Objective  To investigate natural outcome of moderate- and high-risk human papillomavirus (HPV) infection and influencing factors of persistent infection among Kazak women in Xinjiang Uygur Autonomous Region (Xinjiang).

  Methods  A baseline survey was conducted among 2 000 Kazakh women (25 – 64 years old) recruited using cluster sampling at Tacheng region of Xinjiang during June – August 2018. Relevant information of the women were collected with questionnaire interview, routine gynaecological examination, laboratory test, and biopsy if required. A year later, follow-up detections of HPV infection, cell cycle protein-dependent kinase inhibitor (P16), liquid-based cytology (LBC) were performed among 10% of the women negative for HPV and all the women positive for HPV infection at the baseline survey. An end follow-up survey was conducted among all the participants of the study two years after the baseline survey. SPSS 21.0 statistical software was used to analyze influencing factors for natural regression and persistence of HPV infection.

  Results  In the baseline survey, totally 291 HPV-positive women were detected, with 208 monotypic infections (including 164, 14, and 30 high-, moderate-, and low-risk HPV infections) and 83 multiple infections (80, 16, and 33 high-, moderate-, and low-risk HPV infections). At one-year follow-up detection among 193 baseline moderate- high-risk HPV positive women, 92 (47.67%) were found having persistent infection (with top five strains of HPV33, HPV35, HPV58, HPV18 and HPV16 in baseline detection) and 101 (52.33%) were observed having HPV clearance for strains of HPV45, HPV73, HPV82, and HPV83 in the baseline detection; while at the end follow-up among 186 baseline moderate- high-risk HPV positive women, 77 (41.40%) had persistent infection (with top five strains of HPV35, HPV16, HPV33, HPV18 and HPV59 in baseline detection) and 109 (58.60%) showed HPV clearance. The results of logistic regression analysis revealed that the age of ≤ 20 years at first sex (odds ratio OR = 1.85, 95% confidence interval 95%CI: 1.12 – 3.03), having syphilis infection (OR = 3.09, 95%CI: 1.15 – 8.32), and being menopause (OR = 3.09, 95%CI: 1.91 – 5.00) were risk factors for persistent moderate- and high-risk HPV infection during the two-year follow-up period.

  Conclusion  Persistent moderate- and high-risk HPV infection are more likely to occur for infections of HPV35/HPV16/HPV33/HPV18/HPV59 and main risk factors for the persistent infection include early age at first sex, syphilis infection and menopause among Kazakh women in Xinjiang.