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Predictors of Cervical Coinfection with Multiple Human Papillomavirus Types¹

Departments of Oncology [M-C. R., E. L. F.] and Epidemiology and Biostatistics [M-C. R., E. L. F., M. A.], McGill University, Montreal, Quebec, H2W 4507-010 1S6 Canada; Virology Unit, Ludwig Institute for Cancer Research, São Paulo, Brazil [L. L. V., M. C. C.]; Division of Clinical Epidemiology, Montreal General Hospital, Montreal, Quebec, 43G 1A4 Canada [M. A.]; and Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, New York 10461, USA [T. E. R.]

Women infected with multiple human papillomavirus (HPV) types seem to be at higher risk of cervical intraepithelial neoplasia, although there is controversy about whether coinfections are associated with lower or higher grades of dysplasia. There is no established risk factor profile for infection with multiple HPV types. We analyzed data from a prospective cohort of 2075 Brazilian women to identify determinants of HPV coinfection. Cervical specimens were collected for cytology and HPV DNA detection. Data on baseline and time-dependent putative risk factors were obtained by interview. Baseline predictors of HPV coinfection included younger age, greater number of recent sexual partners, a history of condyloma but not of other sexually transmitted diseases, and younger age at first sexual intercourse. In repeated measures analyses, there was a weak positive association between the number of sexual partners in the time interval between two study visits and the risk of coinfection. Our results suggest that the risk factor profile for HPV coinfection among HPV-infected women shares several similarities with risk factors for any HPV infection.

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