New research to be highlighted at the Pediatric Academic Societies 2016 Meeting is the first to suggest that stress and depression play a significant role in whether a woman with human papillomavirus (HPV) can get rid of her infection or not. HPV that lingers in a woman's system eventually can lead to cervical cancer.

The study, "Psychosocial Stress, Maladaptive Coping and HPV Persistence," examined a group of 333 women the researchers began following in 2000. The women were about 19 years old on average when they enrolled in the study. Throughout the study period, they came into the lab every six months so researchers could take a sample to test for HPV.

During the 11th year of the study, when the women were about 28 years old, participants also completed a questionnaire that asked about how much stress they had, how they coped with stress, and if they were depressed. The researchers compared their answers to whether the women had HPV persistence--meaning they still tested positive for the virus--or whether the infection had cleared. The body's immune system often fights off the virus within a couple years of exposure, the researchers said.

"Women who reported self-destructive coping strategies, like drinking, smoking cigarettes or taking drugs when stressed, were more likely to develop an active HPV infection," said principal investigator Anna-Barbara Moscicki, MD, FAAP, chief of the Division of Adolescent and Young Adult Medicine and professor of pediatrics at the University of California, Los Angeles School of Medicine. "We also found that women who were depressed or perceived themselves to have lots of stress were more likely to have HPV persistence," she said, adding that this study is the first to show these connections between stress and HPV persistence.

Research has long linked psychosocial stress with negative health effects, Dr. Moscicki said. Previous studies have shown it can lead to greater numbers of herpes virus outbreaks in those infected, for example, and worse medical outcomes among people with cancer. One theory is that stress may be related to abnormal immune responses, which she said these new research findings may support. Further studies are planned to determine whether cervical inflammatory markers are associated with stress.

Dr. Moscicki said the study suggests women with HPV infection should be advised that stress reduction may help them clear their infection, and that using drinking alcohol or smoking cigarettes may hamper their ability to clear the infections.

"HPV infections are the cause of cervical cancers. But HPV infections are extremely common, and only the few infections that continue years beyond initial infection are at risk of developing cervical cancer," she said. "This is alarming since many of these women acquired their persistent infection as adolescents."