Association Between Serum 25-Hydroxyvitamin D Level and Human Papillomavirus Cervicovaginal Infection in Women in the United States

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Abstract

Background. A sufficient level of vitamin D enhances protection against several infectious diseases; however, its association with cervicovaginal human papillomavirus (HPV) infection has not been studied.

Methods. Data for this cross-sectional study were from National Health and Nutrition Examination Survey 2003–2006. A total of 2353 sexually active women for whom cervicovaginal HPV infection status and serum 25-hydroxyvitamin D (25[OH]D) level were known were studied. Associations between serum 25(OH)D levels (continuous and categorical forms) and cervicovaginal HPV infection (due to high-risk HPV or vaccine-type HPV) were estimated using weighted logistic regression.

Results. After adjustment for age, race/ethnicity, and marital status, the odds of high-risk HPV infection were increased per each 10 ng/mL decrease in serum 25(OH)D level (adjusted odds ratio [aOR], 1.14; 95% confidence interval [CI], 1.02–1.27). Similarly, the odds of vaccine-type HPV infection were increased in women with vitamin D levels that were severely deficient (serum 25[OH]D level, <12 ng/mL; aOR, 2.90; 95% CI, 1.32–6.38), deficient (12–19 ng/mL; aOR, 2.19; 95% CI, 1.08–4.45), and insufficient (20–29 ng/mL; aOR, 2.19; 95% CI, 1.22–3.93), compared with those with vitamin D levels that were sufficient (≥30 ng/mL).

Conclusions. Cervicovaginal HPV prevalence is associated with less-than-optimal levels of serum vitamin D.

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