title: Prevalence, genotype profile and risk factors for multiple human papillomavirus cervical infection in unimmunized female adolescents in Goiânia, Brazil: a community-based study.
abstract: BACKGROUND
  The epidemiology of infection with multiple human papillomavirus (HPV) types in female adolescents is poorly understood. The purpose of this study was to explore the epidemiology of infection with multiple HPV types in adolescents and its association with demographic, behavioral and biological variables, as well as with cytological abnormalities.
  
  
  METHODS
  This community-based study included 432 sexually active females between 15 and 19 years of age. Genotyping for 30 HPV types was performed using a reverse blot strip assay/restriction fragment length polymorphism. Unconditional multivariate logistic regression was performed to identify factors significantly associated with HPV infection. The association between HPV infection and cytological abnormalities was calculated using a prevalence ratio.
  
  
  RESULTS
  The most common HPV types detected were 16, 51, 31, 52 and 18. Of the 121 HPV-positive women, 54 (44.6%) were infected with multiple HPV types. Having more than one lifetime sexual partner was associated with infection with any HPV infection, single HPV infection, and infection with multiple HPV types. The presence of cytological abnormalities was associated with infection with multiple HPV types.
  
  
  CONCLUSIONS
  Co-infecting HPV genotypes occur in a high proportion of sexually active adolescents. Socio-demographic or sexual behavior factors associated with single HPV infection were similar to those associated with multiple HPV types. The higher risk of cytological abnormalities conferred by infection with multiple HPV types suggests a potential role of co-infection in the natural history of HPV infection.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Federal University of Goiás, Goiânia, Brazil. rosanefalves@gmail.com.
authors.forename: Rosane Ribeiro
authors.initials: RR
authors.lastname: Figueiredo Alves
authors.forename: Marília Dalva
authors.initials: MD
authors.lastname: Turchi
authors.forename: Lyana Elias
authors.initials: LE
authors.lastname: Santos
authors.forename: Eleuse Machado de Britto
authors.initials: EM
authors.lastname: Guimarães
authors.forename: Mônica Maria Danda
authors.initials: MM
authors.lastname: Garcia
authors.forename: Mirian Socorro Cardoso
authors.initials: MS
authors.lastname: Seixas
authors.forename: Luisa Lina
authors.initials: LL
authors.lastname: Villa
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Costa
authors.forename: Marise Amaral Rebouças
authors.initials: MA
authors.lastname: Moreira
authors.forename: Maria de Fátima da Costa
authors.initials: Mde F
authors.lastname: Alves
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D015995:Prevalence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D002577:Uterine Cervical Diseases / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D055815:Young Adult