title: Patterns of human papillomavirus types in multiple infections: an analysis in women and men of the high throughput human papillomavirus monitoring study.
abstract: BACKGROUND
  To evaluate the pattern of co-infection of human papillomavirus (HPV) types in both sexes in Sweden.
  
  
  METHODS
  Cell samples from genital swabs, first-void urine, and genital swabs immersed in first-void urine were collected in the present cross-sectional High Throughput HPV Monitoring study. Overall, 31,717 samples from women and 9,949 from men (mean age 25) were tested for 16 HPV types using mass spectrometry. Multilevel logistic regression was used to estimate the expected number of multiple infections with specific HPV types, adjusted for age, type of sample, and accounting for correlations between HPV types due to unobserved risk factors using sample-level random effects. Bonferroni correction was used to allow for multiple comparisons (120).
  
  
  RESULTS
  Observed-to-expected ratio for any multiple infections was slightly above unity in both sexes, but, for most 2-type combinations, there was no evidence of significant departure from expected numbers. HPV6/18 was found more often and HPV51/68 and 6/68 less often than expected. However, HPV68 tended to be generally underrepresented in co-infections, suggesting a sub-optimal performance of our testing method for this HPV type.
  
  
  CONCLUSIONS
  We found no evidence for positive or negative clustering between HPV types included in the current prophylactic vaccines and other untargeted oncogenic types, in either sex.
authors: International Agency for Research on Cancer, Lyon, France.
authors: Salvatore
authors: S
authors: Vaccarella
authors: Anna
authors: A
authors: Söderlund-Strand
authors: Silvia
authors: S
authors: Franceschi
authors: Martyn
authors: M
authors: Plummer
authors: Joakim
authors: J
authors: Dillner
mesh_terms: D000328:Adult; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology*; D062665:Epidemiological Monitoring; D005260:Female; D057166:High-Throughput Screening Assays; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000502:physiology*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology
references: Cancer Epidemiol Biomarkers Prev. 2005 Oct;14(10):2439-45
references: 16214929
references: J Clin Microbiol. 2010 Nov;48(11):4147-55
references: 20844222
references: Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):326-33
references: 16492924
references: J Clin Microbiol. 2012 Jul;50(7):2289-98
references: 22535980
references: J Med Virol. 2011 Nov;83(11):1983-7
references: 21915874
references: J Infect Dis. 2011 Apr 1;203(7):910-20
references: 21402543
references: Cancer Epidemiol Biomarkers Prev. 2013 Feb;22(2):242-50
references: 23221127
references: Cancer Epidemiol Biomarkers Prev. 2005 Jul;14(7):1710-6
references: 16030106
references: Cancer Epidemiol Biomarkers Prev. 2009 Apr;18(4):1077-83
references: 19318438
references: J Clin Microbiol. 2009 Mar;47(3):541-6
references: 19144817
references: J Med Virol. 2011 Oct;83(10):1744-51
references: 21837790
references: Lancet Oncol. 2012 Jan;13(1):100-10
references: 22075170
references: J Infect Dis. 2001 Jan 1;183(1):8-15
references: 11087198
references: J Infect Dis. 2001 Dec 15;184(12):1508-17
references: 11740725
references: J Infect Dis. 1999 Nov;180(5):1415-23
references: 10515798
references: Int J Cancer. 2006 Oct 15;119(8):1934-9
references: 16708372
references: Cancer Epidemiol Biomarkers Prev. 2010 Feb;19(2):503-10
references: 20142247
references: J Infect Dis. 2012 Jan 1;205(1):72-81
references: 22058418
references: Lancet Oncol. 2009 Apr;10(4):321-2
references: 19350698
references: J Infect Dis. 2011 Nov 15;204(10):1500-4
references: 21908729
references: J Infect Dis. 2000 Oct;182(4):1097-102
references: 10979905
references: J Infect Dis. 2011 Aug 1;204(3):385-90
references: 21742837
references: J Infect Dis. 2005 Oct 1;192(7):1158-65
references: 16136457
references: Eur J Clin Microbiol Infect Dis. 2012 May;31(5):627-40
references: 21818524
references: Eur J Cancer. 2012 Jul;48(11):1633-7
references: 22088483
references: Vaccine. 2013 Mar 15;31(12):1604-9
references: 23313651