Laura A Koutsky

Columbia University, New York City, New York, United States

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Publications (189)1350.29 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Data on clinical outcomes of infection with variants of oncogenic human papillomavirus (HPV) types other than HPV16 and HPV18 are rare. We investigated intratypic variations in non-HPV16/18 oncogenic types and their corresponding relationships with cervical intraepithelial neoplasia grades 2-3 (CIN2/3).
    Journal of the National Cancer Institute. 10/2014; 106(10).
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    ABSTRACT: There are limited data on the proportion who have been exposed to vaccine-type human papillomavirus (HPV) among women attending sexually transmitted disease (STD) clinics; this information could inform the potential benefits of HPV vaccination for women attending this venue. Human papillomavirus surveillance was conducted in STD clinics in Baltimore, MD; Boston, MA; Denver, CO; Los Angeles, CA; and Seattle, WA, among women receiving cervical cancer screening from January 2003 to December 2005. The women had specimens collected for cervical cytology HPV testing by L1 consensus polymerase chain reaction testing and serologic assessment for HPV 6, 11, 16, and 18 using the competitive Luminex immunoassay. Results from 880 women with adequate specimens were included. Women were HPV naïve if they were both HPV DNA negative and seronegative for a specific HPV type. One hundred seventy women (19.3%) had HPV 16, 18, 6, or 11 DNA, and 418 (47.5%) were HPV 16, 18, 6, or 11 seropositive. Four hundred ten (46.6%) women were naïve to all 4 types, 570 (64.8%) were naïve to both HPV 16 and 18, and 545 (61.9%) were naïve to both HPV 6 and 11. Almost all (99.3%) women were naïve to at least 1 vaccine HPV type. Almost half of young women age eligible for HPV vaccine and attending STD clinics were naïve to all 4 HPV types, and more than half were naïve to both HPV 16 and 18. This assessment suggests that most young women attending this venue might benefit from HPV vaccination.
    Sexually transmitted diseases 01/2014; 41(1):46-9. · 2.58 Impact Factor
  • The Lancet 11/2013; 382(9904):1554. · 39.21 Impact Factor
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    ABSTRACT: Despite the strong evidence of HPV infection as the etiological agent in a subset of oral cancer, oral α-HPV detection is rare in healthy individuals, and little is known of the existing of novel HPV types in oral cavity. We determined whether novel HPV types can be isolated from oral rinse samples collected from healthy individuals. We performed rolling circle amplification (RCA) coupled with degenerated PCR assay on 48 oral rinse samples to amplify novel HPV types. Full length HPV DNA was cloned using long range PCR. Quantitative type specific Taqman assays were used to determine the prevalence of novel HPV types in 158 archived oral tissue samples. We were able to isolate four novel human papillomavirus types. Full length HPV DNA was cloned for three of the four novel HPV types. All four HPV types belong to the genus Gammapapillomavirus (γ-PV), where HPV 171 is most closely related to HPV 169, showing 88% similarity; HPV 172 is most closely related to HPV 156, showing 70% similarity; HPV 173 is most closely related to HPV 4, showing 73% similarity; oral sample lavage (OSL) 37 is most closely related to HPV 144, showing 69% similarity. Finally, we showed that HPV 173 was rarely present in oral tissues (2/158), HPV 172 was only detected in normal oral tissues (25/76), and HPV 171 was more prevalent in malignant oral tissues (17/82 vs. 10/76, p=0.21). Novel γ-HPV types are present in oral cavity of healthy individuals.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 11/2013; · 3.12 Impact Factor
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    ABSTRACT: Oncogenic human papillomavirus (HPV) viral load may inform the origin of newly detected infections and characterize oncogenic HPV natural history in midadult women. From 2007 to 2011, we enrolled 521 25-65-year-old-female online daters and followed them triannually with mailed health and sexual behavior questionnaires and kits for self-sampling for PCR-based HPV DNA testing. Samples from oncogenic HPV positive women were selected for type-specific DNA load testing by real-time PCR with adjustment for cellularity. Linear or logistic regression models were used to evaluate relationships between viral levels, health and sexual behavior, and longitudinal oncogenic HPV detection. Type-specific viral levels were borderline significantly higher in oncogenic HPV infections that were prevalent versus newly detected (p = 0.092), but levels in newly detected infections were higher than in infections redetected after intercurrent negativity (p < 0.001). Recent sex partners were not significantly associated with viral levels. Compared with prevalent infections detected intermittently, the likelihood of persistent (OR = 4.31, 95% CI: 2.20-8.45) or single-time (OR = 1.32, 95% CI: 1.03-1.71) detection increased per 1-unit increase in baseline log10 viral load. Viral load differences between redetected and newly detected infections suggest a portion of new detections were due to new acquisition, although report of recent new sex partners (a potential marker of new infection) was not predictive of viral load; oncogenic HPV infections in midadult women with new partners likely represent a mix of new acquisition and reactivation or intermittent detection of previous infection. Intermittent detection was characterized by low viral levels, suggesting that intermittent detection of persisting oncogenic HPV infection may be of limited clinical significance.
    International Journal of Cancer 10/2013; · 6.20 Impact Factor
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    ABSTRACT: Background. There are few published estimates of anal human papillomavirus (HPV) infection rates among young men who have sex with men (YMSM).Methods. We estimated incidence and prevalence of type-specific anal HPV infection using clinician-collected anal swabs for HPV DNA testing obtained during a one-year prospective study of 94 YMSM (mean age=21) in Seattle.Results. Seventy percent of YMSM had any HPV infection detected during the study, and HPV-16 and/or -18 was detected in 37%. The incidence rate for any new HPV infection was 38.5 per 1,000 person-months and 15.3 for HPV-16/18; 19% had persistent HPV-16/18 infection. No participant tested positive for all four HPV types in the quadrivalent vaccine. The number of lifetime male receptive anal sex partners was significantly associated with HPV infection. The prevalence of HPV-16/18 was 6% among YMSM with a history of 1 receptive anal sex partner and 31% among YMSM with ≥2 partners.Conclusion. Although the high prevalence of HPV among YMSM highlights the desirability of vaccinating all boys as a strategy to avert the morbidity of HPV infection, most YMSM appear to remain naïve to either HPV-16 or -18 well into their sexual lives and would benefit from HPV immunization.
    The Journal of Infectious Diseases 08/2013; · 5.85 Impact Factor
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    ABSTRACT: BACKGROUND: We present data on Pap test results and HPV prevalence from the HPV Sentinel Surveillance project, a multiyear surveillance project enrolling women from a diverse set of 26 clinics throughout the US from 2003 to 2005. We use mathematical modeling to illustrate the potential timing and magnitude of decreases in Pap test abnormalities in sexually transmitted disease (STD), family planning, and primary care clinics in the US as a result of HPV vaccination. METHODS: The probability of an abnormal Pap result was based on three factors: (1) infection with HPV 16/18, or both; (2) infection with high-risk HPV types other than HPV 16/18; and (3) infection with HPV 6/11, or both. We estimated the relative reduction in the probability of an abnormal Pap result over the first 25 years of a female-only, quadrivalent HPV vaccination program, compared to a scenario of no HPV vaccination in which the probability of abnormal Pap results was assumed constant. RESULTS: The probability of an abnormal Pap result ranged from 7.0% for the lowest risk group (those without any high-risk HPV types and without HPV 6/11) to 45.2% for the highest risk group (those with HPV 16/18 and at least one other high-risk HPV type). Estimated reductions in abnormal Pap results among women in the 21- to 29-year age group were 0.8%, 10.2%, and 11.3% in years 5, 15, and 25 of the vaccine program respectively, in the lower vaccine coverage scenario, and 7.4%, 21.4%, and 22.2%, respectively, in the higher coverage scenario. CONCLUSIONS: Our results suggest that HPV vaccination will have a discernable impact on the probability of Pap abnormalities, but the timing and magnitude of the reduction will depend substantially on vaccine coverage and the degree of cross-protection against high risk HPV types other than HPV 16/18.
    Vaccine 05/2013; · 3.77 Impact Factor
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    ABSTRACT: : Bacterial vaginosis is uncommon in women who are virgins. We estimated effects of sexual debut on vaginal bacterial colonization. : Women who were virgins and aged 18-22 years enrolled in a study of human papillomavirus acquisition were followed every 4 months for up to 2 years. Vaginal swabs from before and after sexual debut or two independent visits for those remaining virgins were tested by quantitative polymerase chain reaction for Lactobacillus crispatus, Lactobacillus jensenii, Lactobacillus iners, Gardnerella vaginalis, and the bacterial vaginosis-associated species Atopobium vaginae, Megasphaera species, Leptotrichia species, Sneathia species, and bacterial vaginosis-associated bacterium-1, -2, and -3. : We evaluated 97 women: 71 who became sexually active and 26 who remained virgins. At first sampling, 22 of 26 (85%) women who remained virgins were colonized with Lactobacillus species compared with 22 of 26 (85%) at follow-up (P>.99). G vaginalis was present in 12 of 26 (46%) initially and 11 of 26 (42%) at follow-up (P>.99). Among women who became sexually active, colonization with Lactobacillus species remained stable: 65 of 71 (92%) compared with 66 of 71 (93%) (P>.99), whereas colonization with G vaginalis increased (28 of 71 [39%] compared with 40 of 71 [56%]; P=.02). Among women who did not initiate sexual activity during the study, two of 26 (8%) had any bacterial vaginosis-associated species detected at both the first and second visits (P>.99). Among women who became sexually active during the study, 15 of 71 (21%) were colonized with bacterial vaginosis-associated species initially compared with 13 of 71 (18%) after sexual debut (P=.77). : Among women who were virgins, vaginal colonization with bacterial vaginosis-associated bacterial species is uncommon and does not change after sexual debut. : II.
    Obstetrics and Gynecology 12/2012; 120(6):1306-13. · 4.80 Impact Factor
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    ABSTRACT: The epidemiology of high-risk (hr) human papillomavirus (HPV) infections in mid-adult women with new sex partners is undefined. We analyzed baseline data from 518 25- to 65-year-old women online daters. Women were mailed questionnaires and kits for self-collecting vaginal specimens for polymerase chain reaction-based hrHPV testing. Risk factors for infection were identified using Poisson regression models to obtain prevalence ratios (PRs). The prevalence of hrHPV infection was 35.9%. In multivariate analysis restricted to sexually active women, the likelihood of hrHPV infection was associated with abnormal Papanicolaou test history (PR = 1.42, 95% confidence interval [CI]: 1.10-1.84), lifetime number of sex partners >14 (compared with 1-4; PR = 2.13, 95% CI: 1.13-4.02 for 15-24 partners; and PR = 1.91, 95% CI: 1.00-3.64 for ≥25 partners), male partners with ≥1 concurrent partnership (PR = 1.34, 95% CI: 1.05-1.71), and male partners whom the subject met online (PR = 1.39, 95% CI: 1.08-1.79). Age was inversely associated with infection only in women who were sexually inactive (PR = 0.67 per 5-year age difference, adjusted for Papanicolaou history and lifetime number of partners). Compared with sexually inactive women, the likelihood of infection increased with increasing risk level (from low-risk to hr partners; P < 0.0001 by trend test). In multivariate analysis, infection with multiple versus single hrHPV types was inversely associated with ever having been pregnant (PR = 0.64, 95% CI: 0.46-0.90) and recent consistent condom use (PR = 0.56, 95% CI: 0.32-0.97), and positively associated with genital wart history (PR = 1.43, 95% CI: 1.03-1.99). Measures of both cumulative and recent sexual history were associated with prevalent hrHPV infection in this hr cohort of mid-adult women.
    Sexually transmitted diseases 11/2012; 39(11):848-56. · 2.58 Impact Factor
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    ABSTRACT: Little is known about the rates and determinants of oral human papillomavirus (HPV) infection, an infection that is etiologically linked with oropharyngeal cancers. A cohort of male university students (18-24 years) was examined every 4 months (212 men, 704 visits). Oral specimens were collected via gargle/rinse and swabbing of the oropharynx. Genotyping for HPV-16 and 36 other α-genus types was performed by polymerase chain reaction-based assay. Data on potential determinants were gathered via clinical examination, in-person questionnaire, and biweekly online diary. Hazards ratios (HR) were used to measure associations with incident infection. Prevalence of oral HPV infection at enrollment was 7.5%, and 12-month cumulative incidence was 12.3% (95% confidence interval [CI], 7.0, 21.3). Prevalence of oral HPV-16 was 2.8% and 12-month cumulative incidence was 0.8% (95% CI, 0.1%-5.7%). None of the incident oral HPV infections and 28.6% of the prevalent oral HPV infections were detected more than once. In a multivariate model, incident oral HPV infection was associated with recent frequency of performing oral sex (≥1 per week: HR, 3.7; 95% CI, 1.4-9.8), recent anal sex with men (HR, 42.9; 95% CI, 8.8-205.5), current infection with the same HPV type in the genitals (HR, 6.2; 95% CI, 2.4-16.4), and hyponychium (HR, 11.8, 95% CI, 4.1-34.2). Although nearly 20% of sexually active male university students had evidence of oral HPV infection within 12 months, most infections were transient. Human papillomavirus type 16 was not common. Sexual contact and autoinoculation appeared to play independent roles in the transmission of α-genus HPV to the oral cavity of young men.
    Sexually transmitted diseases 11/2012; 39(11):860-7. · 2.58 Impact Factor
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    ABSTRACT: Background: Two HPV vaccines are available and recommended for use in adolescent girls aged 11 or 12 years of age. Although catch-up vaccination of 13-26 year olds is also recommended, the benefits of vaccine in this age group, especially those who have had sexual experience, are likely less. There are limited data from STD clinics on the proportion of women who have been exposed to vaccine type HPV; this information could inform the potential benefits of HPV vaccination for women attending this venue. Methods: Surveillance for HPV was conducted in STD clinics in Boston MA, Baltimore MD, Seattle WA, Denver, CO and Los Angeles CA among women receiving cervical cancer screening from January 2003 to December 2005. Females aged 14-59 years had cervical specimens collected for HPV testing by L1 consensus PCR with type-specific hybridization and serologic assessment to HPV 6, 11, 16, 18 using the competitive Luminex immunoassay (PPD, Wilmington NC). Results from 880 females aged 14-26 years with cervical and matching serologic specimens with adequate results were included. We defined women as HPV nave if they were both HPV DNA negative and seronegative for a specific HPV type. Results: One hundred and seventy women (19.3%) had HPV 16, 18, 6 or 11 DNA, and 418 (47.5%) were HPV 16, 18, 6, or 11 seropositive. Overall, 618 (70.2%) women were nave to HPV16, 784 (89.1%) to HPV 18, 575 (65.3%) to HPV 6, and 796 (90.5%) to HPV 11. Four hundred and ten (46.6%) women were nave to all 4 types, 570 (64.8%) were nave to both HPV 16 and 18, and 545 (61.9%) were nave to both HPV 6 and 11. Almost all (99.3%) women were nave to at least one vaccine HPV type. Conclusion: While HPV vaccine ideally should be administered before sexual debut, we found almost all sexually experienced young women attending STD clinics were naive to at least one vaccine type infection and almost half were nave to all four types. This assessment suggests that most young women attending this venue may benefit from vaccination. Future operational research on vaccination at this venue would be useful.
    IDWeek 2012 Meeting of the Infectious Diseases Society of America; 10/2012
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    ABSTRACT: Our objective was to compare human papillomavirus (HPV) detection in paired self-collected vaginal samples transported by overnight mail in liquid specimen transport medium (STM) (wet) or in dry tubes (dry). Women aged 18-24 years were recruited online to self-collect vaginal swab samples at home for HPV testing and 159 women returned paired wet and dry samples. Dry samples were rehydrated with STM upon arrival at the laboratory. HPV was detected by the Roche Linear Array HPV genotyping test (37 genotypes) and Kappa and McNemar statistics were used to compare wet versus dry samples for detecting HPV. Of the subjects tested in this study, 51 % were HPV-positive (in either sample) and 40 % were positive for high-risk HPV. A total of 216 type-specific infections were detected among the 80 HPV-positive women. Almost perfect agreement was observed between paired samples for detecting any HPV (subject-level positive agreement: 91.9 %, κ: 0.85) or type-specific HPV (positive agreement across types: 90.1 %, κ: 0.90). Similar agreement between sample types was seen when testing for high-risk types and 81.9 % of all type-specific infections were detected in both samples. Among discordant pairs, wet samples were 3.3 times more likely to be positive for type-specific HPV than dry samples (P = 0.02). However, in 63.6 % of wet-positive/dry-negative discordant pairs analysed for viral load, type-specific HPV was either undetectable or detected at a low level (<100 copies) in the wet samples, suggesting that the majority of infections missed by using dry samples are less likely to be clinically relevant. Our results indicate that dry transport is a feasible option for transporting at-home self-collected vaginal samples for HPV DNA testing.
    Journal of Medical Microbiology 08/2012; 61(Pt 11):1538-45. · 2.30 Impact Factor
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    ABSTRACT: A survey was administered to male university students who tested positive for high-risk human papillomavirus. Disclosure was more likely in men with fewer partners, in main partnerships, and in longer partnerships. Disclosure was associated with discussing the Pap test/human papillomavirus vaccine with female partners and not associated with a worsening relationship.
    Sexually transmitted diseases 08/2012; 39(8):583-7. · 2.58 Impact Factor
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    ABSTRACT: Variants of human papillomavirus (HPV) type 31 have been shown to be related both to risk of cervical lesions and racial composition of a population. It is largely undetermined whether variants differ in their likelihood of persistence. Study subjects were women who participated in the ASCUS-LSIL Triage Study and who had a newly detected HPV31 infection during a two-year follow-up with six-month intervals. HPV31 isolates were characterized by sequencing and assigned to one of three variant lineages. Loss of the newly detected HPV31 infection was detected in 76 (47.5%) of the 160 women (32/67 with A variants, 16/27 with B variants and 28/66 with C variants). The adjusted hazard ratio associating loss of the infection was 1.2 (95% CI, 0.7-2.1) for women with A variants and 2.1 (95% CI, 1.2-3.5) for women with B variants when compared with those with C variants. Infections with A and C variants were detected in 50 and 41 Caucasian women and in 15 and 23 African-American women, respectively. The likelihood of clearance of the infection was significantly lower in African-American women with C variants than in African-American women with A variants (p = 0.05). There was no difference in the likelihood of clearance between A and C variants among Caucasian women. Our data indicated that infections with B variants were more likely to resolve than those with C variants. The difference in clearance of A vs. C variants in African-Americans, but not in Caucasians, suggests a possibility of the race-related influence in retaining the variant-specific infection.
    International Journal of Cancer 06/2012; · 6.20 Impact Factor
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    ABSTRACT: Although the lineages of human papillomavirus type 31 (HPV31) variants are recognized, their clinical relevance is unknown. The purpose of our study was to examine risk of cervical intraepithelial neoplasia Grades 2-3 (CIN2/3) by HPV31 variants. Study subjects were women who participated in the atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion Triage Study and who had HPV31 infections detected at one or more visits. They were followed semi-annually over 2 years for detection of HPV DNA and cervical lesion. HPV31 isolates were characterized by DNA sequencing and assigned into 1 of 3 variant lineages. CIN2/3 was histologically confirmed in 127 (27.0%) of the 470 HPV31-positive women, 83 diagnosed at the first HPV31-positive visit and 44 thereafter. The odds ratio for the association of 2-year cumulative risk of CIN2/3 was 1.7 (95% CI: 1.0-2.9) for infections with A variants and 2.2 (95% CI: 1.2-3.9) for infections with B variants as compared to those with C variants. Among women without CIN2/3 at the first HPV31-positive visit, the risk of subsequent CIN2/3 was 2.2-fold greater for those with A variants (95% CI: 1.0-4.8) and 2.0-fold greater for those with B variants (95% CI: 0.9-4.9) as compared to those with C variants. Similar associations were observed when CIN3 was used as the endpoint. The findings from our study help to tag HPV31 variants that differ in risk of CIN2/3 and to explain in part why some HPV31 infections regress spontaneously and others lead to disease progression.
    International Journal of Cancer 03/2012; 131(10):2300-7. · 6.20 Impact Factor
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    ABSTRACT: We investigated the feasibility of monitoring trends in prevalence of vaccine-preventable human papillomavirus (HPV) types in different clinic populations. We collected cervical specimens from women presenting to family planning, primary care, and sexually transmitted disease (STD) clinics for routine pap smears in five US cities during 2003-2005. We performed HPV genotyping and calculated annual type-specific prevalences; pre-vaccine era prevalence was highest for HPV 16 (6.0; 95% confidence interval [CI] 5.5-6.6%) and annual prevalences for vaccine-preventable types were stable, with few exceptions, after controlling for clinic type, age group, and city. With sufficient sample size and stable population characteristics, clinic-based surveillance systems can contribute to monitoring HPV vaccine impact in the cervical screening population.
    Vaccine 03/2012; 30(11):1959-64. · 3.77 Impact Factor
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    ABSTRACT: The duration of protection conferred by prophylactic human papillomavirus (HPV) L1 virus-like particle vaccines is a critical determinant of their public health impact. A feature of vaccines that confer long-term immunity is their ability to induce immune memory. We evaluated antibody responses against HPV types 6, 11, 16 and 18 following administration of the quadrivalent HPV-6/11/16/18 vaccine to women who had previously received a monovalent HPV-16 vaccine. As part of an extended follow-up study conducted between 2006 and 2009 in Seattle, Washington, we administered the quadrivalent HPV-6/11/16/18 vaccine to 52 women (19 vaccine and 33 placebo recipients) who had participated in a monovalent HPV-16 vaccine trial 8.5 years earlier. Serum samples were tested for anti-HPV antibodies using competitive Luminex immunoassay. Following administration of the first dose of the quadrivalent HPV-6/11/16/18 vaccine, the anti-HPV-16 geometric mean titer among monovalent HPV-16 vaccine recipients (GMT=5024.0 milli-Merck units per milliliter [mMU/mL]; 95% confidence interval [CI]: 2710.1, 9313.6 mMU/mL) substantially exceeded that among the placebo recipients (GMT=136.1; 95% CI: 78.5, 235.8 mMU/mL; p<0.01) and their own highest anti-HPV-16 response observed during the original trial (GMT at month 7 of the original trial=1552.7 mMU/mL; 95% CI: 1072.6, 2247.7 mMU/mL; p<0.01). The findings suggest that the administration of the three-dose regimen of the monovalent HPV-16 vaccine had produced memory lymphocytes, characterized by a heightened immune response following administration of the quadrivalent HPV-6/11/16/18 vaccine that effectively served as an antigen challenge.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 12/2011; 53(3):239-43. · 3.12 Impact Factor
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    ABSTRACT: The role of circumcision in male HPV acquisition is not clear. Male university students (aged 18-20 years) were recruited from 2003 to 2009 and followed up triannually. Shaft/scrotum, glans, and urine samples were tested for 37 α human papillomavirus (HPV) genotypes. Cox proportional hazards methods were used to evaluate the association between circumcision and HPV acquisition. Logistic regression was used to assess whether the number of genital sites infected at incident HPV detection or site of incident detection varied by circumcision status. In 477 men, rates of acquiring clinically relevant HPV types (high-risk types plus types 6 and 11) did not differ significantly by circumcision status (hazard ratio for uncircumcised relative to circumcised subjects: 0.9 [95% confidence interval{CI}: 0.7-1.2]). However, compared with circumcised men, uncircumcised men were 10.1 (95% CI: 2.9-35.6) times more likely to have the same HPV type detected in all 3 genital specimens than in a single genital specimen and were 2.7 (95% CI: 1.6-4.5) times more likely to have an HPV-positive urine or glans specimen at first detection. Although the likelihood of HPV acquisition did not differ by circumcision status, uncircumcised men were more likely than circumcised men to have infections detected at multiple genital sites, which may have implications for HPV transmission.
    Sexually transmitted diseases 11/2011; 38(11):1074-81. · 2.58 Impact Factor
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    ABSTRACT: Prophylactic human papillomavirus (HPV) vaccines have shown to generate type-specific antibodies against infection with HPV 16 (proto-type HPV vaccine), HPV16/18 (Cervarix), and HPV 6/11/16/18 (Gardasil). These vaccines also appear to partially protect from infection with HPVs closely related to the targeted types, however, the duration of protection provided by both type-specific and cross-reactive antibodies is unknown. It is hypothesized that HPV vaccine-generated cross-reactive antibodies will wane more quickly than will type-specific antibodies. To characterize cross-reactive antibodies in women following HPV vaccination, 863 sera were collected from 353 women who were followed for up to 8.5 years post-HPV16 vaccination. The average number of visits was 2.47; 251 women visited the clinic more than once. Using glutathione-s-transferase-HPV L1 fusion proteins bound to glutathione-casein coated Luminex beads, antibody levels to multiple HPV types will be measured. Fusion proteins of types closely related to HPV 16 (31L1, 33L1, 35L1, 52L1, 58L1 and 67L1) and HPV 18 (39L1, 45L1, 59L1 and 68L1) will be used, as will the other vaccine types (6L1 and 11L1) and more distantly related types within the genus alpha (2L1, 51L1 and 56L1). Additionally, one HPV from a different genus (1L1 genus Mu)will be used for comparison. We will compare the level of antibodies for each non-vaccine HPV type with the level of antibodies to HPV types targeted by the HPV16/18 vaccine or the HPV 6/11/16/18 vaccine. Additionally, the change in antibody levels over time will be calculated to determine if cross-reactive antibodies wane more rapidly than vaccine-type antibodies.
    2011 Society for Advancement of Hispanics/Chicanos and Native Americans in Science National Conference; 10/2011
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    ABSTRACT: Increased duration of hormonal contraceptive (HC) use may be positively associated with the risk of invasive cervical cancer. This is a secondary analysis from the HPV Sentinel Surveillance Study. The authors examined the association between type-specific human papillomavirus (HPV) detection and current HC use among 7718 women attending 26 sexually transmitted disease, family planning and primary care clinics in the USA. There was an association between HC use and HPV-16 detection (adjusted prevalence rate ratio 1.34 (95% CI 1.05 to 1.71) for oral contraceptive users and 1.41 (1.01 to 2.04) for depot-medroxyprogesterone acetate users); there was no association between HC use and detection of other HPV types or any HPV overall. Longitudinal studies are needed to better define this type-specific association and its clinical significance.
    Sexually transmitted infections 08/2011; 87(5):385-8. · 2.18 Impact Factor

Publication Stats

12k Citations
1,350.29 Total Impact Points


  • 2013
    • Columbia University
      New York City, New York, United States
  • 1988–2013
    • University of Washington Seattle
      • • Department of Pathology
      • • Department of Epidemiology
      • • Department of Obstetrics and Gynecology
      • • Department of Medicine
      Seattle, Washington, United States
  • 2012
    • World Health Organization WHO
      • Division of Health Security and Emergencies (DSE)
      Islāmābād, Islāmābād, Pakistan
  • 2010–2011
    • Merck
      Whitehouse Station, New Jersey, United States
    • National Cancer Institute
      Μπογκοτά, Bogota D.C., Colombia
  • 2005–2010
    • Yale University
      • Department of Pediatrics
      New Haven, Connecticut, United States
    • Mayo Foundation for Medical Education and Research
      Rochester, Michigan, United States
  • 2009
    • Danderyds Sjukhus AB
      Tukholma, Stockholm, Sweden
    • National Institutes of Health
      • Division of Cancer Epidemiology and Genetics
      Bethesda, MD, United States
    • University of New Mexico
      • Department of Molecular Genetics/Microbiology
      Albuquerque, NM, United States
    • Danish Cancer Society
      København, Capital Region, Denmark
    • Indiana University-Purdue University Indianapolis
      • Department of Medicine
      Indianapolis, IN, United States
  • 2008
    • Medical University of Vienna
      • Universitätsklinik für Frauenheilkunde
      Vienna, Vienna, Austria
    • Kenya Medical Research Institute
      • Centre for Microbiology Research (CMR)
      Nairobi, Nairobi Province, Kenya
  • 2007
    • University of Melbourne
      Melbourne, Victoria, Australia
  • 2006
    • University of Michigan
      Ann Arbor, Michigan, United States
    • Allegheny General Hospital
      • Center for Genomic Sciences
      Pittsburgh, Pennsylvania, United States
  • 2005–2006
    • Ludwig Institute for Cancer Research Brazil
      San Paulo, São Paulo, Brazil
  • 1990–2006
    • Fred Hutchinson Cancer Research Center
      • Division of Human Biology
      Seattle, WA, United States
  • 2003
    • George Washington University
      • Department of Epidemiology
      Washington, Washington, D.C., United States
  • 2002
    • University of Pittsburgh
      • Department of Obstetrics, Gynecology and Reproductive Sciences
      Pittsburgh, Pennsylvania, United States