Tianyi Bi

Patterns of Co‐infection of HPV52 With Other HPV Genotypes and Their Risks of Cervical Precancer and Carcinoma

ABSTRACT Human papillomavirus 52 (HPV52) is the second most frequent HPV type in high‐grade squamous intraepithelial lesion (HSIL) cases in China. However, few researchers have explored the co‐infection of HPV52 with other HPV genotypes and their correlation with cervical lesions. In this study, 13,809 HPV52‐positive patients visiting the Obstetrics and Gynecology Hospital of Fudan University from 2018 to 2023 were included in the first stage to investigate the risk of cervical lesions among different multiple infection patterns. Another 443 HPV52‐positive patients were further included for sequence alignment and phylogenetic analysis. In the current study, the most common HPV52 dual‐infection patterns were as follows: HPV16 + HPV52, HPV52 + HPV58, HPV52 + HPV53, and HPV52 + HPV81. Compared with HPV52 single infection, the risk of HSIL+ was increased in HPV16 + HPV52 (OR = 3.47, 95% CI: 2.56, 4.69) and HPV52 + HPV58 (OR = 1.99, 95% CI: 1.35, 2.92) groups. The most common triple‐infection patterns were HPV16 + HPV52 + HPV53 and HPV52 + HPV53 + HPV81, followed by HPV52 + HPV53 + HPV58. HPV53 was the most common co‐infection type with HPV52 in cases of triple or more multiple infections. However, compared with dual infection, the addition of HPV53 did not affect the risk of HSIL+. Two synonymous mutations, G207A ( p = 0.029) and C1203T ( p = 0.021), showed statistically significant differences in distribution between single and multiple infection groups. Our results demonstrated that HPV52 showed preferences for co‐infection with HPV16, 585,381. HPV52 co‐infection with HPV16 and HPV58 increased the risk of HSIL+, while co‐infection with HPV53 did not increase the risk of HSIL+. Virus variants with certain mutations may be more susceptible to multiple infections.

A 10‐year Retrospective Analysis on HPV Genotype Switching in a Tertiary Center in China: Infection Characterization and Clinical Outcome

ABSTRACTThis study aims to investigate the phenomenon of human papillomavirus (HPV) genotype switching (HGS), assess the potential influencing factors, and evaluate the clinical impact on the severity of cervical lesions. A total of 2569 HPV positive female patients with records of more than two follow‐up visits were included from the gynecology department at the Obstetrics and Gynecology Hospital of Fudan University, covering the period from May 2012 to September 2022. Patients' age, treatments, vaccination, HPV genotypes before and after HGS, and the final pathology results from colposcopy were recorded. Multifactorial analyses and correlation tests were performed. Single HPV infections accounted for 67% of the total population, while multiple HPV infections comprised 33%. The most prevalent genotypes in single HPV infections were HPV52 (18.6%), HPV16 (12.28%), HPV58 (11.72%), HPV53 (8.63%), and HPV81 (6.81%). Among cases of multiple infections, the most common genotype combinations were HPV52 + HPV53 (3.02%), HPV52 + HPV58 (3.13%), and HPV52 + HPV81 (3.02%). HGS was detected in 38.2% of the total cases (458/1200). The status of medication treatment was not found to correlate with the occurrence of HGS. However, age, surgical treatment status, vaccination status, and the genotype of HPV infection may be correlated with HGS. HPV52, HPV58, HPV53, HPV56, and HPV81 showed a positive association with the occurrence of HGS transitioning from multiple infections to a single infection (HGS‐MS) (p < 0.05). In contrast, HPV52, HPV16, HPV58, HPV39, HPV56, and HPV18 significantly influenced the occurrence of HGS from one single infection to another (HGS‐SS) (p < 0.05), albeit negatively. Notably, only one type of HGS, HGS‐MS, demonstrated a positive correlation with the severity of cervical lesions. Our findings suggest that HPV genotype switching from multiple infections to single infections is associated with cervical intraepithelial neoplasia (CIN). Different patterns of HGS could result from specific HPV genotype infections, particularly HPV16. HGS‐MS is revealed to plays a catalytic role in the progression of cervical lesions.