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

Overview

Journal J Med Virol

Date 2025 Feb 1

PMID 39891593

Authors

Tianyi Bi

Yan Wang

Wenjie Qu

Yaping Wang

Wenqian Shi

Qi Zhou

Zhiheng Wang

Fang Chen

Congjian Xu

Yanyun Li

Affiliations

Soon will be listed here.

Abstract

This 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.

References

Mateos Lindemann M, Sanchez Calvo J, de Antonio J, Sanz I, Diaz E, Rubio M . Prevalence and Distribution of High-Risk Genotypes of HPV in Women with Severe Cervical Lesions in Madrid, Spain: Importance of Detecting Genotype 16 and Other High-Risk Genotypes. Adv Prev Med. 2011; 2011:269468. PMC: 3169348. DOI: 10.4061/2011/269468. View

Senapati R, Nayak B, Kar S, Dwibedi B . HPV genotypes co-infections associated with cervical carcinoma: Special focus on phylogenetically related and non-vaccine targeted genotypes. PLoS One. 2017; 12(11):e0187844. PMC: 5697876. DOI: 10.1371/journal.pone.0187844. View

Ao M, Zheng D, Wang J, Gu X, Xi M . A retrospective study of cytology and HPV genotypes results of 3229 vaginal intraepithelial neoplasia patients. J Med Virol. 2021; 94(2):737-744. DOI: 10.1002/jmv.27311. View

Yuanyue L, Baloch Z, Yasmeen N, Tao Y, Xiaomei W, Xueshan X . The distribution of human papillomavirus genotypes in cervical cancer and intraepithelial neoplasia lesions among Chinese women in Yunnan Province. J Infect Public Health. 2017; 11(1):105-110. DOI: 10.1016/j.jiph.2017.06.012. View

Li N, Cheng C, Liang R, Zhu Q, Xue F, Xu L . Epidemiological analysis of HPV in Sichuan during 2014-2021. Cancer Epidemiol. 2023; 84:102360. DOI: 10.1016/j.canep.2023.102360. View

Liao G, Jiang X, She B, Tang H, Wang Z, Zhou H . Multi-Infection Patterns and Co-infection Preference of 27 Human Papillomavirus Types Among 137,943 Gynecological Outpatients Across China. Front Oncol. 2020; 10:449. PMC: 7154087. DOI: 10.3389/fonc.2020.00449. View

Bonde J, Bottari F, Iacobone A, Cocuzza C, Sandri M, Bogliatto F . Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review. J Low Genit Tract Dis. 2020; 25(1):27-37. PMC: 7748037. DOI: 10.1097/LGT.0000000000000573. View

Waxman A, Chelmow D, Darragh T, Lawson H, Moscicki A . Revised terminology for cervical histopathology and its implications for management of high-grade squamous intraepithelial lesions of the cervix. Obstet Gynecol. 2012; 120(6):1465-71. PMC: 4054813. DOI: 10.1097/aog.0b013e31827001d5. View

Chen R, Fu Y, You B, Li Y, Yao Y, Wang X . Clinical characteristics of single human papillomavirus 53 infection: a retrospective study of 419 cases. BMC Infect Dis. 2021; 21(1):1158. PMC: 8591956. DOI: 10.1186/s12879-021-06853-7. View

10.

Halec G, Schmitt M, Dondog B, Sharkhuu E, Wentzensen N, Gheit T . Biological activity of probable/possible high-risk human papillomavirus types in cervical cancer. Int J Cancer. 2012; 132(1):63-71. DOI: 10.1002/ijc.27605. View

11.

Zhang R, Xu W, Yang S, Hu D, Bai L, Xiang R . Prevalence of High-Risk Human Papillomavirus Infection, Associated Risk Factors, and Relationship With Cervical Precancerous Lesions in Perimenopausal and Older Women in an Area With High Cervical Cancer Incidence in China. Cureus. 2024; 16(4):e58081. PMC: 11009475. DOI: 10.7759/cureus.58081. View

12.

Liu S, Li Y, Song Y, Wu X, Baloch Z, Xia X . The diversity of vaginal microbiome in women infected with single HPV and multiple genotype HPV infections in China. Front Cell Infect Microbiol. 2023; 12:642074. PMC: 9806233. DOI: 10.3389/fcimb.2022.642074. View

13.

Najioullah F, Dorival M, Joachim C, Dispagne C, Macni J, Abel S . Genotype distribution of cervical HPV among Caribbean women in a population-based study in Martinique: The DEPIPAPUFR study. PLoS One. 2021; 16(10):e0257915. PMC: 8496807. DOI: 10.1371/journal.pone.0257915. View

14.

Prado J, Calleja-Macias I, Bernard H, Kalantari M, Macay S, Allan B . Worldwide genomic diversity of the human papillomaviruses-53, 56, and 66, a group of high-risk HPVs unrelated to HPV-16 and HPV-18. Virology. 2005; 340(1):95-104. DOI: 10.1016/j.virol.2005.06.024. View

15.

Aimagambetova G, Babi A, Issanov A, Akhanova S, Udalova N, Koktova S . The Distribution and Prevalence of High-Risk HPV Genotypes Other than HPV-16 and HPV-18 among Women Attending Gynecologists' Offices in Kazakhstan. Biology (Basel). 2021; 10(8). PMC: 8389608. DOI: 10.3390/biology10080794. View

16.

Zappacosta R, Lattanzio G, Viola P, Ianieri M, Gatta D, Rosini S . A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology. Clin Interv Aging. 2014; 9:683-8. PMC: 3998847. DOI: 10.2147/CIA.S57294. View

17.

Kim M, Park N, Jeong J, Park J . Multiple Human Papilloma Virus (HPV) Infections Are Associated with HSIL and Persistent HPV Infection Status in Korean Patients. Viruses. 2021; 13(7). PMC: 8310096. DOI: 10.3390/v13071342. View

18.

Kocjan B, Seme K, Mocilnik T, Jancar N, Vrtacnik-Bokal E, Poljak M . Genomic diversity of human papillomavirus genotype 53 in an ethnogeographically closed cohort of white European women. J Med Virol. 2007; 79(4):431-8. DOI: 10.1002/jmv.20787. View

19.

Babi A, Issa T, Gusmanov A, Akilzhanova A, Issanov A, Makhmetova N . Prevalence of high-risk human papillomavirus infection and genotype distribution among Kazakhstani women with abnormal cervical cytology. Ann Med. 2024; 56(1):2304649. PMC: 10798292. DOI: 10.1080/07853890.2024.2304649. View

20.

Chen L, Dong Y, Li J, Zhao J, Wang D, Xu L . The genomic distribution map of human papillomavirus in Western China. Epidemiol Infect. 2021; 149:e135. PMC: 8193771. DOI: 10.1017/S0950268821001175. View