Persistent high-risk human papillomavirus (HR-HPV) infections play a major role in the development of invasive cervical cancer (CC), and screening for such infections is in many countries the primary method of detecting and preventing CC. HPV typing can be used for triage and risk stratification of women with atypical squamous cells of undetermined significance (ASC-US)/low-grade cervical lesions (LSIL), though the current clinical practice in Mexico is to diagnose CC or its preceding conditions mainly via histology and HR-HPV detection. Additional information regarding these HPV infections, such as viral load and co-infecting agents, might also be useful for diagnosing, predicting, and evaluating the possible consequences of the infection and of its prevention by vaccination. The goal of this follow-up hospital case study was to determine if HPV types, multiple HPV infections, and viral loads were associated with infection persistence and the cervical lesion grade. A total of 294 cervical cytology samples drawn from patients with gynecological alterations were used in this study. HPV types were identified by real-time PCR DNA analysis. A subset of HPV-positive patients was reevaluated to identify persistent infections. We identified HPV types 16, 18, and 39 as the most prevalent. One hundred five of the patients (59%) were infected with more than one type of HPV. The types of HPV associated with multiple HPV infections were 16, 18, and 39. In the follow-up samples, 38% of patients had not cleared the initially detected HPV infection, and these were considered persistent. We found here an association between multiple HPV infections and high viral loads with and infection persistence. Our findings suggest there are benefits in ascertaining viral load and multiple HPV infections status of HR-HPV infections for predicting the risk of persistence, a requirement for developing CC. These findings contribute to our understanding of HPV epidemiology and may allow screening programs to better assess the cancer-developing risks associated with individual HR-HPV infections.

中文翻译：

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墨西哥女性持续性宫颈病变中的多种HPV感染和病毒载量关联。

持续性高危型人乳头瘤病毒（HR-HPV）感染在浸润性宫颈癌（CC）的发展中起着重要作用，在许多国家中筛查此类感染是检测和预防CC的主要方法。HPV分型可用于未明确意义的非典型鳞状细胞（ASC-US）/低度宫颈病变（LSIL）的女性的分流和风险分层，尽管墨西哥目前的临床实践主要是诊断CC或其先前疾病通过组织学和HR-HPV检测。有关这些HPV感染的其他信息，例如病毒载量和共感染因子，也可能有助于诊断，预测和评估感染的可能后果以及通过疫苗预防感染的可能性。这项随访医院案例研究的目的是确定HPV类型，多次HPV感染和病毒载量是否与感染持续性和宫颈病变等级相关。这项研究共使用了294例从妇科改变患者中抽取的宫颈细胞学样本。HPV类型通过实时PCR DNA分析鉴定。重新评估了一部分HPV阳性患者，以识别持续感染。我们确定HPV类型16、18和39是最流行的。一百零五名患者（59％）感染了一种以上的HPV。与多种HPV感染相关的HPV类型为16、18和39。在随访样本中，有38％的患者未清除最初检测到的HPV感染，因此被认为是持久性的。我们在这里发现多种HPV感染与高病毒载量和感染持续性之间的关联。我们的研究结果表明，确定HR-HPV感染的病毒载量和多种HPV感染状况对于预测持续性风险（发展CC的必要条件）有好处。这些发现有助于我们对HPV流行病学的理解，并可能使筛查程序更好地评估与单个HR-HPV感染相关的癌症发展风险。