HPV clearance and persistency in young women – five years follow of WOLVES- study

Objectives: Long term persistency of HPV-HR infections is essential in the genesis of cervical cancer. Persistency seems to be rare in young women but the type specific clinical course of HR-infections in young women is still not fully understood.

Methods: WOLVES (Wolfsburg HPV epidemiological study) invited all women born 1988/89 with a first residency in Wolfsburg to participate. Participants were followed with annual examinations from 2009/10 till 2014/15.

Results: Between October 2009 and March 2014, 1181 women were recruited. HPV-prevalence was 308/1181 (26.1%). Rates of new infections were 15.7% (98/623) in the first, 13.4% (52/389) in the second, 10.0% (22/219) in the third and 8.4% (10/119) in the fourth year of follow-up. Overall HPV persistency occurred in 17.3% (148/857) in the first, 13.2% (84/638) in the second, 9.5% (42/441) in the third and 7.5% (19/253) in the fourth year of follow-up. 182 women with initially negative HPV result (n = 848) were tested HPV positive once in 5 year follow-up with four proven CIN2+ (0.36%). In HPV positive women (n = 308) the risk for CIN2+ into 5 years was 11.7% (n = 36). In persistend infections (n = 149) HPV16 (n = 37), HPV51 (n = 20) and HPV31 (n = 13) were most frequent and resembled the type distribution among CIN2, while all CIN3 were linked to HPV16.

Conclusions: Spontaneous clearance was lower than reported otherwise, while HC2- and type-specific persistency were more common than expected. Prevalent HPV infections were cleared < 50% within two years. We conclude that the risk of HPV persistency in young women may be higher than assumed.