Human papillomavirus infection with multiple types

Pattern of coinfection and risk of cervical disease

Anil K. Chaturvedi, Hormuzd A. Katki, Allan Hildesheim, Ana Cecilia Rodríguez, Wim Quint, Mark Schiffman, Leen Jan Van Doorn, Carolina Porras, Sholom Wacholder, Paula Gonzalez, Mark E. Sherman, Rolando Herrero

Research output: Contribution to journalArticle

147 Citations (Scopus)

Abstract

Objective. We investigated coinfection patterns for 25 human papillomavirus (HPV) types and assessed the risk conferred by multiple HPV types toward cervical disease. Methods. 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 SPF10/LiPA25. 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. Results. 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. Conclusions. Coinfecting HPV genotypes occur at random and lead to cervical disease independently.

Original languageEnglish (US)
Pages (from-to)910-920
Number of pages11
JournalJournal of Infectious Diseases
Volume203
Issue number7
DOIs
StatePublished - Apr 1 2011

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Papillomavirus Infections
Coinfection
Odds Ratio
Genotype
Confidence Intervals
Infection
Papillomavirus Vaccines
Costa Rica

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Chaturvedi, A. K., Katki, H. A., Hildesheim, A., Rodríguez, A. C., Quint, W., Schiffman, M., ... Herrero, R. (2011). Human papillomavirus infection with multiple types: Pattern of coinfection and risk of cervical disease. Journal of Infectious Diseases, 203(7), 910-920. https://doi.org/10.1093/infdis/jiq139

Human papillomavirus infection with multiple types : Pattern of coinfection and risk of cervical disease. / Chaturvedi, Anil K.; Katki, Hormuzd A.; Hildesheim, Allan; Rodríguez, Ana Cecilia; Quint, Wim; Schiffman, Mark; Van Doorn, Leen Jan; Porras, Carolina; Wacholder, Sholom; Gonzalez, Paula; Sherman, Mark E.; Herrero, Rolando.

In: Journal of Infectious Diseases, Vol. 203, No. 7, 01.04.2011, p. 910-920.

Research output: Contribution to journalArticle

Chaturvedi, AK, Katki, HA, Hildesheim, A, Rodríguez, AC, Quint, W, Schiffman, M, Van Doorn, LJ, Porras, C, Wacholder, S, Gonzalez, P, Sherman, ME & Herrero, R 2011, 'Human papillomavirus infection with multiple types: Pattern of coinfection and risk of cervical disease', Journal of Infectious Diseases, vol. 203, no. 7, pp. 910-920. https://doi.org/10.1093/infdis/jiq139
Chaturvedi, Anil K. ; Katki, Hormuzd A. ; Hildesheim, Allan ; Rodríguez, Ana Cecilia ; Quint, Wim ; Schiffman, Mark ; Van Doorn, Leen Jan ; Porras, Carolina ; Wacholder, Sholom ; Gonzalez, Paula ; Sherman, Mark E. ; Herrero, Rolando. / Human papillomavirus infection with multiple types : Pattern of coinfection and risk of cervical disease. In: Journal of Infectious Diseases. 2011 ; Vol. 203, No. 7. pp. 910-920.
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abstract = "Objective. We investigated coinfection patterns for 25 human papillomavirus (HPV) types and assessed the risk conferred by multiple HPV types toward cervical disease. Methods. 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 SPF10/LiPA25. 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. Results. 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. Conclusions. Coinfecting HPV genotypes occur at random and lead to cervical disease independently.",
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AU - Schiffman, Mark

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