title: Occurrence of cervical infection with multiple human papillomavirus types is associated with age and cytologic abnormalities.
abstract: BACKGROUND
  Few aspects of the occurrence of infections with multiple HPV types have been described. Since the immunity conferred by vaccines is type-specific, the epidemiology of such coinfections needs to be addressed.
  
  
  OBJECTIVE
  The goal of the study was to document the prevalence and incidence of infection with multiple HPV types and the distribution of HPV types in coinfections.
  
  
  METHODS
  In a prospective cohort of 2075 Brazilian women, cervical specimens were collected for cytology and HPV detection. Information on potential risk factors was obtained by interview.
  
  
  RESULTS
  The prevalence of HPV coinfections was 3% among cytologically normal women, 10% among women with ASCUS, 23% among those with LSIL, and 7% among those with HSIL. The incidence rate of coinfection declined markedly with age (Ptrend<0.001). Some HPV types co-occurred less frequently than expected, namely, HPV 16 and 18 occurring with other oncogenic HPV types and HPV 6/11.
  
  
  CONCLUSIONS
  We have observed that occurrence of HPV coinfection was dependent both on age and on the presence of cytologic abnormalities. These results may have implications for vaccine development and for public health decisions about vaccination programs.
authors.affiliation: Department of Oncology, McGill University, Montreal, Quebec, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Rousseau
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Costa
authors.forename: Michal
authors.initials: M
authors.lastname: Abrahamowicz
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rohan
authors.forename: Eduardo
authors.initials: E
authors.lastname: Franco
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D002577:Uterine Cervical Diseases / Q000453:epidemiology* / Q000821:virology; D014626:Vaginal Smears; D014765:Viral Vaccines
chemical_list: D014765:Viral Vaccines