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Cited by 352Cervical Cancer and HPV ResearchReproductive tract infections researchHead and Neck Cancer Studies

Human Papillomavirus Infections with Multiple Types and Risk of Cervical Neoplasia

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Trottier, Helen, Mahmud, Salaheddin, Costa, Maria Cecilia, Sobrinho, João P., Duarte-Franco, Eliane, Rohan, Thomas E., Ferenczy, Alex, Villa, Luisa L. +1 more·2006·Cancer Epidemiology, Biomarkers & Prevention
DOI 10.1158/1055-9965.epi-06-0129
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Abstract

Background: Besides an established role for certain human papillomavirus (HPV) genotypes in the etiology of cervical cancer, little is known about the influence of multiple-type HPV infections on cervical lesion risk. We studied the association between multiple HPV types and cervical lesions among 2,462 Brazilian women participating in the Ludwig-McGill study group investigation of the natural history of HPVs and cervical neoplasia. Methods: Cervical specimens were typed by a PCR protocol. The cohort's repeated-measurement design permitted the assessment of the relation between the cumulative and concurrent number of HPV types and any-grade squamous intraepithelial lesions (SIL) and high-grade SIL (HSIL). Result: At individual visits, 1.9% to 3.2% of the women were infected with multiple HPVs. Cumulatively during the first year and the first 4 years of follow-up, 12.3% and 22.3% were infected with multiple types, respectively. HSIL risk markedly increased with the number of types [odds ratio (OR), 41.5; 95% confidence interval (95% CI), 5.3-323.2 for single-type infections; OR, 91.7; 95% CI, 11.6-728.1 for two to three types; and OR, 424.0; 95% CI, 31.8-5651.8 for four to six types, relative to women consistently HPV-negative during the first year of follow-up]. The excess risks for multiple-type infections remained after exclusion of women infected with HPV-16, with high-risk HPV types, or persistent infections, particularly for any-grade SIL. Coinfections involving HPV-16 and HPV-58 seemed particularly prone to increase risk. Conclusion: Infections with multiple HPV types seem to act synergistically in cervical carcinogenesis. These findings have implications for the management of cervical lesions and prediction of the outcome of HPV infections. (Cancer Epidemiol Biomarkers Prev 2006;15(7):1274–80)

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Authors
Trottier, H., Mahmud, S., Costa, M. C., Sobrinho, J. P., Duarte-Franco, E., Rohan, T. E., Ferenczy, A., Villa, L. L., & Franco, E. L.
Affiliations
  • Jewish General Hospital (CA)
  • McGill University (CA)
  • 3Ludwig Institute for Cancer Research, São Paulo, Brazil; and
  • 1Division of Cancer Epidemiology and
  • Albert Einstein College of Medicine (US)
ORCID
Venue
Cancer Epidemiology, Biomarkers & Prevention
Publisher
American Association for Cancer Research (AACR)
Published
2006-07-01
Volume
15
Issue
7
Pages
1274-1280
ISSN
  • 1055-9965 (ISSN-L)
  • 1538-7755
DOI
10.1158/1055-9965.epi-06-0129
OpenAlex
W2021401697
Cited by
352
References
1
Citations by year
2026: 18 · 2025: 14 · 2024: 22 · 2023: 9 · 2022: 12 · 2021: 18 · 2020: 13 · 2019: 10 · 2018: 15 · 2017: 11 · 2016: 27 · 2015: 19 · 2014: 26 · 2013: 23 · 2012: 16
FWCI
13.72
Type
journal article
Language
en
Open access
Locations
  • Cancer Epidemiology Biomarkers & Prevention (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Ludwig Institute for Cancer Research
  • U.S. Public Health Service (MA13647)
  • Canadian Institutes of Health Research
  • National Cancer Institute (CA70269, R01CA070269)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
Keywords
human papillomavirus, multiple HPV infection, co-infection, cervical neoplasia, squamous intraepithelial lesions, high-grade squamous intraepithelial lesion, HPV16, HPV58, synergistic carcinogenesis, persistent HPV infection, cervical cancer risk
MeSH terms
Adolescent, Adult, Brazil, Carcinoma, Squamous Cell, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, DNA, Viral, Female, Humans, Middle Aged, Prospective Studies, Risk Factors, Vaginal Smears, Cohort Studies, Polymerase Chain Reaction, Papillomaviridae, Papillomavirus Infections

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