Recurrent Cervical HPV16 DNA Detection in Unvaccinated Women According to Presumed HPV16 Exposure Based on IgG and IgM Seroreactivity

Little is known about natural humoral immunity against recurrent HPV DNA detection. The objective was to assess the risk of cervical HPV16 DNA detection in unvaccinated women according to HPV16 IgG and IgM seroreactivity status. We analyzed data from 618 women (mean age of 32 years) participating in the Ludwig-McGill cohort. Women were classified into three HPV16 exposure groups based on IgG and IgM seroreactivity measured by enzyme-linked immunosorbent assay (ELISA): likely unexposed, recently exposed, and past exposed. HPV DNA was tested by PCR every 4-6 months. Associations between presumed HPV16 exposure and HPV16 DNA detection were measured using Cox regressions. Past exposed women had significantly higher risk of having HPV16 DNA detection (adjusted hazard ratio (aHR) [95% confidence interval (CI)] = 5.03 [2.00-12.63]) and recurrent detections (6.33 [2.38-16.82]) during the first year, compared to unexposed women. Recently exposed women showed similar patterns with HRs of lower magnitude. Naturally developed HPV16 IgG and IgM antibodies were positively associated with primary and recurrent HPV16 DNA detection. HPV antibodies may serve as serological markers for past and latent infections, enabling risk stratification in resource-limited settings. Testing for specific IgM antibodies could help identify women at risk of recurrent HPV16 DNA detection.