ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2019
Role of HPV Genotype, Multiple Infections, and Viral Load on the Risk of High-Grade Cervical Neoplasia.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 2 of them syntheses that pooled it.
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Who cites it
71 citing papers in PubMed, 2 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- The impact of HPV/HIV co-infection on immunosuppression, HPV genotype, and cervical cancer biomarkers.BMC cancer · 2025Pooled it
- Kushen gel for the treatment of high-risk human papillomavirus infection: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- HPV integration as a triage tool for HPV-positive women in cervical cancer screening.Tumour virus research · 2026Article
- Bidirectional Interactions Between Cervicovaginal Microbiota and Human Papillomavirus Drive Persistence and Disease Progression.International journal of molecular sciences · 2026Review
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- International Collaborative Study on Human Papillomavirus Analytical Thresholds for Sensitivity and Specificity in Cervical Screening.Journal of medical virology · 2026Article
- Chemoradiation Reprograms Tumor Cells and the Immune Microenvironment in Cervical Cancer.Cancer research · 2026Article
- Cervical intraepithelial neoplasia: the expanding spectrum of cervical squamous intraepithelial lesions with focus on morphologic and molecular nuances.Virchows Archiv : an international journal of pathology · 2026Review
- Determination of Human Papillomavirus prevalence in the female population from Zanjan, Iran.Preventive medicine reports · 2026Article
- Gene expression, viral load, and bovine papillomavirus coinfection in blood and cutaneous warts of cattle.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 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
- Pathological changes of high-risk human papillomavirus-positive cervical lesions after surgery and analysis of risk factors for persistent positivity.American journal of translational research · 2026Article
- Prevalence and clinical correlates of human papillomavirus infection: A study of 7,601 women attending a tertiary referral center in Greece.CytoJournal · 2026Article
- Cofactors in Human Papillomavirus Carcinogenesis.Current topics in microbiology and immunology · 2026Review
- [Cervical cancer screening in Germany 2020-2022 : An analysis of the first round of screening according to the specifications of the oKFE-RL].Pathologie (Heidelberg, Germany) · 2026Article
- Multiple high-risk human papillomavirus infections exacerbate cervical lesion risk: epidemiological evidence from suining, Sichuan.Virology journal · 2025Article
- APTIMA mRNA vs. DNA-Based HPV Assays: Analytical Performance Insights from a Resource-Limited South African Setting.International journal of molecular sciences · 2025Article
- Article
- Improving the Sensitivity-Specificity Balance of Human Papillomavirus Testing on Self- and Clinician-Collected Samples in South Africa.JCO global oncology · 2025Article
- Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundHuman papillomavirus (HPV) testing provides a much more sensitive method of detection for high-grade lesions than cytology, but specificity is low. Here, we explore the extent to which full HPV genotyping, viral load, and multiplicity of types can be used to improve specificity.
methodsA population-based sample of 47,120 women undergoing cervical screening was tested for 13 high-risk HPV genotypes. Positive predictive values (PPV) for cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+;
resultsHigh-risk HPV was detected in 15.4% of women. A hierarchy of HPV genotypes based on sequentially maximizing PPVs for CIN3+ found HPV16>33>31 to be the most predictive, followed sequentially by HPV18>35>58>45>52>59>51>39>56>68. After adjusting for higher ranked genotypes, the inclusion of multiple HPV infections added little to risk prediction. High viral loads for HPV18, 35, 52, and 58 carried more risk than low viral loads for HPV16, 31, and 33. High viral load for HPV16 was significantly more associated with CIN3+ than low viral load.
conclusionsHPV genotype and viral load, but not multiplicity of HPV infections, are important predictors of CIN2+ and CIN3+. IMPACT: The ability to identify women at higher risk of CIN2+ and CIN3+ based on both HPV genotype and viral load could be important for individualizing triage plans, particularly as HPV becomes the primary screening test.
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