HIV infection Am. J. Clinical Nutrition, May 1, 2007; 85(5): 1327 - 1334. [Abstract] [Full Text] [PDF]

				N. Van de Velde, M. Brisson, and M.-C. Boily Modeling Human Papillomavirus Vaccine Effectiveness: Quantifying the Impact of Parameter Uncertainty Am. J. Epidemiol., April 1, 2007; 165(7): 762 - 775. [Abstract] [Full Text] [PDF]

				J. J. Kim, T. C. Wright, and S. J. Goldie Cost-effectiveness of Human Papillomavirus DNA Testing in the United Kingdom, The Netherlands, France, and Italy J Natl Cancer Inst, June 15, 2005; 97(12): 888 - 895. [Abstract] [Full Text] [PDF]

				N. F. Schlecht, R. W. Platt, A. Negassa, E. Duarte-Franco, T. E. Rohan, A. Ferenczy, L. L. Villa, and E. L. Franco Modeling the Time Dependence of the Association between Human Papillomavirus Infection and Cervical Cancer Precursor Lesions Am. J. Epidemiol., November 1, 2003; 158(9): 878 - 886. [Abstract] [Full Text] [PDF]

				R. L. Sedjo, D. J. Roe, M. Abrahamsen, R. B. Harris, N. Craft, S. Baldwin, and A. R. Giuliano Vitamin A, Carotenoids, and Risk of Persistent Oncogenic Human Papillomavirus Infection Cancer Epidemiol. Biomarkers Prev., September 1, 2002; 11(9): 876 - 884. [Abstract] [Full Text] [PDF]

				J. J. Kim, T. C. Wright, and S. J. Goldie Cost-effectiveness of Alternative Triage Strategies for Atypical Squamous Cells of Undetermined Significance JAMA, May 8, 2002; 287(18): 2382 - 2390. [Abstract] [Full Text] [PDF]

				W. C. Bailey, C. L. Kohler, J. M. Richards Jr, R. A. Windsor, C. M. Brooks, L. B. Gerald, B. Martin, D. M. Higgins, and T. Liu Asthma Self-management: Do Patient Education Programs Always Have an Impact? Arch Intern Med, November 8, 1999; 159(20): 2422 - 2428. [Abstract] [Full Text] [PDF]

				J. J. Allison, C. I. Kiefe, E. F. Cook, M. S. Gerrity, E. J. Orav, and R. Centor The Association of Physician Attitudes about Uncertainty and Risk Taking with Resource Use in a Medicare HMO Med Decis Making, August 1, 1998; 18(3): 320 - 329. [Abstract] [PDF]