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Department of Pediatrics, Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287 [Y. S., B. C., R. P. V.]; Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, 455 Sao Paulo-SP, CEP 01246, Brazil [J. E-N.]; Institut Catala dOncologia, 08907, Barcelona Spain [F. X. B.]; Unit of Field and Intervention Studies, International Agency for Research on Cancer, Lyon 69372, France [N. M.]; Department of Pathology, Free University Hospital, Amsterdam 1081 HV, the Netherlands [J. M. M. W., C. J. L. M. M.]; and Department of Molecular Medicine and Immunology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland 21205 [K. V. S.]
Serum samples from 194 cases and 217 controls participating in a case-control study of invasive cervical cancer in Brazil were examined for antibodies to human papillomavirus (HPV) 16 virus-like particles (VLPs) by ELISA. The prevalence of antibody in cases and controls was 47.4 versus 24.4% (P < 0.001). The prevalence was higher in women who had HPV-16 DNA in the genital tract (54.2%) than in those with other HPVs (36.8%) or no HPVs (44.8%), but the differences were not statistically significant. Among cases and controls, HPV-16 VLP antibodies were associated with a greater number of lifetime sexual partners (
2 for trend, P < 0.001). Among controls, age was inversely associated with HPV-16 VLP seroreactivity (
2 for trend, P = 0.019). The sera were previously tested for antibodies to HPV-16 E6 and E7 oncoproteins; there was no correlation between antibody titers to HPV-16 E6 or E7 and VLPs. The HPV-16 serological assays were compared as screening tests for invasive cervical cancer. The sensitivity and specificity estimates were 47.4 and 75.6% for HPV-16 VLP serology, 63.4 and 89.9% for either HPV-16 E6 or E7 serology, and 53.6 and 93.6% for high titers of either HPV-16 E6 or E7 or VLP antibodies. The utility of HPV-16 VLP ELISA as a screening test for invasive cervical cancer is limited by a high seroprevalence in women with probable prior exposure to HVP 16 but without disease.
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