ArticleThe Journal of infectious diseases2011
Human papillomavirus infection with multiple types: pattern of coinfection and risk of cervical disease.
Article in The Journal of infectious diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 168 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
168 citing papers in PubMed, 2 syntheses or guidelines pooled it, 322 citations in OpenAlex.
- The role of multiple high-risk human papillomavirus infection on the persistence recurrence of high-grade cervical lesions after standard treatment: A systematic review and a meta-analysis.Acta obstetricia et gynecologica Scandinavica · 2024Pooled it
- Prevalence and distribution of human papillomavirus genotypes in cervical intraepithelial neoplasia in China: a meta-analysis.Archives of gynecology and obstetrics · 2020Pooled it
- Discriminating high-risk cervical Human Papilloma Virus infections with urinary biomarkers via non-targeted GC-MS-based metabolomics.PloS one · 2018Trial
- Prevention of persistent human papillomavirus infection by an HPV16/18 vaccine: a community-based randomized clinical trial in Guanacaste, Costa Rica.Cancer discovery · 2011Trial
- Human Papillomavirus Condylomas of Extragenital Site in Immunocompetent Man, New York, USA, 2025.Emerging infectious diseases · 2026Article
- Cervicovaginal Virome Restructuring Associated with HPV Status, Bacterial Dysbiosis, and Cervical Cytological Abnormalities.Viruses · 2026Article
- Multiple High-Risk HPV Infections and Opportunistic HPV Prevalence Among Women Aged 18-25 Years with NILM, ASC-US, or LSIL Cytology: A 2024 Cross-Sectional Study.Pathogens (Basel, Switzerland) · 2026Article
- Human Papillomavirus Positivity and Genotype Distribution Among Korean Females: A Large-Scale Laboratory-Based Analysis.Journal of clinical medicine · 2026Article
- Epidemiological approaches to evaluate clinical unmasking of HPV-associated cervical lesions in the HPV vaccination era.International journal of cancer · 2026Review
- The Epidemiology of Human Papillomavirus (HPV) Infections in Poland in the Light of the Nationwide HPV Vaccination Program for Children Aged 12-13 and Updated HPV DNA Detection Guidelines.International journal of molecular sciences · 2026Article
- Dynamic changes of HPV genotypes in a tourism-influenced populated area, Northeastern Iran.PloS one · 2026Article
- Co-infection of multiple human papillomavirus genotypes and its effects on symptomatic risks and transmission dynamics: an integrated epidemiological and modelling study in Fujian, China.BMJ public health · 2026Article
- HPV Type Replacement After HPV Vaccination.Current topics in microbiology and immunology · 2026Review
- Risk factors for HR-HPV persistence and residual or recurrent high-grade squamous intraepithelial neoplasia after LEEP.Frontiers in medicine · 2026Article
- HPV genotype distribution and cervical lesion severity in HPV-positive women: a study from the Guizhou Province cervical cancer screening program.Virology journal · 2025Article
- Impact of Single- Versus Multiple-Type HPV Infections on Cervical Cytological and Histological Abnormalities: The Dominant Oncogenic Potential of HPV16 Single-Type Infections.Diagnostics (Basel, Switzerland) · 2025Article
- Unveiling the burden of human papillomavirus infection and risk factors among Indigenous women in Mizoram, Northeast India.BMC infectious diseases · 2025Article
- Urinary detection of high-risk HPV DNA to enhance cervical cancer screening in developing countries.Microbiology spectrum · 2025Article
- Accurate identification of bovine deltapapillomavirus in equine sarcoids by ddPCR.Scientific reports · 2025Article
- Bovine Papillomavirus Genotypic Diversity and a Putative Novel Viral Type in Ecuador.Veterinary sciences · 2025Article
108 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
Abstract
objectiveWe investigated coinfection patterns for 25 human papillomavirus (HPV) types and assessed the risk conferred by multiple HPV types toward cervical disease.
methodsSexually 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 SPF(10)/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.
resultsOf 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 α9 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.
conclusionsCoinfecting HPV genotypes occur at random and lead to cervical disease independently.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.