Human Papillomavirus Infection with Multiple Types: Pattern of Coinfection and Risk of Cervical Disease
Human Papillomavirus Infection with Multiple Types: Pattern of Coinfection and Risk of Cervical Disease
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DOI：
10.1093/infdis/jiq139
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发表时间：
2011-04-01
影响因子：
6.4
通讯作者：
Herrero, Rolando
中科院分区：
文献类型：
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作者：
Chaturvedi, Anil K.;Katki, Hormuzd A.;Herrero, Rolando
目标。我们调查了25种人乳头瘤病毒（HPV）类型的合并感染模式，并评估了多种HPV类型对宫颈疾病的风险。在nci赞助的哥斯达黎加HPV疫苗试验的预防接种登记访问中，性活跃的女性（n= 5871）进行了分析。采用SPF10/LiPA（25）对25例hpv进行基因分型。我们计算优势比（or）来评估每种基因型与其他24种基因型的共感染模式。将这些OR汇总并与配对特异性OR进行比较，以确定偏离汇总OR的基因型组合。我们比较了多次感染和单次感染之间CIN2+/HSIL+的风险，并评估了附加的统计相互作用。在2478名hpv阳性妇女中，1070名（43.2%）感染多种类型。多重感染的发生频率明显高于预期的偶然性。然而，这种与合并感染相关的亲和力（300种类型组合的合并OR =2.2； 95%置信区间[CI]=2.1-2.4）在不同的HPV类型组合中没有差异。与单一感染相比，多个α 9种合并感染与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，疾病风险与个体类型的估计风险总和相似，几乎没有证据表明存在协同作用。同时感染HPV基因型随机发生，并独立导致宫颈疾病。
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/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.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 alpha 9 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.