Acquisition, prevalence and clearance of type-specific human papillomavirus infections in young sexually active Indian women: A community-based multicentric cohort study
Richard Muwonge, Partha Basu, Tarik Gheit, Devasena Anantharaman, Yogesh Verma, Neerja Bhatla, Smita Joshi, Pulikottil Okuru Esmy, Usha Rani Poli, Anand Shah, Eric Zomawia, Surendra S. Shastri, Sharmila Pimple, Priya R. Prabhu, Sanjay Hingmire, Aruna Chiwate, Catherine Sauvaget, Eric Lucas, Sylla G. Malvi, Maqsood Siddiqi, Subha Sankaran, Thiraviam Pillai Rameshwari Ammal Kannan, Rintu Varghese, Uma Divate, Shachi Vashist, Gauravi Mishra, Radhika Jadhav, Massimo Tommasino, M. Radhakrishna Pillai, Rengaswamy Sankaranarayanan, Kasturi Jayant, for the Indian HPV vaccine study group
Abstract
In context of the ongoing multi-centric HPV vaccine study in India, unvaccinated married women (N = 1484) aged 18-23 years were recruited in 2012-2015 as age-matched controls to the vaccinated women and followed up yearly. We assess type-specific prevalence, natural history and potential determinants of human papillomavirus (HPV) infection in these unvaccinated women. Cervical samples were collected yearly for at least four consecutive years. A Multiplex Type-Specific E7-Based polymerase chain reaction assay was used to detect 21 HPV types. HPV prevalence was 36.4% during 6 years. Most common HPV types were 16 (6.5%) and 31 (6.1%). Highest persistence were observed for HPV 35 (62.5%) and 52 (25%). New HPV acquisition rate was 5.6/1000 person-months of observation (PMO), highest for HPV 16 (1.1/1000 PMO). Type-specific clearance rates ranged between 2.9-5.5/100 PMO. HPV 16 and/or 18 infections were 41% (95% CI 4-63%) lower among women with 2-<3 years between marriage and first cervical sample collection compared to those with <2 years. HPV prevalence and acquisition rates in young Indian women were lower than their Western counterparts. HPV 16 infections being most common shows the importance and potential impact of HPV vaccination in India. Women with 2-3 years exposure had reduced risk possibly due to higher infections clearance.