Multiple HPV 16 infection with two strains: a possible marker of neoplastic progression

Abstract

Background: We studied the cases of single and multiple HPV infection and analyzed the correlation with negative cases, and preneoplastic and neoplastic lesions of the uterine cervix with the aim of making a contribution to the prognostic factor under discussion. Methods: Nine hundred nine women undergoing second level screening because they had been positive at cervical cytology were enrolled. All the patients underwent colposcopy and cervical biopsy with viral genotyping. We divided mHPV infection based on the number of genotypes present: infections with 2 strains, 3 strains, 4 strains and 5 or more strains. Statistical analysis: The analysis of the data was made using the χ2 test. Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p < 0.05 were considered statistically significant. Results: The presence of genotype HPV16 in our study was associated with a 12 times greater risk of developing a high-grade lesion, OR = 12.70. The patients with single infections had the highest incidence of CIN2+ (34.1%) with respect to those with multiple infections (10.6%).When we studied in the mHPV infection the prevalence of the combinations between the genotypes, we found that in mHPV16 infections, the combinations HPV16, 18 and HPV16, 31 were the most frequent (55.5%) in CIN3 lesion. Conclusions: Our results suggest that single HPV infections have a greater risk of developing SCC with respect to multiple infections. Multiple HPV infections are relevant only in the first phase of the lesion (CIN1-CIN2), while they are absent in carcinomas, where infections are of a single genotype. In particular, among multiple infections, HPV16 infection with 2 HR genotypes is associated significantly with CIN2 / CIN3 (21/30) and has 4 times greater risk of developing a high-grade lesion. Thus, it is probable that only specific combinations of HPV (HPV16,18-HPV 16,31) can be associated with a clinically significant impact, while other combinations can simply be correlated because of a common infection or diagnostic method used. Therefore, multiple HPV16 infections with two high-risk genotypes is a major risk of CIN2/CIN3.

Multiple Human Papilloma Virus (HPV) Infections Are Associated with HSIL and Persistent HPV Infection Status in Korean Patients

“…A study by Schimitt et al also reported that multiple HPV types were prevalent in LSIL and HSIL [ 36 ]. It is generally accepted that progression to HSIL and SQCC correlates with monoclonal expansion of HPV-infected host cells [ 29 ]; however, some previous studies have suggested that multiple HPV infections confer synergistic impact on the developing SIL [ 11 , 12 , 37 ], which supports the impact of multiple HPV infections on SIL in this study. Possibly, different HPV genotypes infect different cells in distinct lesions in the same patient; subsequent studies are warranted to validate this hypothesis.…”

“…To date, >18 anogenital HPVs have been classified as oncogenic, these include HPV 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69, 73, and 82 [ 8 , 9 ]. Although HPV 16, 18, 31, and 51 are common HR-HPV genotypes [ 9 , 10 ], the distribution pattern of HPV genotypes shows diverse regional variation [ 11 , 12 , 13 , 14 ]. For example, HPV 18, 52, and 58 are reported to be more prevalent in Asian populations [ 15 ].…”

Evidence for HPV DNA in the placenta of women who resorted to elective abortion

“…Human papillomavirus infection (HPV) is a sexually transmitted disease associated with cervical carcinogenesis whose prevalence of genotypes shows significant differences worldwide [ 1 , 2 ]. In its single or multiple form [ 3 ] persistent high-risk human papilloma virus infection (hr HPV) is necessary [ 4 ] for progression of Cervical Intraepithelial Neoplasia (CIN) lesions. HPV infection is the most common sexually transmitted disease (STD) in the world, however, recent studies have shown that the infection can also be acquired by vertical transmission and through the placenta from mother to child [ 5 , 6 ].…”

Development and validation of a multiplex qPCR assay for detection and relative quantification of HPV16 and HPV18 E6 and E7 oncogenes

“…In this work, 15 samples with HPV18 and HPV16 co-infections were detected. Detection of HPV co-infections is of particular interest as a combination of HPV16/18 co-infection has been associated with grade 2 and 3 cervical intraepithelial neoplasia (CIN) 40 . Viral loads per millions of human cells were determined for HPV16 and HPV18 as these could be a marker of CIN2 and be a predictor of lesion progression 27 , 41 , 42 .…”