title: Multiple-type human papillomavirus (HPV) infections: a cross-sectional analysis of the prevalence of specific types in 309,000 women referred for HPV testing at the time of cervical cytology.
abstract: OBJECTIVE
  To determine the frequency of multiple-type cervical human papillomavirus (HPV) infections, and whether any types are involved in multiple-type infections more or less frequently than might be expected if these infections occur randomly.
  
  
  METHODS
  In this retrospective analysis of type-specific HPV testing, results from women 18 to 65 years old with samples collected between July 2007 and May 2011 were considered.Multivariate logistic regression analysis was used to model the presence of each of the 24 most prevalent HPV types, adjusting for one other HPV type, age, laboratory region, and age-by-region interactions.
  
  
  RESULTS
  Human papillomavirus infection was present in 74,543 (24.1%) of 309,471 women and 65,492 (21.1%) were positive for one of the top 24 most prevalent HPV types. The most common HPV type was type 16, occurring in 4.1% of the entire sample. A total of 14,181 women were positive for 2 or more HPV types (4.6% of entire sample and 19.0% of HPV-positive sample). Two-way HPV type comparisons were analyzed. Types 52, 53, 81, and 83 were more likely to occur in multiple infections with other types; and types 16, 58, and 66 were less likely to occur in multiple infections with other types. Human papillomavirus types 72 and 81 have the strongest positive relationship (odds ratio, 5.2; 95% confidence interval, 3.6-7.4). Human papillomavirus types 33 and 66 have the strongest negative relationship (odds ratio, 0.4; 95% confidence interval, 0.2-0.6).
  
  
  CONCLUSIONS
  In this population, multiple-type HPV infections were present in 4.6% of all women. Our findings suggest that there may be both competitive and cooperative interactions between HPV types.
authors: Department of Obstetrics, Gynecology and Women's Health, and Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
authors: Elizabeth Louise
authors: EL
authors: Dickson
authors: Rachel Isaksson
authors: RI
authors: Vogel
authors: Robin L
authors: RL
authors: Bliss
authors: Levi S
authors: LS
authors: Downs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000166:cytology / Q000821:virology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000453:epidemiology* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D004279:DNA, Viral
references: Int J Cancer. 2003 Sep 1;106(3):396-403
references: 12845680
references: J Infect Dis. 2011 Apr 1;203(7):910-20
references: 21402543
references: Am J Obstet Gynecol. 2009 Mar;200(3):245.e1-7
references: 19254582
references: N Engl J Med. 2003 Feb 6;348(6):518-27
references: 12571259
references: J Infect Dis. 2011 Aug 1;204(3):385-90
references: 21742837
references: Cancer Causes Control. 2009 Oct;20(8):1387-96
references: 19475481
references: Cancer Epidemiol Biomarkers Prev. 2011 Jul;20(7):1398-409
references: 21602310
references: Lancet. 2006 Apr 15;367(9518):1247-55
references: 16631880
references: Eur J Cancer. 2012 Jul;48(11):1633-7
references: 22088483
references: J Med Virol. 2009 Feb;81(2):271-7
references: 19107962
references: Cancer Epidemiol Biomarkers Prev. 2005 Oct;14(10):2439-45
references: 16214929
references: Int J Cancer. 2006 Sep 1;119(5):1095-101
references: 16586444
references: Sex Transm Dis. 2003 Jul;30(7):581-7
references: 12838088
references: Br J Cancer. 2008 May 20;98(10):1704-9
references: 18392052
references: JAMA. 2007 Feb 28;297(8):813-9
references: 17327523
references: J Natl Cancer Inst. 1990 Sep 19;82(18):1477-84
references: 2167986
references: Virology. 2005 Jun 20;337(1):76-84
references: 15914222
references: Cancer Epidemiol Biomarkers Prev. 2006 Jul;15(7):1274-80
references: 16835323
references: J Med Virol. 2008 Jul;80(7):1264-74
references: 18461626
references: Cancer Epidemiol Biomarkers Prev. 2009 Apr;18(4):1077-83
references: 19318438
references: Mol Cell Probes. 1992 Apr;6(2):145-52
references: 1355266