TY - JOUR
T1 - Human papillomavirus infection with multiple types
T2 - Pattern of coinfection and risk of cervical disease
AU - Chaturvedi, Anil K.
AU - Katki, Hormuzd A.
AU - Hildesheim, Allan
AU - Rodríguez, Ana Cecilia
AU - Quint, Wim
AU - Schiffman, Mark
AU - Van Doorn, Leen Jan
AU - Porras, Carolina
AU - Wacholder, Sholom
AU - Gonzalez, Paula
AU - Sherman, Mark E.
AU - Herrero, Rolando
N1 - Funding Information:
The Costa Rican Vaccine Trial (CVT) is a longstanding collaboration between investigators in Costa Rica and Intramural Research Program (IRP) of the National Cancer Institute (NCI). The CVT trial is sponsored and funded by NCI (N01-CP-11005) with support from the NIH Office for Research on Women’s Health and conducted in agreement with the Ministry of Health of Costa Rica.Vaccine was provided for CVT by GSK Biologicals, under a Clinical Trials Agreement with NCI. GSK also provided support for aspects of the trial associated with regulatory submission needs of the company under FDA BB-IND 7920. Douglas Lowy and John
PY - 2011/4/1
Y1 - 2011/4/1
N2 - 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.
AB - 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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U2 - 10.1093/infdis/jiq139
DO - 10.1093/infdis/jiq139
M3 - Article
C2 - 21402543
AN - SCOPUS:79953005484
SN - 0022-1899
VL - 203
SP - 910
EP - 920
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 7
ER -