HPV prevalence at enrollment and baseline results from the Carolina Women’s Care Study, a longitudinal study of HPV persistence in women of college age

Carolyn E Banister,^1,* Amy R Messersmith,^2,* Hrishikesh Chakraborty,³ Yinding Wang,³ Lisa B Spiryda,⁴ Saundra H Glover,⁵ Lucia Pirisi,⁶ Kim E Creek<sup>1

1</sup>Department of Drug Discovery and Biomedical Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, ²Department of Pharmaceutical Sciences, Presbyterian College School of Pharmacy, Clinton, ³Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, ⁴Department of Obstetrics and Gynecology, University of South Carolina School of Medicine Columbia, ⁵Department of Health Services Policy and Management, and Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, ⁶Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC, USA

^*These authors contributed equally to this work

Background: Cervical cancer, a rare outcome of high-risk human papillomavirus (HPV) infection, disproportionately affects African American women, who are about twice more likely than European American women to die of the disease. Most cervical HPV infections clear in about one year. However, in some women HPV persists, posing a greater risk for cervical dysplasia and cancer. The Carolina Women’s Care Study (CWCS) was conducted to explore the biological, genetic, and lifestyle determinants of persistent HPV infection in college-aged European American and African American women. This paper presents the initial results of the CWCS, based upon data obtained at enrollment.
Methods: Freshman female students attending the University of South Carolina were enrolled in the CWCS and followed until graduation with biannual visits, including two Papanicolaou tests, cervical mucus collection, and a questionnaire assessing lifestyle factors. We recruited 467 women, 293 of whom completed four or more visits for a total of 2274 visits.
Results and conclusion: CWCS participants were 70% European American, 24% African American, 3% Latina/Hispanic, and 3% Asian. At enrollment, 32% tested positive for any HPV. HPV16 infection was the most common (18% of infections). Together, HPV16, 66, 51, 52, and 18 accounted for 58% of all HPV infections. Sixty-four percent of all HPV-positive samples contained more than one HPV type, with an average of 2.2 HPV types per HPV-positive participant. We found differences between African American and European American women in the prevalence of HPV infection (38.1% African American, 30.7% European American) and abnormal Papanicolaou test results (9.8% African-American, 5.8% European American). While these differences did not reach statistical significance at enrollment, as the longitudinal data of this cohort are analyzed, the sample size will allow us to confirm these results and compare the natural history of HPV infection in college-aged African American and European American women.

Keywords: human papillomavirus, Carolina Women’s Care Study, papillomavirus persistence, race/ethnicity, health disparities