Human papillomavirus infections with multiple types and risk of cervical neoplasia

Helen Trottier, Salaheddin Mahmud, Maria Cecilia Costa, João P. Sobrinho, Eliane Duarte-Franco, Thomas E. Rohan, Alex Ferenczy, Luisa L. Villa, Eduardo L. Franco

Research output: Contribution to journalArticle

223 Citations (Scopus)

Abstract

Background: Besides an established role for certain human papillomavirus (HPV) genotypes in the etiology of cervical cancer, little is known about the influence of multiple-type HPV infections on cervical lesion risk. We studied the association between multiple HPV types and cervical lesions among 2,462 Brazilian women participating in the Ludwig-McGill study group investigation of the natural history of HPVs and cervical neoplasia. Methods: Cervical specimens were typed by a PCR protocol. The cohort's repeated-measurement design permitted the assessment of the relation between the cumulative and concurrent number of HPV types and any-grade squamous intraepithelial lesions (SIL) and high-grade SIL (HSIL). Result: At individual visits, 1.9% to 3.2% of the women were infected with multiple HPVs. Cumulatively during the first year and the first 4 years of follow-up, 12.3% and 22.3% were infected with multiple types, respectively. HSIL risk markedly increased with the number of types [odds ratio (OR), 41.5; 95% confidence interval (95% CI), 5.3-323.2 for single-type infections; OR, 91.7; 95% CI, 11.6-728.1 for two to three types; and OR, 424.0; 95% CI, 31.8-5651.8 for four to six types, relative to women consistently HPV-negative during the first year of follow-up]. The excess risks for multiple-type infections remained after exclusion of women infected with HPV-16, with high-risk HPV types, or persistent infections, particularly for any-grade SIL. Coinfections involving HPV-16 and HPV-58 seemed particularly prone to increase risk. Conclusion: Infections with multiple HPV types seem to act synergistically in cervical carcinogenesis. These findings have implications for the management of cervical lesions and prediction of the outcome of HPV infections.

Original languageEnglish (US)
Pages (from-to)1274-1280
Number of pages7
JournalCancer Epidemiology Biomarkers and Prevention
Volume15
Issue number7
DOIs
StatePublished - Jul 2006

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Papillomavirus Infections
Neoplasms
Human papillomavirus 16
Odds Ratio
Confidence Intervals
Infection
Natural History
Coinfection
Uterine Cervical Neoplasms
Carcinogenesis
Genotype
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Trottier, H., Mahmud, S., Costa, M. C., Sobrinho, J. P., Duarte-Franco, E., Rohan, T. E., ... Franco, E. L. (2006). Human papillomavirus infections with multiple types and risk of cervical neoplasia. Cancer Epidemiology Biomarkers and Prevention, 15(7), 1274-1280. https://doi.org/10.1158/1055-9965.EPI-06-0129

Human papillomavirus infections with multiple types and risk of cervical neoplasia. / Trottier, Helen; Mahmud, Salaheddin; Costa, Maria Cecilia; Sobrinho, João P.; Duarte-Franco, Eliane; Rohan, Thomas E.; Ferenczy, Alex; Villa, Luisa L.; Franco, Eduardo L.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 15, No. 7, 07.2006, p. 1274-1280.

Research output: Contribution to journalArticle

Trottier, H, Mahmud, S, Costa, MC, Sobrinho, JP, Duarte-Franco, E, Rohan, TE, Ferenczy, A, Villa, LL & Franco, EL 2006, 'Human papillomavirus infections with multiple types and risk of cervical neoplasia', Cancer Epidemiology Biomarkers and Prevention, vol. 15, no. 7, pp. 1274-1280. https://doi.org/10.1158/1055-9965.EPI-06-0129
Trottier, Helen ; Mahmud, Salaheddin ; Costa, Maria Cecilia ; Sobrinho, João P. ; Duarte-Franco, Eliane ; Rohan, Thomas E. ; Ferenczy, Alex ; Villa, Luisa L. ; Franco, Eduardo L. / Human papillomavirus infections with multiple types and risk of cervical neoplasia. In: Cancer Epidemiology Biomarkers and Prevention. 2006 ; Vol. 15, No. 7. pp. 1274-1280.
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title = "Human papillomavirus infections with multiple types and risk of cervical neoplasia",
abstract = "Background: Besides an established role for certain human papillomavirus (HPV) genotypes in the etiology of cervical cancer, little is known about the influence of multiple-type HPV infections on cervical lesion risk. We studied the association between multiple HPV types and cervical lesions among 2,462 Brazilian women participating in the Ludwig-McGill study group investigation of the natural history of HPVs and cervical neoplasia. Methods: Cervical specimens were typed by a PCR protocol. The cohort's repeated-measurement design permitted the assessment of the relation between the cumulative and concurrent number of HPV types and any-grade squamous intraepithelial lesions (SIL) and high-grade SIL (HSIL). Result: At individual visits, 1.9{\%} to 3.2{\%} of the women were infected with multiple HPVs. Cumulatively during the first year and the first 4 years of follow-up, 12.3{\%} and 22.3{\%} were infected with multiple types, respectively. HSIL risk markedly increased with the number of types [odds ratio (OR), 41.5; 95{\%} confidence interval (95{\%} CI), 5.3-323.2 for single-type infections; OR, 91.7; 95{\%} CI, 11.6-728.1 for two to three types; and OR, 424.0; 95{\%} CI, 31.8-5651.8 for four to six types, relative to women consistently HPV-negative during the first year of follow-up]. The excess risks for multiple-type infections remained after exclusion of women infected with HPV-16, with high-risk HPV types, or persistent infections, particularly for any-grade SIL. Coinfections involving HPV-16 and HPV-58 seemed particularly prone to increase risk. Conclusion: Infections with multiple HPV types seem to act synergistically in cervical carcinogenesis. These findings have implications for the management of cervical lesions and prediction of the outcome of HPV infections.",
author = "Helen Trottier and Salaheddin Mahmud and Costa, {Maria Cecilia} and Sobrinho, {Jo{\~a}o P.} and Eliane Duarte-Franco and Rohan, {Thomas E.} and Alex Ferenczy and Villa, {Luisa L.} and Franco, {Eduardo L.}",
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AU - Mahmud, Salaheddin

AU - Costa, Maria Cecilia

AU - Sobrinho, João P.

AU - Duarte-Franco, Eliane

AU - Rohan, Thomas E.

AU - Ferenczy, Alex

AU - Villa, Luisa L.

AU - Franco, Eduardo L.

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N2 - Background: Besides an established role for certain human papillomavirus (HPV) genotypes in the etiology of cervical cancer, little is known about the influence of multiple-type HPV infections on cervical lesion risk. We studied the association between multiple HPV types and cervical lesions among 2,462 Brazilian women participating in the Ludwig-McGill study group investigation of the natural history of HPVs and cervical neoplasia. Methods: Cervical specimens were typed by a PCR protocol. The cohort's repeated-measurement design permitted the assessment of the relation between the cumulative and concurrent number of HPV types and any-grade squamous intraepithelial lesions (SIL) and high-grade SIL (HSIL). Result: At individual visits, 1.9% to 3.2% of the women were infected with multiple HPVs. Cumulatively during the first year and the first 4 years of follow-up, 12.3% and 22.3% were infected with multiple types, respectively. HSIL risk markedly increased with the number of types [odds ratio (OR), 41.5; 95% confidence interval (95% CI), 5.3-323.2 for single-type infections; OR, 91.7; 95% CI, 11.6-728.1 for two to three types; and OR, 424.0; 95% CI, 31.8-5651.8 for four to six types, relative to women consistently HPV-negative during the first year of follow-up]. The excess risks for multiple-type infections remained after exclusion of women infected with HPV-16, with high-risk HPV types, or persistent infections, particularly for any-grade SIL. Coinfections involving HPV-16 and HPV-58 seemed particularly prone to increase risk. Conclusion: Infections with multiple HPV types seem to act synergistically in cervical carcinogenesis. These findings have implications for the management of cervical lesions and prediction of the outcome of HPV infections.

AB - Background: Besides an established role for certain human papillomavirus (HPV) genotypes in the etiology of cervical cancer, little is known about the influence of multiple-type HPV infections on cervical lesion risk. We studied the association between multiple HPV types and cervical lesions among 2,462 Brazilian women participating in the Ludwig-McGill study group investigation of the natural history of HPVs and cervical neoplasia. Methods: Cervical specimens were typed by a PCR protocol. The cohort's repeated-measurement design permitted the assessment of the relation between the cumulative and concurrent number of HPV types and any-grade squamous intraepithelial lesions (SIL) and high-grade SIL (HSIL). Result: At individual visits, 1.9% to 3.2% of the women were infected with multiple HPVs. Cumulatively during the first year and the first 4 years of follow-up, 12.3% and 22.3% were infected with multiple types, respectively. HSIL risk markedly increased with the number of types [odds ratio (OR), 41.5; 95% confidence interval (95% CI), 5.3-323.2 for single-type infections; OR, 91.7; 95% CI, 11.6-728.1 for two to three types; and OR, 424.0; 95% CI, 31.8-5651.8 for four to six types, relative to women consistently HPV-negative during the first year of follow-up]. The excess risks for multiple-type infections remained after exclusion of women infected with HPV-16, with high-risk HPV types, or persistent infections, particularly for any-grade SIL. Coinfections involving HPV-16 and HPV-58 seemed particularly prone to increase risk. Conclusion: Infections with multiple HPV types seem to act synergistically in cervical carcinogenesis. These findings have implications for the management of cervical lesions and prediction of the outcome of HPV infections.

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