title: [Relationship between multiple infection of human papillomavirus and cervical neoplasia among Chinese women in urban areas].
abstract: OBJECTIVE
  To investigate the prevalence of multiple infections of human papillomavirus (HPV) and its relationship with cervical neoplasia among Chinese women in urban areas.
  
  
  METHODS
  A population-based cross-sectional study was performed among 1712 women (1027 in Shenzhen, Guangdong province and 685 in Shenyang, Liaoning province, respectively) aged 15 - 59 years in China. One community was chosen by cluster sampling in each city. Exfoliated cervical cell was collected and HPV types were detected.
  
  
  RESULTS
  The total HPV prevalence of multiple infections was 4.73% (81/1712). There was no significant difference of HPV infection between two cities (Shenzhen vs Shenyang: 4.38% (45/1027) vs 5.26% (36/685); chi(2) = 0.70, P = 0.404). Among all multiple infections, HPV16-related infection was the most common one, accounting for 23.46% (19/81), followed by HPV52 and 58 (19.75% for each, 16/81). HPV prevalence of multiple infections were 3.42% (55/1606), 17.39% (12/69) and 37.84% (14/37) among the women with normal cervix, low-grade lesion and high-grade lesion, respectively. The HPV prevalence of multiple infections increased with the severity of cervical neoplasia (Z = 9.38, P = 0.01). The risk of high-grade lesion increased more dramatically among the women with multiple infections than single infections (adjusted OR = 96.61, 95%CI: 32.07 - 291.06 vs adjusted OR = 34.60, 95%CI: 12.59 - 95.02 for multiple and single infections, respectively). However, the risk of low-grade lesion increased relatively similarly among the women with the multiple and single infections (OR = 15.00, 95%CI: 6.89 - 32.65 vs OR = 12.04, 95%CI: 6.88 - 21.08 for multiple and single infections, respectively). Multiple-sexual-partner was the key risk factor for multiple infection of HPV (OR = 2.04, 95%CI: 1.19 - 3.49).
  
  
  CONCLUSIONS
  Multiple infections may play a higher role than single infection in the development of cervical neoplasia. Multiple HPV infections could be introduced into the strategy for cervical cancer prevention as a possible biomarker.
authors.affiliation: Cancer Hospital & Institute, Chinese Academy of Medical Sciences, National Office for Cancer Prevention and Control, Beijing 100021, China.
authors.forename: Ni
authors.initials: N
authors.lastname: Li
authors.forename: Min
authors.initials: M
authors.lastname: Dai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014505:Urban Population; D002577:Uterine Cervical Diseases / Q000453:epidemiology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology*