Multiple human papillomavirus infection with or without type 16 and risk of cervical intraepithelial neoplasia among women with cervical cytological abnormalities

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the impact of multiple human papillomavirus (HPV) infections on the risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) in subjects with cervical cytological abnormalities.

Methods: A cross-sectional study of 3,842 women attending a colposcopy service was carried out. Genotyping of 18 high-risk, seven low-risk, and two undefined-risk HPVs was carried out by the INNO-LiPA genotyping system.

Results: The final colposcopic/pathological diagnoses were as follows: 1,933 (50.3 %) subjects were negative; 1,041 (27.1 %) CIN1; 280 (7.3 %) CIN2; 520 (13.5 %) CIN3; and 68 (1.8 %) invasive cervical cancer. The prevalence of HPV infection was 75.8 % (2,911/3,842), whereas multiple HPVs were detected in 34.5 % of HPV-positive subjects (2,255/3,842). The adjusted risks of CIN3+ in the group with multiple compared to the group with single infection were 2.31 (95 % CI = 1.54–3.47), among HPV16-positive women, and 3.25 (95 % CI = 2.29–4.61, p = 0.21 compared with HPV16-positive subjects), in HPV16-negative subjects. Out of a total of 1,285 subjects with mild lesions, followed up for a median of 16.1 months (interquartile range = 8.9–36.8), the rate of progression to CIN2–3 was 0.6 % (5/541) among subjects negative or with low-risk HPVs, 1.7 % (8/463) among those with single high-risk HPV, and 5 % (14/281, p 

Conclusions: Among women with cervical cytological abnormalities, infection by multiple high-risk HPVs increased the risk of CIN3+ in both HPV16-positive and HPV16-negative subjects. These findings suggest a potential synergistic interaction between high-risk HPVs, favoring the progression of CIN lesions.

Original languageEnglish
Pages (from-to)1669-1676
Number of pages8
JournalCancer Causes and Control
Volume25
Issue number12
DOIs
Publication statusPublished - Nov 18 2014

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Cervical Intraepithelial Neoplasia
Papillomavirus Infections
Multiple Abnormalities
Colposcopy
Infection
Uterine Cervical Neoplasms
Cross-Sectional Studies

Keywords

  • Cervical cancer
  • Cervical intraepithelial neoplasia
  • Colposcopy
  • Human papillomavirus infection

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{29e63c72341e4cfaaa52345a729c522d,
title = "Multiple human papillomavirus infection with or without type 16 and risk of cervical intraepithelial neoplasia among women with cervical cytological abnormalities",
abstract = "Purpose: To evaluate the impact of multiple human papillomavirus (HPV) infections on the risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) in subjects with cervical cytological abnormalities.Methods: A cross-sectional study of 3,842 women attending a colposcopy service was carried out. Genotyping of 18 high-risk, seven low-risk, and two undefined-risk HPVs was carried out by the INNO-LiPA genotyping system.Results: The final colposcopic/pathological diagnoses were as follows: 1,933 (50.3 {\%}) subjects were negative; 1,041 (27.1 {\%}) CIN1; 280 (7.3 {\%}) CIN2; 520 (13.5 {\%}) CIN3; and 68 (1.8 {\%}) invasive cervical cancer. The prevalence of HPV infection was 75.8 {\%} (2,911/3,842), whereas multiple HPVs were detected in 34.5 {\%} of HPV-positive subjects (2,255/3,842). The adjusted risks of CIN3+ in the group with multiple compared to the group with single infection were 2.31 (95 {\%} CI = 1.54–3.47), among HPV16-positive women, and 3.25 (95 {\%} CI = 2.29–4.61, p = 0.21 compared with HPV16-positive subjects), in HPV16-negative subjects. Out of a total of 1,285 subjects with mild lesions, followed up for a median of 16.1 months (interquartile range = 8.9–36.8), the rate of progression to CIN2–3 was 0.6 {\%} (5/541) among subjects negative or with low-risk HPVs, 1.7 {\%} (8/463) among those with single high-risk HPV, and 5 {\%} (14/281, p Conclusions: Among women with cervical cytological abnormalities, infection by multiple high-risk HPVs increased the risk of CIN3+ in both HPV16-positive and HPV16-negative subjects. These findings suggest a potential synergistic interaction between high-risk HPVs, favoring the progression of CIN lesions.",
keywords = "Cervical cancer, Cervical intraepithelial neoplasia, Colposcopy, Human papillomavirus infection",
author = "Arsenio Spinillo and Barbara Gardella and Marianna Roccio and Paola Alberizzi and Stefania Cesari and Morbini Patrizia and Enrico Silini",
year = "2014",
month = "11",
day = "18",
doi = "10.1007/s10552-014-0471-6",
language = "English",
volume = "25",
pages = "1669--1676",
journal = "Cancer Causes and Control",
issn = "0957-5243",
publisher = "Springer International Publishing AG",
number = "12",

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TY - JOUR

T1 - Multiple human papillomavirus infection with or without type 16 and risk of cervical intraepithelial neoplasia among women with cervical cytological abnormalities

AU - Spinillo, Arsenio

AU - Gardella, Barbara

AU - Roccio, Marianna

AU - Alberizzi, Paola

AU - Cesari, Stefania

AU - Patrizia, Morbini

AU - Silini, Enrico

PY - 2014/11/18

Y1 - 2014/11/18

N2 - Purpose: To evaluate the impact of multiple human papillomavirus (HPV) infections on the risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) in subjects with cervical cytological abnormalities.Methods: A cross-sectional study of 3,842 women attending a colposcopy service was carried out. Genotyping of 18 high-risk, seven low-risk, and two undefined-risk HPVs was carried out by the INNO-LiPA genotyping system.Results: The final colposcopic/pathological diagnoses were as follows: 1,933 (50.3 %) subjects were negative; 1,041 (27.1 %) CIN1; 280 (7.3 %) CIN2; 520 (13.5 %) CIN3; and 68 (1.8 %) invasive cervical cancer. The prevalence of HPV infection was 75.8 % (2,911/3,842), whereas multiple HPVs were detected in 34.5 % of HPV-positive subjects (2,255/3,842). The adjusted risks of CIN3+ in the group with multiple compared to the group with single infection were 2.31 (95 % CI = 1.54–3.47), among HPV16-positive women, and 3.25 (95 % CI = 2.29–4.61, p = 0.21 compared with HPV16-positive subjects), in HPV16-negative subjects. Out of a total of 1,285 subjects with mild lesions, followed up for a median of 16.1 months (interquartile range = 8.9–36.8), the rate of progression to CIN2–3 was 0.6 % (5/541) among subjects negative or with low-risk HPVs, 1.7 % (8/463) among those with single high-risk HPV, and 5 % (14/281, p Conclusions: Among women with cervical cytological abnormalities, infection by multiple high-risk HPVs increased the risk of CIN3+ in both HPV16-positive and HPV16-negative subjects. These findings suggest a potential synergistic interaction between high-risk HPVs, favoring the progression of CIN lesions.

AB - Purpose: To evaluate the impact of multiple human papillomavirus (HPV) infections on the risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) in subjects with cervical cytological abnormalities.Methods: A cross-sectional study of 3,842 women attending a colposcopy service was carried out. Genotyping of 18 high-risk, seven low-risk, and two undefined-risk HPVs was carried out by the INNO-LiPA genotyping system.Results: The final colposcopic/pathological diagnoses were as follows: 1,933 (50.3 %) subjects were negative; 1,041 (27.1 %) CIN1; 280 (7.3 %) CIN2; 520 (13.5 %) CIN3; and 68 (1.8 %) invasive cervical cancer. The prevalence of HPV infection was 75.8 % (2,911/3,842), whereas multiple HPVs were detected in 34.5 % of HPV-positive subjects (2,255/3,842). The adjusted risks of CIN3+ in the group with multiple compared to the group with single infection were 2.31 (95 % CI = 1.54–3.47), among HPV16-positive women, and 3.25 (95 % CI = 2.29–4.61, p = 0.21 compared with HPV16-positive subjects), in HPV16-negative subjects. Out of a total of 1,285 subjects with mild lesions, followed up for a median of 16.1 months (interquartile range = 8.9–36.8), the rate of progression to CIN2–3 was 0.6 % (5/541) among subjects negative or with low-risk HPVs, 1.7 % (8/463) among those with single high-risk HPV, and 5 % (14/281, p Conclusions: Among women with cervical cytological abnormalities, infection by multiple high-risk HPVs increased the risk of CIN3+ in both HPV16-positive and HPV16-negative subjects. These findings suggest a potential synergistic interaction between high-risk HPVs, favoring the progression of CIN lesions.

KW - Cervical cancer

KW - Cervical intraepithelial neoplasia

KW - Colposcopy

KW - Human papillomavirus infection

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