Factors associated with persistence and clearance of HPV16/18 among rural Chinese women: a cohort study in Wufeng, Hubei province

Human papillomavirus (HPV) persistence is the most critical cause of cervical cancer. This study focuses on exploring the prevalence and risk factors related to persistent HPV infection among rural Chinese women. Participants were recruited through a multi-stage stratified cluster sample. A total of 847 women were initially selected in 2015, and 159 were detected HPV-DNA positive at baseline. A two-year follow-up was conducted for those who were HPV-DNA positive at baseline. HPV infection was evaluated at both baseline and follow-up. Depending on the results of two HPV tests, women were divided into two categories: (1) persistence; (2) clearance. Student's t, chi-square and logistic regression were employed to find the risk factors for HPV persistence and the relationship between HPV persistence and cervical intraepithelial neoplasia (CIN). Among 129 participants with HPV16/18 infection at baseline, 60 (46.51 percent) were reported to have persistent HPV16/18 infection. Oral contraceptive use and menopause were the significant factors related to persistent HPV16/18 infection. The persistence of HPV infection was significantly related to CIN. Our results indicate that better HPV prevention strategies for rural Chinese women should be developed.