医学
沙眼衣原体
HPV感染
宫颈上皮内瘤变
人口
衣原体
宫颈癌
队列
队列研究
内科学
妇科
免疫学
癌症
环境卫生
作者
Kirsten Egebjerg Jensen,Louise T. Thomsen,Sven Schmiedel,Kirsten Frederiksen,Bodil Norrild,Adriaan van den Brule,Thomas Iftner,Susanne K. Kjær
标识
DOI:10.1136/sextrans-2013-051431
摘要
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.
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