ArticlePloS one2016
Epidemiologic Evaluation of Human Papillomavirus Type Competition and the Potential for Type Replacement Post-Vaccination.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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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
13 citing papers in PubMed.
- Epidemiological approaches to evaluate clinical unmasking of HPV-associated cervical lesions in the HPV vaccination era.International journal of cancer · 2026Review
- HPV Type Replacement After HPV Vaccination.Current topics in microbiology and immunology · 2026Review
- Changes in Genital Human Papillomavirus (HPV) Prevalence During 12 Years of Girls-Only Bivalent HPV Vaccination: Results From a Biennial Repeated Cross-sectional Study.The Journal of infectious diseases · 2025Article
- Concurrent Infection With Multiple Human Papillomavirus Types Among Unvaccinated and Vaccinated 17-Year-Old Norwegian Girls.The Journal of infectious diseases · 2022Article
- Behavioral factors associated with multiple-type HPV genital infections: data from a cross-sectional study in young women in Brazil.Reproductive health · 2021Article
- Human Papillomavirus Genotype Replacement: Still Too Early to Tell?The Journal of infectious diseases · 2021Article
- Article
- Progress in Vaccination of Prophylactic Human Papillomavirus Vaccine.Frontiers in immunology · 2020Review
- Vaccination of Young Women Decreases Human Papillomavirus Transmission in Heterosexual Couples: Findings from the HITCH Cohort Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2019Article
- Human papillomavirus 16E6/E7 activates autophagy via Atg9B and LAMP1 in cervical cancer cells.Cancer medicine · 2019Article
- Capturing multiple-type interactions into practical predictors of type replacement following human papillomavirus vaccination.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2019Article
- Human Papillomavirus Infection and Transmission Among Couples Through Heterosexual Activity (HITCH) Cohort Study: Protocol Describing Design, Methods, and Research Goals.JMIR research protocols · 2019Article
- Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundMillions of women have been vaccinated with one of two first-generation human papillomavirus (HPV) vaccines. Both vaccines remain in use and target two oncogenic types (HPVs 16 and 18); however, if these types naturally compete with others that are not targeted, type replacement may occur following reductions in the circulating prevalence of targeted types. To explore the potential for type replacement, we evaluated natural HPV type competition in unvaccinated females.
methodsValid HPV DNA typing information was available from five epidemiological studies conducted in Canada and Brazil (n = 14,685; enrollment across studies took place between1993 and 2010), which used similar consensus-primer PCR assays, capable of detecting up to 40 HPV types. A total of 38,088 cervicovaginal specimens were available for inclusion in our analyses evaluating HPV type-type interactions involving vaccine-targeted types (6, 11, 16, and 18), and infection with each of the other HPV types.
resultsAcross the studies, the average age of participants ranged from 21.0 to 43.7 years. HPV16 was the most common type (prevalence range: 1.0% to 13.8%), and in general HPV types were more likely to be detected as part of a multiple infection than as single infections. In our analyses focusing on each of the vaccine-targeted HPV types separately, many significant positive associations were observed (particularly involving HPV16); however, we did not observe any statistically significant negative associations.
conclusionsOur findings suggest that natural HPV type competition does not exist, and that type replacement is unlikely to occur in vaccinated populations.
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