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. 2022 Jun:13:200233.
doi: 10.1016/j.tvr.2021.200233. Epub 2021 Dec 25.

The association between viral load and concurrent human papillomavirus infection at the genital and anal sites of young women and the impact of vaccination

Kahren van Eer  1 , Ihsane Laâbi  2 , Birgit H B van Benthem  3 , Renske D M Steenbergen  4 , Audrey J King  5 ; Medical Microbiological Laboratories and the Public Health Services: Medical Microbiological Laboratories: Certe; ETZ Hospital Tilburg: A. Buiting; Erasmus Medical Center; University Medical Center Utrecht; Public Health Laboratory Amsterdam; Maastricht University Medical Center; Jeroen Bosch Hospital; Radboud University Medical Center; LabMicTA; Medical Laboratory dr. Stein and Collegae; Canisius Wilhelmina Hospital; Public Health Services: PHS Drenthe; PHS IJsselland; PHS Gelderland-Zuid; University Medical Center Utrecht; PHS Rotterdam-Rijnmond; PHS Groningen; PHS Zuid Limburg; PHS Fryslân; PHS Twente; PHS Hart voor Brabant; PHS Amsterdam; PHS Gelderland-Midden
Collaborators, Affiliations

The association between viral load and concurrent human papillomavirus infection at the genital and anal sites of young women and the impact of vaccination

Kahren van Eer et al. Tumour Virus Res. 2022 Jun.

Abstract

Concurrent genital-anal human papillomavirus (HPV) infections may impose an increased anal cancer risk in women with HPV-related genital lesions. High viral load may facilitate genital-anal HPV concurrence. Genital and anal HPV is reduced by a bivalent HPV16/18 vaccine, yet the effect on concurrent genital-anal HPV remains unclear. This study analyzed viral load in concurrent genital-anal HPV infections, relative to genital-only and anal-only HPV infections and the impact of vaccination in young women. We included 1074 women, who provided both genital and anal swabs. HPV detection and genotyping was performed using the SPF10-DEIA-LiPA25. HPV copy numbers were measured with type-specific qPCRs and corrected for cellular content to obtain the viral load. Concurrent genital-anal HPV often had significantly higher genital viral load (0.09-371 c/cell) than genital-only HPV (3.17E-04-15.9 c/cell, p < 0.0001 to p < 0.05). Moreover, nearly all concurrent genital-anal HPV types had higher genital copy numbers per PCR reaction (157-416E04 c/rxn) than anal copy numbers (0.90-884E01 c/rxn, p < 0.0001 to p < 0.001). Vaccinated women had significantly less infections with HPV16/18 vaccine-types (2.8% vs 13.7%, p < 0.0001) and HPV31/35/45 cross-protective types (7.4% vs 21.1%, p < 0.0001) than unvaccinated women. In conclusion, particularly high genital viral load is found in concurrent genital-anal HPV infections, which are effectively reduced by vaccination.

Keywords: Anal; Concurrent; Genital; Human papillomavirus; Vaccination; Viral load.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: R.D.M.S. has a minority share in Self-screen BV, a university spin-off company. The other authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Fig. 1
Fig. 1
Flowchart depicting the inclusion numbers from the PASSYON study.
Fig. 2
Fig. 2
Viral load of lrHPV6/11, hrHPV16/18/33/35/39/51/52/56/58/59 and potential hrHPV66. Panel A and B respectively visualize the comparisons of the genital and anal viral load of type-specific HPV concurrently found in the genital and anal sites (blue) to the viral load of HPV only found in the genital or anal site (grey). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
Fig. 3
Fig. 3
The frequency of HPV infections with the bivalent vaccine types (HPV16/18) and bivalent cross-protective types (HPV31/35/45) in all eligible vaccinated and unvaccinated women. Infections were stratified into four categories: concurrent genital-anal, genital-only, anal-only, and overall.
See this image and copyright information in PMC

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