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Background <p>Persistent infection with high-risk human papillomavirus (HR-HPV) is a necessary cause of cervical cancer and its precancerous lesions. This study aimed to identify factors associated with HR-HPV persistence in Chinese women.</p> Methods <p>This study is a population-based, nationwide, multi-center prospective cohort study initiated in 2017, and a total of 10,481 women undergoing cervical cancer screening were enrolled. A subset of 1,684 women who tested HR-HPV positive at baseline were included in the analysis. The results of their HPV testing at baseline and during three follow-up visits (2018–2020) were used to assess 1-, 2-, and 3-year HR-HPV persistence. Variables with statistically significant associations in univariate analyses, expressed as odds ratios (ORs) with 95% confidence intervals (CIs), were subsequently entered into a stepwise multivariate logistic regression model to identify independent predictors of HR-HPV persistence.</p> Results <p>The mean age of 1,684 HPV-positive women at baseline was 47.6 ± 9.5 (interquartile range (IQR) = 42–54) years. The most prevalent genotypes at baseline were HPV52 (28.3%), HPV16 (20.2%), HPV58 (17.8%), HPV33 (6.7%), and HPV18 (6.2%). Overall HR-HPV persistence rates declined over time were 66.8% at 1 year, 48.3% at 2 years, and 39.9% at 3 years. Infection with HPV33 (OR = 2.40, 95% CI: 1.42–4.01), HPV52 (OR = 1.95, 95% CI: 1.45–2.64), or HPV58 (OR = 2.01, 95% CI: 1.40–2.88), as well as postmenopausal status (OR = 2.84, 95% CI: 2.17–3.72), were significantly associated with 3-year persistence, and alcohol consumption was associated with a reduced risk of persistence (OR = 0.49, 95% CI: 0.30–0.79). Furthermore, HPV16 was the most frequently detected genotype in cervical intraepithelial neoplasia grades 2 and worse (CIN2+), indicating it plays a predominant role in chronically pathogenic of high cervical disease.</p> Conclusion <p>These findings underscore the importance of genotype-specific and host-related factors in HR-HPV persistence and support the implementation of tailored cervical cancer screening strategies. Women infected with HPV33, HPV52, or HPV58, along with HPV16 may require closer long-term monitoring to prevent progression to high-grade cervical lesions.</p>

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Factors related to cervicogenital high-risk human papillomavirus persistence among Chinese women: a nationwide multi-center cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月16日

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  • Jing Li,
  • Chong-Bi Huang,
  • Fan Zhao,
  • Dan-Dan Zhao,
  • Meng-Yin Ao,
  • Shao-Kai Zhang,
  • Zhi-Fang Li,
  • Le-Ni Kang,
  • You-Lin Qiao,
  • Wen Chen,
  • Yin Liu,
  • Lian Xu,
  • Xi Zeng,
  • Ming-Wei Yuan,
  • Shao-Long Xue,
  • Shu-Yuan Liu,
  • Ming-Rong Xi,
  • Guang-Dong Liao

摘要

Background

Persistent infection with high-risk human papillomavirus (HR-HPV) is a necessary cause of cervical cancer and its precancerous lesions. This study aimed to identify factors associated with HR-HPV persistence in Chinese women.

Methods

This study is a population-based, nationwide, multi-center prospective cohort study initiated in 2017, and a total of 10,481 women undergoing cervical cancer screening were enrolled. A subset of 1,684 women who tested HR-HPV positive at baseline were included in the analysis. The results of their HPV testing at baseline and during three follow-up visits (2018–2020) were used to assess 1-, 2-, and 3-year HR-HPV persistence. Variables with statistically significant associations in univariate analyses, expressed as odds ratios (ORs) with 95% confidence intervals (CIs), were subsequently entered into a stepwise multivariate logistic regression model to identify independent predictors of HR-HPV persistence.

Results

The mean age of 1,684 HPV-positive women at baseline was 47.6 ± 9.5 (interquartile range (IQR) = 42–54) years. The most prevalent genotypes at baseline were HPV52 (28.3%), HPV16 (20.2%), HPV58 (17.8%), HPV33 (6.7%), and HPV18 (6.2%). Overall HR-HPV persistence rates declined over time were 66.8% at 1 year, 48.3% at 2 years, and 39.9% at 3 years. Infection with HPV33 (OR = 2.40, 95% CI: 1.42–4.01), HPV52 (OR = 1.95, 95% CI: 1.45–2.64), or HPV58 (OR = 2.01, 95% CI: 1.40–2.88), as well as postmenopausal status (OR = 2.84, 95% CI: 2.17–3.72), were significantly associated with 3-year persistence, and alcohol consumption was associated with a reduced risk of persistence (OR = 0.49, 95% CI: 0.30–0.79). Furthermore, HPV16 was the most frequently detected genotype in cervical intraepithelial neoplasia grades 2 and worse (CIN2+), indicating it plays a predominant role in chronically pathogenic of high cervical disease.

Conclusion

These findings underscore the importance of genotype-specific and host-related factors in HR-HPV persistence and support the implementation of tailored cervical cancer screening strategies. Women infected with HPV33, HPV52, or HPV58, along with HPV16 may require closer long-term monitoring to prevent progression to high-grade cervical lesions.