Human papillomavirus (HPV) causes a number of neoplastic diseases in humans. Here, we show a complex normal HPV community in a cohort of 103 healthy human subjects, by metagenomics analysis of the shotgun sequencing data generated from the NIH Human Microbiome Project. The overall HPV prevalence was 68.9% and was highest in the skin (61.3%), followed by the vagina (41.5%), mouth (30%), and gut (17.3%). Of the 109 HPV types as well as additional unclassified types detected, most were undetectable by the widely used commercial kits targeting the vaginal/cervical HPV types. These HPVs likely represent true HPV infections rather than transitory exposure because of strong organ tropism and persistence of the same HPV types in repeat samples. Coexistence of multiple HPV types was found in 48.1% of the HPV-positive samples. Networking between HPV types, cooccurrence or exclusion, was detected in vaginal and skin samples. Large contigs assembled from short HPV reads were obtained from several samples, confirming their genuine HPV origin. This first large-scale survey of HPV using a shotgun sequencing approach yielded a comprehensive map of HPV infections among different body sites of healthy human subjects.
IMPORTANCEThis nonbiased survey indicates that the HPV community in healthy humans is much more complex than previously defined by widely used kits that are target selective for only a few high-and low-risk HPV types for cervical cancer. The importance of nononcogenic viruses in a mixed HPV infection could be for stimulating or inhibiting a coexisting oncogenic virus via viral interference or immune cross-reaction. Knowledge gained from this study will be helpful to guide the designing of epidemiological and clinical studies in the future to determine the impact of nononcogenic HPV types on the outcome of HPV infections.
Human papillomaviruses (HPVs) are a group of doublestranded, nonenveloped, small DNA viruses that are widely prevalent among human populations. To date, 176 types of HPV isolated from different body sites have been identified and collected in two HPV databases (http://pave.niaid.nih.gov, http: //www.hpvcenter.se) searched on 30 November 2013, and the number is growing (1-3).HPV is a well-established cause of cervical cancers (4-8). It is well known that long-term persistence of HPV infection is a necessity for development of cervical cancers, and the majority of women with HPV infection show a "healthy" phenotype for most of their lifetime (9). HPV infection has been linked worldwide to several cancers outside the reproductive system, including cancers of the oropharynx, pharynx, larynx, tonsils, and so on (10-15). Around 30 HPV types, notably types 16 (i.e., HPV16) and 18, which showed a strong association with cervical cancers, were designated high-or low-risk types. Although more and more nonrisk types have been observed from various human samples by traditional HPV detection methods (16-18), our understanding of HPV prevalence has been limited by the narrowed spectrum of amplicon-based me...