Troja, C; Hoofnagle, AN; Szpiro, A; Stern, JE; Lin, J; Winer, RL
BACKGROUND: Associations between vitamin D biomarkers and persistent high-risk human papillomavirus (hrHPV) detection have not been evaluated.
METHODS: 2011-2012 stored sera from 72 women ages 30-50 years with prevalent hrHPV (n=116 type-specific infections) were tested for 5 vitamin D biomarkers: 25(OH)D and 4 emerging biomarkers, 1,25(OH)2D, 24,25(OH)2D, free vitamin D, and vitamin D binding protein (DBP). hrHPV detection patterns (persistent versus transient/sporadic) were determined using cervicovaginal swabs collected monthly for 6 months. Associations between vitamin D and short-term type-specific hrHPV persistence were estimated using logistic regression. Our primary exposure was continuous 25(OH)D, with additional biomarkers evaluated as secondary exposures. Primary models adjusted for age, race, BMI, education, contraceptives, smoking, season, and calcium/phosphate levels. Sensitivity analyses restricted from 19 hrHPV types to 14 used in cervical cancer screening.
RESULTS: In primary analyses, non-significant positive associations with hrHPV persistence were observed for measures of 25(OH)D and 24,25(OH)2D. Associations were stronger and significant restricting to 14 hrHPV types (25(OH)D per 10ng/mL increase: aOR=1.82,95%CI:1.15-2.88 and aOR=4.19,95%CI:1.18-14.88 DBP-adjusted; 25(OH)D≥30 vs <30ng/mL: aOR=8.85,95%CI:2.69-29.06; 24,25(OH)2D: aOR=1.85,95%CI:1.18-2.88). 1,25(OH)2D was unassociated with persistence.
CONCLUSIONS: Serum vitamin D measured by multiple biomarkers showed positive associations with short-term hrHPV persistence that were significant only when restricting to 14 clinically-relevant hrHPV types.