1. Though not statistically significant, there was a U-shaped found between vitamin C levels and HPV infection risk, with women having inadequate, or saturated levels of vitamin C sharing higher HPV risk.
Evidence Rating Level: 2 (Good)
Human papillomavirus (HPV) is incredibly common. Many types of HPV infection can be cleared by one’s immune system, but persistent HPV infection is associated with more than 5% of cancers. Three successful HPV vaccines currently exist, but challenges remain in the prevention of HPV infection. Vitamin C is an important natural nutrient, that is known to prevent, shorten and alleviate a variety of infections. Previous studies have found that dietary vitamin C was negatively associated with the risk of persistence of HPV infection, with another study finding that low dietary vitamin C was associated with a higher risk of HPV infection. This cross-sectional study was the first to examine the relationship between vitamin C levels and HPV infection in larger samples, predicting that vitamin C may have a protective role against cervicovaginal HPV infection. 2174 women between the ages of 18-59 years were enrolled in the study. Serum vitamin C was collected and measured, and HPV infection was measured by extracting HPV DNA from vaginal swabs that were self-collected. Other factors considered were age, race, education, marital status, poverty income ration, health condition, health insurance, alcohol consumption, first age participating in vaginal, anal or oral sex, BMI and levels of various other vitamins. After adjusting for these factors, it was found the relationship between vitamin C and HPV infection was nonlinear, and rather showed a U-shape curve. In women under 25, vitamin C levels had no association with HPV infection, and in women older than 25, there was a negative association with HPV infection, perhaps related to a higher prevalence of HPV infection and higher rates of auto clearance in those under 25 years of age. Overall, no significant association was found with HPV infection and serum vitamin C levels (OR 0.998; 95% CI 0.994–1.001). The lowest risk of HPV infection was found when vitamin C levels were approximately 69.5 µmol/L. When vitamin C levels were above or below this level, an increased risk was seen, suggesting a U-shaped curve. This study did find some association between adequate vitamin C levels and HPV infection for those between the ages of 25-59, though these results were not significant. Future studies are needed to associate the relationship between vitamin C and HPV persistence, as well as to further characterize the biochemical mechanisms of how vitamin may serve a protective role against HPV infection.
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