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Correlates of the Spread of Human Papillomavirus Infection¹

Laboratory of Tumor Virus Epidemiology, Microbiology and Tumor Biology Center, Karolinska Institute, S-17177 Stockholm, Sweden [I. S., J. D.]; Swedish Institute for Infectious Disease Control, S-17182 Stockholm, Sweden [I. K., J. D.]; and Department of Infectious Disease Epidemiology, National Public Health Institute, FIN-00300 Helsinki, Finland [J. D.]

Knowledge of the correlates of human papillomavirus (HPV) seropositivity is of interest for planning of preventive measures and for evaluation of possible confounding in epidemiological studies. The epidemiological determinants for seropositivity for oncogenic and benign HPV types were assessed using a serosurvey of 275 healthy Swedish women, stratified by age and lifetime number of sexual partners. Seroprevalences were compared with 17 behavioral variables obtained by interview and 3 laboratory-diagnosed microbiological exposures. In univariate analysis, history of gonorrhea and condylomatosis, human herpesvirus type 8 and herpes simplex virus 2 seropositivities, lifetime number of sexual partners, and current partner’s lifetime number of sexual partners were associated with oncogenic HPV seropositivity. Noteworthy lack of correlations included smoking habits and oral contraceptive use. In multivariate analysis, only the number of lifetime sexual partners [odds ratio (OR), 8.7; 95% confidence interval (CI), 3.3–22.6] and seropositivity for benign HPV types remained significant (OR, 2.9; 95% CI, 1.6–5.3). Seropositivity for benign HPV was primarily associated with condyloma history (OR, 3.6; 95% CI, 1.2–10.8) and seropositivity for oncogenic HPV (OR, 2.9; 95% CI, 1.6–5.2). An association with sexual history lost significance in the multivariate model. In conclusion, lifetime number of sexual partners is the major determinant of acquisition of oncogenic HPV. By contrast, benign HPV infection associates more strongly with condyloma history than with sexual history per se.

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