Grant Number:	5R01CA123467-02 Interpret this number
Primary Investigator:	Gravitt, Patti
Organization:	Johns Hopkins University
Project Title:	HPV Infection Among Perimenopausal Women in the 1945-64 Birth Cohor
Fiscal Year:	2008

DESCRIPTION (provided by applicant): Understanding the natural history of human papillomavirus (HPV) infection throughout the female life span will be critical in guiding future cervical cancer prevention programs, including screening and HPV vaccination. Age-specific trends of HPV prevalence show a second peak of HPV among older women in some populations. Few studies have been conducted to understand this observation, and historical cohorts will be of little value for further investigation. Women currently reaching the age of menopause in the US have experienced different risks throughout their lifetime due to the strong cohort effects that resulted from the sexual revolution that occurred in the 1960s and 1970s. It is therefore imperative to study contemporaneous cohorts of women through the menopausal transition to gain an understanding of the natural history of HPV infection in later life, including the risk of new HPV infections, reactivation of previously acquired infections, and persistence and disease progression of either reactivated or newly acquired infection. We propose to conduct a prospective cohort study of 1500 women belonging to the 1945-1965 'baby boomer' birth cohort to accomplish the following specific aims: (1) To compare the prevalence, (2) incidence, and (3) duration of HPV infection and squamous intraepithelial lesions (SIL) in pre-, peri-, and post-menopausal women, and (4) to estimate the minimum fraction of incident HPV DMA detection and seroconversion associated with reactivation vs. new sexual exposures. We will enroll a racially and socioeconomically diverse cohort in Baltimore, Maryland and follow the women for HPV and SIL every four months over a two year period. Our observational data will be supported by detailed molecular epidemiologic characterization of the viral infection (viral load, variant status, and gene expression) and the host response (cervical cytokine expression) among women with persistent vs. resolving infections. The successful completion of the study will provide stable estimates of risk of new HPV detection and SIL as a function of menopausal transitions and sexual exposures vs. reactivation in a contemporaneous cohort of aging women with the US. This information will be critical for development of cost-effective cervical cancer prevention policies. The complementary molecular studies will add important biological information that may lead to new approaches in screening and treatment of cervical HPV infections and neoplasia.




Association of Vaginal Microbiota with Signs and Symptoms of the Genitourinary Syndrome of Menopause across Reproductive Stages.
Authors: Shardell M. , Gravitt P.E. , Burke A.E. , Ravel J. , Brotman R.M. .
Source: The Journals Of Gerontology. Series A, Biological Sciences And Medical Sciences, 2021-04-27 00:00:00.0; , .
EPub date: 2021-04-27 00:00:00.0.
PMID: 33903897
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Rates of New Human Papillomavirus Detection and Loss of Detection in Middle-aged Women by Recent and Past Sexual Behavior.
Authors: Paul P. , Hammer A. , Rositch A.F. , Burke A.E. , Viscidi R.P. , Silver M.I. , Campos N. , Youk A.O. , Gravitt P.E. .
Source: The Journal Of Infectious Diseases, 2021-04-23 00:00:00.0; 223(8), p. 1423-1432.
PMID: 32870982
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Uptake of HPV testing and extended cervical cancer screening intervals following cytology alone and Pap/HPV cotesting in women aged 30-65 years.
Authors: Silver M.I. , Rositch A.F. , Phelan-Emrick D.F. , Gravitt P.E. .
Source: Cancer Causes & Control : Ccc, 2018 Jan; 29(1), p. 43-50.
EPub date: 2017-11-09 00:00:00.0.
PMID: 29124542
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Natural History of HPV Infection across the Lifespan: Role of Viral Latency.
Authors: Gravitt P.E. , Winer R.L. .
Source: Viruses, 2017-09-21 00:00:00.0; 9(10), .
EPub date: 2017-09-21 00:00:00.0.
PMID: 28934151
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Race is Associated With Sexual Behaviors and Modifies the Effect of Age on Human Papillomavirus Serostatus Among Perimenopausal Women.
Authors: Rettig E.M. , Fakhry C. , Rositch A.F. , Burke A.E. , Chang K. , Silver M.I. , Viscidi R. , Gravitt P. .
Source: Sexually Transmitted Diseases, 2016 Apr; 43(4), p. 231-7.
PMID: 26967299
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Patient concerns about human papillomavirus testing and 5-year intervals in routine cervical cancer screening.
Authors: Silver M.I. , Rositch A.F. , Burke A.E. , Chang K. , Viscidi R. , Gravitt P.E. .
Source: Obstetrics And Gynecology, 2015 Feb; 125(2), p. 317-29.
PMID: 25568994
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Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection.
Authors: Brotman R.M. , Shardell M.D. , Gajer P. , Tracy J.K. , Zenilman J.M. , Ravel J. , Gravitt P.E. .
Source: The Journal Of Infectious Diseases, 2014-12-01 00:00:00.0; 210(11), p. 1723-33.
EPub date: 2014-12-01 00:00:00.0.
PMID: 24943724
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Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009.
Authors: Rositch A.F. , Nowak R.G. , Gravitt P.E. .
Source: Cancer, 2014-07-01 00:00:00.0; 120(13), p. 2032-8.
EPub date: 2014-07-01 00:00:00.0.
PMID: 24821088
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Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy.
Authors: Brotman R.M. , Shardell M.D. , Gajer P. , Fadrosh D. , Chang K. , Silver M.I. , Viscidi R.P. , Burke A.E. , Ravel J. , Gravitt P.E. .
Source: Menopause (new York, N.y.), 2014 May; 21(5), p. 450-8.
PMID: 24080849
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Characterizing the temporal dynamics of human papillomavirus DNA detectability using short-interval sampling.
Authors: Liu S.H. , Cummings D.A. , Zenilman J.M. , Gravitt P.E. , Brotman R.M. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2014 Jan; 23(1), p. 200-8.
PMID: 24130223
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Obesity and human papillomavirus infection in perimenopausal women.
Authors: Liu S.H. , Rositch A.F. , Viscidi R.P. , Silver M.I. , Burke A.E. , Gravitt P.E. .
Source: The Journal Of Infectious Diseases, 2013-10-01 00:00:00.0; 208(7), p. 1071-80.
EPub date: 2013-10-01 00:00:00.0.
PMID: 23840046
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A cohort effect of the sexual revolution may be masking an increase in human papillomavirus detection at menopause in the United States.
Authors: Gravitt P.E. , Rositch A.F. , Silver M.I. , Marks M.A. , Chang K. , Burke A.E. , Viscidi R.P. .
Source: The Journal Of Infectious Diseases, 2013-01-15 00:00:00.0; 207(2), p. 272-80.
EPub date: 2013-01-15 00:00:00.0.
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The correlation between human papillomavirus positivity and abnormal cervical cytology result differs by age among perimenopausal women.
Authors: Rositch A.F. , Silver M.I. , Burke A. , Viscidi R. , Chang K. , Duke C.M. , Shen W. , Gravitt P.E. .
Source: Journal Of Lower Genital Tract Disease, 2013 Jan; 17(1), p. 38-47.
PMID: 22885643
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Contributions of recent and past sexual partnerships on incident human papillomavirus detection: acquisition and reactivation in older women.
Authors: Rositch A.F. , Burke A.E. , Viscidi R.P. , Silver M.I. , Chang K. , Gravitt P.E. .
Source: Cancer Research, 2012-12-01 00:00:00.0; 72(23), p. 6183-90.
EPub date: 2012-12-01 00:00:00.0.
PMID: 23019223
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Comparison of normalization methods for measuring immune markers in cervical secretion specimens.
Authors: Marks M.A. , Eby Y. , Howard R. , Gravitt P.E. .
Source: Journal Of Immunological Methods, 2012-08-31 00:00:00.0; 382(1-2), p. 211-5.
EPub date: 2012-08-31 00:00:00.0.
PMID: 22677266
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Evidence and impact of human papillomavirus latency.
Authors: Gravitt P.E. .
Source: The Open Virology Journal, 2012; 6, p. 198-203.
PMID: 23341855
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Differences in the concentration and correlation of cervical immune markers among HPV positive and negative perimenopausal women.
Authors: Marks M.A. , Viscidi R.P. , Chang K. , Silver M. , Burke A. , Howard R. , Gravitt P.E. .
Source: Cytokine, 2011 Dec; 56(3), p. 798-803.
PMID: 22015106
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The known unknowns of HPV natural history.
Authors: Gravitt P.E. .
Source: The Journal Of Clinical Investigation, 2011 Dec; 121(12), p. 4593-9.
PMID: 22133884
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Adult male circumcision: will it reduce disease caused by human papillomavirus?
Authors: Viscidi R.P. , Shah K.V. .
Source: The Journal Of Infectious Diseases, 2010-05-15 00:00:00.0; 201(10), p. 1447-9.
PMID: 20370482
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Progress and pitfalls in defining the influence of highly active antiretroviral therapy on human papillomavirus-associated cervical disease.
Authors: Gravitt P.E. , Kirk G.D. .
Source: The Journal Of Infectious Diseases, 2010 Mar; 201(5), p. 650-2.
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