The associations between dietary and circulating nutritional factors and human papillomavirus persistence among a cohort of young women

Abstract

Oncogenic human papillomavirus (HPV) infection is the primary etiologic factor for cervical dysplasia and cancer. An increased risk of cervical dysplasia is associated with persistent HPV infections. The rates of HPV infection are high compared to the relatively low rates of cervical dysplasia and cancer. This suggests that other factors are essential for HPV infection to advance to neoplasia. Previous studies have suggested that nutritional status may be associated with cervical dysplasia and cancer. This prospective study of 346 women investigated the relationship of HPV persistence with dietary and circulating concentrations of specific antioxidant nutrients or methyl donors over a scheduled 9-month period. Results suggest an inverse association of vitamin E (p for trend, 0.033) with an HPV persistence risk of 0.40 (95% CI = 0.18-0.91) among women consuming the highest tertile compared with the lowest tertile of vitamin E intake. A possible threshold effect was observed for lutein (p for trend, 0.054) with decreased risk observed for levels greater than or equal to the medium tertile (≥ 1042.4 μg per day). A protective association was also observed for dietary vegetable intakes of greater than or equal to the medium tertile (≥ 117 grams per day). Protection was not observed when supplements were included with food sources. Using circulating measures, elevated levels of cis-lycopene (p for trend, 0.046) and vitamin B12 (p for trend, 0.037) were inversely associated with HPV persistence. Women with circulating levels in the highest tertile of vitamin B12 were less likely to have persistent infection (OR = 0.40, 95% CI = 0.17-0.96) than those in the lowest tertile. Findings from this study suggest that elevated dietary intake of vitamin E, lutein, and vegetables as well as circulating levels of cis-lycopene and vitamin B12 reduce the risk of HPV persistence. Collectively, the results from this study suggest that improved nutritional status may reduce HPV persistence.