A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica

Philip E. Castle, Mark Schiffman, Rolando Herrero, Allan Hildesheim, Ana Cecilia Rodriguez, M. Concepcion Bratti, Mark E. Sherman, Sholom Wacholder, Robert Tarone, Robert D. Burk

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297 Scopus citations


Background. Cross-sectional human papillomavirus (HPV) DNA prevalence peaks at young ages, reflecting sexual acquisition and typically rapid clearance. In some populations, HPV prevalence demonstrates a second peak in older women. Longitudinal data may help to explain this second peak. Methods. We followed a population-based cohort of 7237 women in Guanacaste, Costa Rica, in which we had previously observed a second peak in the baseline HPV prevalence in older women. We tested for >40 HPV types by polyrnerase chain reaction. We analyzed age-specific patterns of acquisition and persistence 5-7 years after enrollment for individual HPV types. Results. At enrollment and follow-up, cross-sectional data revealed U-shaped age-specific HPV prevalence curves for virtually every type, with higher prevalences in the younger and older women than in the middle-aged women. Prospectively, acquisition of types decreased significantly as women aged (PTrend<.05, for both), with the highest peak in young women and a secondary minor peak in older women. Type-specific persistence of HPV increased with age (PTrend<.0001). Overall, HPV acquisition predominated at younger ages, whereas persistent infections gradually became more prominent with age (PTrend<.0001). Conclusions. Newly apparent infections decreased, whereas persistence increased, with age; this latter tendency supports the utility of HPV screening in older women.

Original languageEnglish (US)
Pages (from-to)1808-1816
Number of pages9
JournalJournal of Infectious Diseases
Issue number11
StatePublished - Jun 1 2005


ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Castle, P. E., Schiffman, M., Herrero, R., Hildesheim, A., Rodriguez, A. C., Bratti, M. C., Sherman, M. E., Wacholder, S., Tarone, R., & Burk, R. D. (2005). A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica. Journal of Infectious Diseases, 191(11), 1808-1816. https://doi.org/10.1086/428779