Persistent human papilloma virus (HPV) infection is known to be associated with cervical lesions. The chief object of the study is to investigate if the pathogenicity of multiple HPV infections is different from a single infection. Furthermore, we would like to corroborate the discrepancy with clearance rates. Between August 1, 2020, and September 31, 2021, 5089 women underwent a colposcopy-directed biopsy in our hospital. We divided the 2999 patients who met the criteria into multiple and single HPV infection groups. The HPV genotypes were identified using the flow cytometry fluorescence hybridization technology. Binary logistic regression and survival analysis were used to perform statistics. Among HPV-positive individuals, 34.78% (1043/2999) were positive for 2 or more HPV types. After adjusting for the main factors, compared with single infection, multiple infections were associated with a significantly decreased risk of high squamous intraepithelial lesions (HSIL) (odds ratio [OR]: 0.570; 95% confidence interval [CI]: 0.468-0.694). In the mean time, the clearance rates of multiple infections were significantly higher (OR: 2.240; 95% CI: 1.919-2.614). When analyzing specific types covered by the 9-valent HPV vaccine, consistency between the lower risk of HSIL and the higher clearance rate was found in the most groups. Compared with a single infection, multiple HPV infections have a lower risk of HSIL, which may be related to its higher clearance rate. It suggests that aggressive treatment of multiple HPV infections early in their detection may be beneficial.

Purpose This study aimed to investigate male HPV infection, re-examination rate, clearance rate and relevant influencing factors as well as HPV infection between heterosexual partners in Wenzhou, China. Methods The study enrolled 2359 men who accepted ≥1 HPV detection in the First Affiliated Hospital of Wenzhou Medical University between June 2014 and June 2020. An outpatient follow-up was carried out for collecting HPV re-test results among males who were tested HPV positive. In addition, we collected female sexual partners’ HPV infection state through outpatient information system or telephone call. For males who had not re-tested HPV more than half a year after the first HPV positive result, a telephone follow-up would be provided. Results Male HPV prevalence was 39.39% (928/2359) at baseline, of which the median age was 38.00 years. The percentage of co-infection and HR HPV infection was 35.24% (327/928) and 61.08% (874/1431). Genotype-specific concordance of HPV infection among heterosexual partners was 61.19% (123/201). The most common types were HPV6, HPV52, HPV16, HPV53, HPV11, HPV43 and HPV58. Percentage of males finishing HPV re-examination was low (40.09%). Infection with HR HPV, discomfort or HPV-related diseases and sexual partners with HPV infection were possible motivator for male HPV re-test. The medium time to male HPV clearance was 300.000 (95% CI=274.845–325.155) days. Infection with HR HPV, sexual partners with HPV infection and growth of age might prolong HPV persistence time included. Conclusion Males are susceptible population for genital HPV infection as well as females. Whereas, males are generally less aware of HPV and its influence on their couples. The study showed that male HPV testing as well as the role of males in the diagnosis and treatment of HPV-associated cervical diseases for females should be popularized and co-treatment of couples was necessary.