Detection of multiple human papillomavirus types in the lower genital tract correlates with cervical dysplasia

Some human papillomavirus (HPV) types, such as HPV 16, are clearly associat ed with cervical dysplasia; however, the role played by other HPV types occ asionally found in dysplasia is less certain. In addition, most methods use d to detect HPV in clinical specimens cannot easily distinguish among more than two or three HPV types in a single specimen. Therefore, the significan ce of infection with multiple HPV types is not known. To address this quest ion, we analyzed cervicovaginal lavage specimens from three cohorts of wome n for HPV DNA using a PCR/reverse blot assay system that permits the detect ion and partial quantitation of 26 genital HPV types. As expected, 94.1% of women who had dysplasia (n = 34) and 71.4% of women who had atypical squam ous cells of uncertain significance (ASCUS) (n = 21) on cytology had HPV DN A detected compared to 54.5% of age matched women with normal cytology. HPV 16 DNA was detected in 35% of dysplasia patients compared to 9% of cytolog ic normals (P = 0.0044). Dysplasia patients had a mean of 3.29 (range 0-10) different HPV types detected com pa red to 1.04 (range 0-7) HPV types amon g those with normal cytology (P < 0.0001). These data support a possible ro le for multiple HPV types in the development or progression of cervical dys plasia. J. Med. Virol. 64:550-559, 2001. (C) 2001 Wiley-Liss, Inc.