Co-detection of human papillomavirus and human herpesvirus in women from Yunnan, China: associations with cervical lesion severity.

backgroundHuman papillomavirus (HPV) is necessary but not sufficient for cervical carcinogenesis. Human herpesviruses (HHVs) may act as cofactors, yet evidence is inconsistent. We assessed HPV genotypes, HHVs, and their co-detection patterns across cervical disease grades in Yunnan, China.

methodsCervical exfoliated cell samples were collected from women attending gynecology clinics and classified as NILM, CIN1, CIN2, CIN3, or cervical cancer. HPV genotyping and detection of HSV-1/2, VZV, EBV, CMV, HHV-6, HHV-7, and HHV-8 were performed by PCR based assays.

resultsThe cohort included 1096 women. Median age increased with disease severity, from 39.00 years in NILM to 51.00 years in cervical cancer (p < 0.001). HPV prevalence was higher in lesion and cancer groups than in NILM (any HPV 48.56% vs. 64.71% to 70.00%, p = 0.033; any high-risk HPV 43.69% vs. 58.82% to 65.12%, p = 0.013). The most frequent genotypes were HPV-52, HPV-16, HPV-58, and HPV-45. HPV-16 positivity increased with severity (p = 0.023), while HPV-18 did not (p = 0.084). Overall HHV DNA detection was 19.89%. CMV was the most frequently detected HHV at 9.67%, followed by HHV-7 at 5.11%, VZV at 3.74%, and EBV at 1.92%. HSV-1/2, HHV-6, and HHV-8 were rarely detected, each in approximately 0.5% of samples. Trend tests revealed no monotonic gradient in any HHV detection rate across lesion grades. VZV detection rates differed significantly across disease categories by Fisher's exact test (p = 0.022). In adjusted models, overall HHV DNA detection was not significantly associated with either CIN2 + or CIN3+. In contrast, high-risk HPV and HPV-16 were consistently associated with increased odds of CIN2 + and CIN3+. Exploratory analyses identified genotype-specific HPV-HHV co-detection patterns, including HPV-26 with HSV-1/2, HPV-83 with EBV, and HPV-45 with CMV.

conclusionsIn this hospital-based cohort from Yunnan, age and high-risk HPV, particularly HPV-16, were associated with cervical disease severity. HHV DNA was detectable in a subset of participants but showed no significant association with CIN2 + or CIN3 + after adjustment. These findings highlight the dominant association of HPV, particularly HPV-16, with cervical lesion severity and provide regional data for future longitudinal studies of HPV-HHV DNA co-detection. CLINICAL TRIAL NUMBER: Not applicable.