The role of body mass index in incidence and persistence of cervical human papillomavirus infection

Purpose: This study aimed to assess the association between body mass index and incident or persistent cervical high-risk human papillomavirus (hrHPV) infection. Methods: This cohort study included 6809 women from the general Danish population who participated in two clinical visits (in 1991–1993 and in 1993–1995). Height and weight were measured by nurses, lifestyle data were obtained by structured interviews, and cervical cytology samples were obtained for hrHPV DNA testing. We conducted log-binomial regression to estimate risk ratios (RRs) with 95% confidence intervals (CIs) of incident and type-specific persistent hrHPV infection according to body mass index, adjusting for age, education, smoking, and the number of sexual partners in the past year. Results: We found no increased risk of incident hrHPV infection in women who were underweight (RR _adjusted, 0.97; 95% CI, 0.64–1.48), overweight (RR _adjusted, 0.98, 95% CI, 0.82–1.17), or obese (RR _adjusted, 0.93; 95% CI, 0.63–1.36) compared with women of normal weight. The risk of hrHPV persistence was similar in overweight (RR _adjusted, 0.98; 95% CI, 0.71–1.34) and obese (RR _adjusted, 1.00; 95% CI, 0.56–1.79) women compared with women of normal weight, whereas underweight women had a lower risk (RR _adjusted, 0.32; 95% CI, 0.11–0.95). Conclusions: Overweight and obesity were not associated with HPV incidence or persistence when adjusting for sexual behavior.