MedPage Today (12.13.12)
Researchers have indicated that reactivation of latent human papillomavirus (HPV) infection in older women could hide an age-related increase in HPV detection at menopause. The age-specific prevalence of 14 high-risk HPV genotypes decreased in women with fewer than five lifetime sexual partners, but not women with five or more partners.
Patti E. Gravitt, PhD of the Johns Hopkins School of Public Health and colleagues studied women aged 35 to 60 years who were attending clinics for routine gynecologic assessment. At baseline, participants received a gynecologic examination, including testing for genotype-specific HPV and a questionnaire about social and demographic status, reproductive and menstrual history, medication use, and past and current sexual history.
Statistical analysis was completed on more than 800 women of mean age 47 years. The 24 women who reported a new sexual partner within six months had the highest prevalence of HPV and high-risk HPV. In women with fewer than five lifetime sexual partners, prevalence of HPV and high-risk HPV decreased as age increased. Women with five or more lifetime partners were presumed to have an increased risk of HPV reactivation, but the prevalence of HPV and high-risk HPV declined during ages 35 to 40, increased in women 40 to 54, and then decreased among those ages 55 to 60. The population-attributable risk (PAR) associated with five or six more lifetime sexual partners was three times greater in older women, but older women had a fourfold lower PAR associated with a new sexual partner than younger women. The researchers suggest that the data raised the possibility that reactivation may increase around age 50 years and contribute to a larger amount of HPV detection at older ages rather than new acquisition.
The study, “A Cohort Effect of the Sexual Revolution May Be Masking an Increase in Human Papillomavirus Detection at Menopause in the United States,” was published ahead of print by the Journal of Infectious Diseases (2012; doi: 10.1093/infdis/jis660).