title: Multiple Human Papilloma Virus Infections and Their Impact on the Development of High-Risk Cervical Lesions.
abstract: OBJECTIVE
  Individuals are often infected with multiple genotypes of human papillomavirus (HPV) simultaneously, but the role these infections play in the development of cervical disease is not well established. This study aimed to determine the association of multiple HPV infections with high-risk cervical lesions (hrCLs).
  
  
  METHODS
  HPV genotyping was performed on 798 SurePath specimens collected between December 1, 2009, and April 30, 2011. The cases were classified as hrCL (n = 90) or non-hrCL (n = 708) based on cytology diagnoses. The association between hrCL and HPV infection patterns was analyzed.
  
  
  RESULTS
  Multiple HPV infections were frequently encountered (38.2%) in the cohort. Increased frequency of hrCLs was associated with a single high-risk HPV (hrHPV) infection. An additive or synergistic effect was not observed for hrCL in multiple HPV infections. The hrCL rates appeared to decrease in various patterns of multiple HPV infections, but the reduction was not statistically significant.
  
  
  CONCLUSIONS
  Multiple HPV infections are common with no additive or synergistic effect on the development of hrCL. Conversely, reduced hrCL rates were observed in various patterns of multiple HPV infections compared to their single-genotype infection counterparts, suggestive of possible intergenotypic competition or more effective immune response triggered by multiple infections. Further studies in larger cohorts are needed.
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Salazar
authors.forename: Haijun Steve
authors.initials: HS
authors.lastname: Zhou
authors.forename: Jiaqiong
authors.initials: J
authors.lastname: Xu
authors.forename: Leif E
authors.initials: LE
authors.lastname: Peterson
authors.forename: Mary R
authors.initials: MR
authors.lastname: Schwartz
authors.forename: Dina R
authors.initials: DR
authors.lastname: Mody
authors.forename: Yimin
authors.initials: Y
authors.lastname: Ge
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D065309:Atypical Squamous Cells of the Cervix / Q000473:pathology / Q000821:virology*; D060085:Coinfection; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000821:virology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D004279:DNA, Viral