National Reference Laboratory of STI for Human Papillomavirus, Poliomavirus and genital Herpes Virus, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal.
Clin Microbiol Infect. 2011 Jun;17(6):941-6. doi: 10.1111/j.1469-0691.2010.03387.x. Epub 2010 Dec 3.
Persistent infection with high-risk (HR) human papillomavirus (HPV) types is necessary for cervical cancer development. However, little is known about the influence of multiple HPV infections on cervical lesion risk. The aim of this study was to evaluate the frequency of single and multiple HPV infections in Portuguese women, and to assess the frequency of multiple infections in cervical intraepithelial neoplasia (CIN). HPV prevalence, type-specific prevalence and extent of multiple infections were assessed in 1057 cervical samples. The Clinical Array HPV assay was used to detect 35 HPV types. According to histological diagnosis, 425 samples were normal, 375 were CIN1, and 257 were CIN2+. HPV status was studied in relation to age and lesion severity. The prevalence of HPV infection was 52.7%; 25.4%, 67.2% and 76.7% were positive for any HPV type in the normal, CIN1 and CIN2+ cases, respectively. Among HPV-positive cases, 32.0% were associated with multiple infections. Among multiple infections, 96.1% harboured HR HPV types and 38.2% HR-low risk (LR) HPV types. Overall, 33 different HPV types (18 HR and 15 LR) were detected. HR HPV types (44.1%) were significantly more prevalent than LR HPV types (8.6%). The most frequent genotype was HPV 16 (25.5%), followed by HPV 31, 53, 66, 58, and 51. Multiple infections showed a significant increase (p 0.005) according to severity of neoplasia, particularly for HR-HR HPV infections (p 0.003). No association between age and multiple HPV infections was observed (p 0.812). However, multiple HR HPV infections were more frequent in women under 30 years of age (35.3%).
高危型（HR）人乳头瘤病毒（HPV）持续感染是宫颈癌发展的必要条件。然而，人们对多种 HPV 感染对宫颈病变风险的影响知之甚少。本研究旨在评估葡萄牙女性中 HPV 单一和多重感染的频率，并评估多重 HPV 感染在宫颈上皮内瘤变（CIN）中的频率。对 1057 例宫颈样本进行 HPV 流行率、型特异性流行率和多重感染程度评估。采用临床 HPV 检测阵列（Clinical Array HPV assay）检测 35 种 HPV 类型。根据组织学诊断，425 例为正常，375 例为 CIN1，257 例为 CIN2+。研究 HPV 状态与年龄和病变严重程度的关系。HPV 感染的流行率为 52.7%；正常、CIN1 和 CIN2+病例中，HPV 阳性率分别为 25.4%、67.2%和 76.7%。HPV 阳性病例中，32.0%与多重感染相关。多重感染中，96.1%携带 HR-HPV 类型，38.2%携带 HR-低危（LR）HPV 类型。共检测到 33 种不同的 HPV 类型（18 种 HR 和 15 种 LR）。HR-HPV 类型（44.1%）明显比 LR-HPV 类型（8.6%）更为常见。最常见的基因型是 HPV16（25.5%），其次是 HPV31、53、66、58 和 51。根据肿瘤的严重程度，多重感染显著增加（p<0.005），特别是 HR-HR HPV 感染（p<0.003）。未观察到年龄与多重 HPV 感染之间存在关联（p=0.812）。然而，30 岁以下女性中多重 HR-HPV 感染更为常见（35.3%）。
