Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, EPS 7072. Rockville, MD 20852, USA.
J Infect Dis. 2011 Apr 1;203(7):910-20. doi: 10.1093/infdis/jiq139.
We investigated coinfection patterns for 25 human papillomavirus (HPV) types and assessed the risk conferred by multiple HPV types toward cervical disease.
Sexually active women (n=5,871) in the NCI-sponsored Costa Rica HPV Vaccine Trial's prevaccination enrollment visit were analyzed. Genotyping for 25 HPVs was performed using SPF(10)/LiPA(25). We calculated odds ratios (ORs) to assess coinfection patterns for each genotype with 24 other genotypes. These ORs were pooled and compared with pair-specific ORs to identify genotype combinations that deviated from the pooled OR. We compared risk of CIN2+/HSIL+between multiple and single infections and assessed additive statistical interactions.
Of the 2478 HPV-positive women, 1070 (43.2%) were infected with multiple types. Multiple infections occurred significantly more frequently than predicted by chance. However, this affinity to be involved in a coinfection (pooled OR for 300 type-type combinations=2.2; 95% confidence interval [CI]=2.1-2.4) was not different across HPV type-type combinations. Compared with single infections, coinfection with multiple α9 species was associated with significantly increased risk of CIN2+(OR=2.2; 95% CI=1.1-4.6) and HSIL+(OR=1.6; 95% CI=1.1-2.4). However, disease risk was similar to the sum of estimated risk from individual types, with little evidence for synergistic interactions.
Coinfecting HPV genotypes occur at random and lead to cervical disease independently.
我们调查了 25 种人乳头瘤病毒（HPV）型的合并感染模式，并评估了多种 HPV 型感染对宫颈疾病的风险。
分析了 NCI 赞助的哥斯达黎加 HPV 疫苗试验预接种登记访问中活跃的性活跃女性（n=5871）。使用 SPF(10)/LiPA(25)对 25 种 HPV 进行基因分型。我们计算了比值比（OR）来评估每种基因型与 24 种其他基因型的合并感染模式。这些 OR 被汇总并与特定对 OR 进行比较，以确定偏离汇总 OR 的基因型组合。我们比较了多重和单一感染之间的 CIN2+/HSIL+风险，并评估了加性统计相互作用。
在 2478 名 HPV 阳性女性中，有 1070 名（43.2%）感染了多种类型。多重感染的发生频率明显高于随机预期。然而，这种合并感染的亲和力（300 种型-型组合的汇总 OR=2.2；95%置信区间[CI]：2.1-2.4）在不同的 HPV 型-型组合中没有差异。与单一感染相比，多种 α9 种属的合并感染与 CIN2+（OR=2.2；95%CI=1.1-4.6）和 HSIL+（OR=1.6；95%CI=1.1-2.4）的风险显著增加相关。然而，疾病风险与从个体类型估计的风险总和相似，几乎没有协同相互作用的证据。
合并感染的 HPV 基因型是随机发生的，并独立导致宫颈疾病。
