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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Chlamydia trachomatis and risk of cervical intraepithelial neoplasia grade 3 or worse in women with persistent human papillomavirus infection: a cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • Kirsten E Jensen
  • Louise T Thomsen
  • Sven Schmiedel
  • Kirsten Frederiksen
  • Bodil Norrild
  • Adriaan van den Brule
  • Thomas Iftner
  • Susanne K Kjær
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OBJECTIVES: Some studies suggest that Chlamydia trachomatis (CT) enhances cervical carcinogenesis; however, a possible confounding effect of persistent human papillomavirus (HPV) infection was not addressed. We examined the potential role of CT infection in the development of subsequent cervical intraepithelial neoplasia grade 3 or worse (CIN3+) in women with prevalent HPV infection and in a subgroup of women with persistent HPV infection.

METHODS: Participants in this population-based cohort study underwent a structured interview, including history of CT infection, and subsequently cervical exfoliated cells were obtained for HPV DNA and CT DNA testing. Women with high-risk HPV DNA infection and no prevalent cervical disease constituted the overall study population (n=1390). A subgroup of women with persistent HPV infection (n=320) was also identified. All women were passively followed for development of cervical lesions in the national Pathology Data Bank. HRs and 95% CIs for CIN3+ during follow-up (up to 19 years) were estimated in an accelerated failure time model.

RESULTS: Women who reported more than one CT infection had a statistically significantly increased risk of CIN3+ (high-risk HPV-positive, HR=2.51, 95% CI 1.44 to 4.37) (persistent HPV infection, HR=3.65, 95% CI 1.53 to 8.70). We found no association between CT DNA and subsequent risk of CIN3+ among women who were HPV-positive or had a persistent HPV infection at baseline.

CONCLUSIONS: Repeated CT infections increased the risk of CIN3+ among women with prevalent as well as persistent high-risk HPV infection.

OriginalsprogEngelsk
TidsskriftSexually Transmitted Infections
Vol/bind90
Udgave nummer7
Sider (fra-til)550-5
Antal sider6
ISSN1368-4973
DOI
StatusUdgivet - nov. 2014

ID: 45305501