HPV亚临床感染、潜伏感染及PDT治疗的免疫学进展

人乳头瘤病毒（HPV）感染人体后引起机体多种良恶性病变，部分患者可通过自身免疫系统清除病毒，部分患者呈现亚临床感染和潜伏感染状态，后者导致病情迁延不愈，经常复发。亚临床感染和潜伏感染给临床带来极大困扰，其机制涉及非特异性免疫、特异性免疫和免疫逃逸。光动力疗法（PDT）主要是通过直接杀死病原体或通过PDT激活的免疫反应消除病原体来治疗HPV亚临床感染和潜伏感染的。本文就亚临床感染和潜伏感染的发生机制及PDT治疗亚临床感染和潜伏感染的免疫机制做一综述。     

醋酸白试验对尖锐湿疣患者HPV亚临床感染的评价

HPV亚临床感染从潜伏感染到尖锐湿疣过程中有着中间作用,它可发展为尖锐湿疣,也可以逐渐消退或消失.临床上醋酸白试验常被用于检查尖锐湿疣患者是否伴有HPV亚临床感染,但其敏感性和特异性尚未明确[1].我们将尖锐湿疣患者醋酸白试验阳性和阴性的肉眼观察正常的部位分别取材,利用原位杂交法检测切片中HPV-DNA,结合组织病理学,初步探讨醋酸白试验在诊断HPV亚临床感染中的价值,现将结果报道如下.     

尖锐湿疣治疗方案和复发因素及其对策

尖锐湿疣是由人乳头瘤病毒(HPV)引起的常见性传播疾病。该病治疗方案主要为外用及系统药物、侵袭治疗(激光、冷冻及手术等)、光动力疗法、热疗及免疫治疗等。尖锐湿疣复发因素包括HPV潜伏感染及亚临床感染、细胞免疫功能低下、HPV分型、疣体情况(大小、数目及分布部位)、精神因素、不良生活习惯以及合并其他生殖道感染等。目前没有能绝对预防尖锐湿疣复发的手段,彻底清除可见疣体、清除潜伏和亚临床HPV感染、提高机体免疫功能、改变不良生活习惯及治疗合并生殖道感染等有利于预防尖锐湿疣复发。     

尖锐湿疣高危人群分泌物人乳头瘤病毒基因分型检测结果及临床分析

目的分析尖锐湿疣高危人群分泌物人乳头瘤病毒（HPV）基因分型检测结果及临床特点。方法应用荧光定量聚合酶链反应（FQ—PCR）对尖锐湿疣高危人群分泌物标本进行HPV—DNA分型检测。结果436例分泌物中，总阳性率35．1％。其中6／11型101例次，16型52例次，18型43例次。尖锐湿疣治疗后3～6个月复查，男、女阳性率分别44．7％和46．8％。性伴或配偶患尖锐湿疣，受检男、女阳性率为30．8％和46．3％。非尖锐湿疣性病患者男、女阳性率分别为27．9％和29．1％。自检男、女阳性率分别为19．0％和38．0％。可疑CA男、女阳性率分别为13．3％和39．5％。结论分泌物检测中HPV6／11型最多。非尖锐湿疣性病患者、性伴或配偶患尖锐湿疣、可疑尖锐湿疣和要求自检患者均可发生HPV感染，尖锐湿疣治疗后3～6个月仍有HPV残留，因这些患者均属于尖锐湿疣高危人群，应进行HPV检测。     

人乳头瘤病毒的亚临床及潜伏感染研究进展

人乳头瘤病毒 (HumanpapillomavirusHPV)感染人体皮肤粘膜后可引起显性尖锐湿疣和无明显皮损的HPV亚临床及潜伏感染。HPV亚临床感染 (Subcliniealhumanpapillo mavirusinfection ,SPI)是指临床肉眼不能辨认的病变 ,需要借助放大镜、阴道镜、尿道镜及 3%～ 5 %的冰醋酸外涂或湿敷后才能观察到的发白病变区域。HPV潜伏感染 (latentpapillomavirusinfection,LPl)是指人乳头瘤病毒进入皮肤粘膜后不引起任何临床表现和组织学改变的一种HPV存在状态 ,只能用分子生物学方法发现。目前公认HPV亚临床及潜伏感染是尖锐湿疣 (CondylomaAcumi…     

尖锐湿疣合并感染其他性病的临床研究

目的：对尖锐湿疣发病与其他性传播疾病的关系展开研究分析,旨在为临床治疗尖锐湿疣提供有利依据。方法：随机选取2011年3月至2013年3月期间我院接收救治的400例尖锐湿疣患者,分成男性组和女性组各200例。对两组淋球菌、沙眼衣原体以及解脲支原体等进行检测对比,并对两组于中西医结合主动免疫基础上给予光动力疗法治疗,对其治疗后临床疗效进行观察对比。结果：两组400例患者经过临床检测研究后,对其病原体检测结果进行观察对比。男性组患者合并其他性病总感染率34.0％,女性组患者合并其他性病总感染率56.0％,男性组总感染率显著低于女性组,数据差异具有统计学意义（P＜0.05）;两组患者合并解脲支原体感染16.0％、26.0％,显著高于淋球菌感染10.0％、16.0％,显著高于沙眼衣原体感染8.0％、14.0％,数据差异具有统计学意义（P均＜0.05）;两组400例患者于中西医结合主动免疫基础上给予光动力疗法治疗后,对其临床疗效进行观察对比。其中合并其他性病病原体感染的患者治愈情况为男性组总有效率95.5％,女性组总有效率94.6％,比较男女患者间数据无显著差异（P＞0.05）。单一HPV感染者治愈情况为男性组有效率94.7％,女性组有效率94.3％,比较男女患者间数据无显著差异（P＞0.05）。同时合并其他性病病原体患者与单一HPV感染患者间数据也无显著差异（P＞0.05）。结论：尖锐湿疣复发受尖锐湿疣合并其他性病感染重要影响,临床治疗尖锐湿疣患者通过对患者其他性病病原体进行有效检测,并及时对合并其他感染的患者开展治疗,临床疗效显著。     

宁波地区男性肛周尖锐湿疣的流行病学调查

目的:分析宁波地区男性肛周尖锐湿疣的临床与流行病学特征,以期为男性肛周尖锐湿疣的防治提供借鉴。方法:回顾自2011年6月到2012年6月宁波部分地区男性肛周尖锐湿疣患者的资料,采用个体匹配,调查每1个病例的同时,调查3个职业和年龄相同的的正常人作为对照。对患者的一般情况、个人社会行为、个人性行为、感染HPV病毒的亚型、复发的情况等,统计并分析其流行性特征。结果:我们发现男性肛周尖锐湿疣患者年龄平均(27.74±7.21)岁,受教育程度相对较高、易发生抑郁,肛交(OR=7.621,95%CI:2.610-22.256)、患有梅毒或艾滋病(OR=3.840,95%CI:2.079-7.093)、使用公共用品(OR=1.860,95%CI:0.721-3.027)、性病防护知识差(OR=1.649,95%CI:1.052-2.585)、多性伴侣(OR=1.109,95%CI:1.075-1.146)是男性患者发生肛周尖锐湿疣的危险因素,嗜酒、熬夜、吸烟、皮损HPV型别为16型、皮损HPV型别为复合型是男性患者发生肛周尖锐湿疣复发的主要促进因素。结论:针对高危人群应加强性健康教育普及,提高性安全意识,尤其针对男男性行为者应当予以广泛关注并采取良好有效的干预机制,对于男性肛周尖锐湿疣应注意禁止饮酒、不熬夜,以防止复发。     

外阴尖锐湿疣亚临床感染的病理改变与HPV型别的关系

目的探讨外阴尖锐湿疣亚临床感染的病理形态变化特点及其与HPV型别的关系。方法选择在桂林医学院附属医院性病门诊就诊的未经治疗的肛周、外生殖器部位典型尖锐湿疣患者进行醋酸白试验初筛,收集到80例醋酸白试验阳性的HPV亚临床感染患者,对其进行活组织病理及HPV-DNA检测。结果外阴尖锐湿疣亚临床感染病理形态特点与典型尖锐湿疣存在差异,高危和低危HPV-DNA型别感染在尖锐湿疣亚临床感染组织病理中Ⅰ,Ⅱ型挖空细胞差异存在统计学意义(P=0.030)。结论 HPV低危型和高危型感染导致的尖锐湿疣亚临床感染的组织病理学改变不同,高危型感染中Ⅱ型挖空细胞更为明显,应引起临床重视。     

尖锐湿疣组织中人乳头状瘤病毒感染与生存素和增殖细胞核抗原的表达

目的 探讨人乳头状瘤病毒（HPV）6／11、16／18在尖锐湿疣（CA）组织中的感染情况及其与生存素和增殖细胞核抗原（PCNA）表达的关系。方法 HPV分型PCR检测试剂盒检测HPV6／11、16／18在41例尖锐湿疣组织、23例正常皮肤组织中的表达情况，同时用SP免疫组化法检测生存素及PCNA蛋白的表达。结果 ①正常对照组未检测到HPV6／11、16／18感染；HPV6／11在尖锐湿疣中的感染率为87．80％（36／41），与正常对照组比较差异有统计学意义（P〈0．005）；HPV16／18在尖锐湿疣中的感染率为19．51％（8／41），与正常对照组比较差异无统计学意义（P〉0．05）。②生存素和PCNA在尖锐湿疣组织中的阳性率分别为53．66％（22／41）和87．80％（36／41），在正常皮肤组织中的阳性率分别为8．70％（2／23）和47．83％（11／23）。尖锐湿疣组中生存素和PCNA表达的阳性率与正常对照组比较差异均有统计学意义．且尖锐湿疣中两者的阳性表达呈正相关（P=0．009）。③生存素及PCNA在有HPV6／11感染患者中的表达明显强于无HPV6/11感染患者。结论 HPV感染可上调生存素与PCNA的表达。     

光动力疗法治疗男性尿道尖锐湿疣的疗效观察及护理体会

目的：探讨光动力疗法治疗男性尿道尖锐湿疣的疗效及护理。方法：63例男性尿道尖锐湿疣患者均应用光动力疗法治疗,按照护理方式的不同分为干预组（32例）和对照组（31例）,观察两组的疗效、不良反应和复发率。结果：干预组患者的缓解率为93．75％,略高于对照组的87．10％,两组间的差异无统计学意义（P〉0．05）。干预组共有4例出现不良反应,明显低于对照组的9例（P〈0．05）。干预组患者复发共有2例（6．67％）,而对照组共有6例（22．22％）,两组差异具有统计学意义（P〈0．05）。结论：光动力疗法治疗男性尖锐湿疣具有较好的治疗效果,而系统的护理干预能够降低不良反应和复发率。     

Type-specific HPV infection and multiple HPV types: prevalence and risk factor profile in nearly 12,000 younger and older Danish women

OBJECTIVES: Human papillomavirus (HPV) is considered a necessary cause of cervical cancer. The aim of the current study was to determine the burden of HPV infection among randomly sampled Danish women before the vaccine against HPV is implemented. Further we assessed the risk factor profile for prevalent high risk (HR) HPV infection and infection with multiple HR HPV types. METHODS: In the present cross-sectional study, we used baseline data from a population-based cohort study where participants were interviewed and had a gynecological examination. Cervical samples were analyzed for HR HPV using Hybrid capture 2 in 10,544 women aged 20-29 years and 1443 women aged 40-50 years. Genotyping was performed using LiPA. RESULTS: The prevalence of HR HPV was 17.9% and 4.4% in women aged 20-29 years and 40-50 years, respectively. HPV16 was the most common HR type overall and among women with abnormal cytology. Multiple HPV types were highly prevalent, notably in the younger cohort. Lifetime number of sexual partners was the main risk factor for HR HPV infection (adj. OR = 2.8 and OR = 3.4 for > or =15 partners vs. < or =4 in respectively younger and older women), whereas number of recent sexual partners was only associated with risk in younger women. Number of partners, oral contraceptive use and self-reported chlamydia infection increased the risk of having multiple HR HPV types (compared to having a single HR HPV type). CONCLUSIONS: HR HPV infection was common among younger women, with HPV16 as the predominant type. We confirmed the importance of sexual activity for the risk of HR HPV infection. In addition, we found that sexual behavior also play an important role for the risk of having multiple HR HPV types.     

Penile lesions and human papillomavirus in male sexual partners of women with cervical intraepithelial neoplasia

BACKGROUND: Genital human papillomavirus infection (HPV) is causally associated with cervical carcinomas and premalignant lesions. Limited information is available about the prevalence of HPV and penile lesions in male sexual partners of women with cervical intraepithelial neoplasia (CIN). OBJECTIVE: The aim of this study was to identify the presence of penile lesions and HPV in penile scrapings from male sexual partners of women with CIN. METHODS: One hundred seventy-five male sexual partners of women with CIN were screened by peniscopy after acetowhite staining and HPV testing on penile scrapings. RESULTS: Penile lesions were seen in 68% of the male sexual partners. More than one lesion type was diagnosed in 15%. Flat lesions, papular lesions, and condylomata acuminata were seen in 83%, 29%, and 4%, respectively. HPV was detected in 59% of the penile scrapings, containing mainly oncogenic HPV types. When penile lesions were present at peniscopy, 67% of penile scrapings were positive for HPV, whereas 37% were HPV-positive when no lesions were visible. CONCLUSIONS: Penile lesions are frequently found in sexual partners of women with CIN. Most of these lesions are subclinical (ie, only visible after acetowhite staining) and are often associated with the presence of high-risk HPV, indicating that male sexual partners of women with CIN might constitute a reservoir for high-risk HPV.     

Sexual behavior, human papillomavirus type 16 (HPV 16) infection, and HPV 16 seropositivity

BACKGROUND: Sexual behaviors have been linked to seropositivity for human papillomavirus (HPV) but not with the magnitude of the seroreactivity. GOALS: The objective of this analysis was to examine the association of sexual behavior, cervical HPV 16 DNA positivity at enrollment (past) and at diagnosis (current), and other potential determinants with the likelihood and magnitude of HPV 16 seropositivity at diagnosis. STUDY DESIGN: With use of stored specimens from an incidence case-control study at Kaiser Permanente (Portland, OR), women were tested for seroreactivity to HPV 16 by enzyme-linked immunosorbent assay with virus-like particles at diagnosis and were tested for past and concurrent cervical HPV 16 DNA positivity with MY09/MY11 L1 consensus primer PCR. Questionnaire data were used to ascertain past sexual behavior. RESULTS: Increased lifetime number of sex partners (P(Trend) < 0.001), past HPV 16 DNA positivity (odds ratio = 6.9; 95% confidence interval = 1.5-31), and a current cytologic diagnosis (P(Trend) < 0.03) were independently associated with HPV 16 seropositivity. Among the seropositive, only lifetime number of sex partners (P(Trend) < 0.001) and past HPV 16 DNA positivity (P = 0.003) were independently associated with mean signal strength (optical density) in an age-adjusted analysis. Women negative for past and concurrent HPV 16 DNA had a significant trend of increasing optical densities associated with greater numbers of lifetime partners (P(Trend) < 0.001). Conversely, the mean signal strength for those women who were ever HPV 16 DNA-positive during the study did not depend on lifetime numbers of sex partners (P(Trend) = 0.36). CONCLUSIONS: HPV 16 seropositivity is a surrogate for past HPV 16 infection. Circulating levels of antibodies to HPV 16 may reflect recent HPV 16 infection or the frequency of past HPV 16 infection.     

Gender differences in sexual biomarkers and behaviors associated with human papillomavirus-16, -18, and -33 seroprevalence

BACKGROUND: The elevated risk for incident head and neck cancer among human papillomavirus (HPV)-16-seropositive individuals has substantiated a role for HPV in the etiology of head and neck cancers. The relationship between HPV seroreactivity and prevalent oral HPV infection in men and women without cancer has yet to be investigated. GOAL: The goal of this study was to evaluate a possible association between oral HPV infection and HPV seroreactivity after adjustment for gender, sexual behaviors, and sexually transmitted disease. STUDY DESIGN: A cross-sectional study of factors associated with HPV-16, -18, and -33 seroreactivity was performed in a population of 586 men and women with and without HIV infection. Antibodies in sera were measured by use of a virus-like protein (VLP)-based enzyme-linked immunosorbent assay. Exfoliated cells from the tonsillar and oral mucosa were analyzed for the presence of 38 mucosal HPV types by polymerase chain reaction. RESULTS: Women had significantly greater seroreactivity for all HPV types investigated when compared with men (odds ratio, 4.3; 95% confidence interval, 3.0-6.0). Seroprevalence was greatest in men and women aged 35 to 45 years. Tonsillar HPV infection, oral sex with men, and HIV infection were independently associated with HPV seroreactivity in men after adjustment for age and number of sexual partners. In women, HSV-2 seropositivity and a history of sexually transmitted diseases were similarly important. Oral and tonsillar HPV infection were not associated with HPV seroreactivity in women. CONCLUSION: HPV seropositivity is associated with sexually transmitted diseases among women and possibly mucosal HPV exposures in men. Tonsillar HPV infection could impact seroprevalence, particularly in men.     

宫颈上皮内瘤变患者HPV感染情况及转阴率的相关因素分析

目的:研究宫颈上皮内瘤变(CIN)患者人乳头瘤病毒(HPV)感染情况及转阴率的相关影响因素。方法:选取我院2012年1月至2016年1月173例宫颈上皮内瘤患者为研究对象,进行HPV检测。所有患者均在我院接受宫颈上皮内瘤变手术治疗,对术后6个月HPV转阴的患者进行相关影响因素分析。结果:正常组(60例)、CINⅠ级组(68例)、CINⅡ级组(59例)、CINⅢ级组(46例)的HPV感染率分别为18.3%、63.2%、81.4%、95.7%。年龄、病毒负荷量、病理切缘、避孕方式、性伴侣个数、配偶性伴侣个数等6项影响HPV转阴率的相关因素差异具有统计学意义(P0.05)。结论:HPV感染率随宫颈上皮内瘤变病变程度增加而上升,严密检测HPV有利于预警病情发展,提高宫颈癌诊断准确率。年龄、病毒负荷量、病理切缘、避孕方式、性伴侣个数、配偶性伴侣是HPV转阴率的相关影响因素,控制相关影响因素对宫颈上皮内瘤变的预后有重要意义。     

Seropositivity against HPV 16 capsids: a better marker of past sexual behaviour than presence of HPV DNA.

OBJECTIVES: To assess if seropositivity to human papillomavirus type 16 capsids is a better marker of sexual history than the presence of HPV DNA. STUDY DESIGN: A population based age stratified random sample of 234 Norwegian women (mean age 32.8 years, range 20-44) was examined for HPV serum antibodies, cervical HPV DNA, cytology and age in relation to sexual behaviour. RESULTS: Neither age nor age at first sexual intercourse was associated with HPV 16 antibodies. Adjusted ORs for 4-5; 6-10 and > 10 versus 0-1 lifetime sexual partners, were 13.1 (95% CI 1.5-110.8), 8.2 (1.0-69.6) and 10.5 (1.2-94.0) for HPV 16 seropositivity, respectively; and 2.6 (0.2-27.8), 3.4 (0.4-31.7) and 4.1 (0.4-42.8) for HPV 16 DNA positivity, respectively. CONCLUSION: Seropositivity to HPV 16 capsids is positively associated with the number of sexual partners, suggesting that HPV 16 is predominantly sexually transmitted. The fact that serology had a stronger association with number of sexual partners than viral DNA suggests that seroreactivity is a better measure of lifetime history of HPV infection.     

Higher prevalence of human papillomavirus infection in migrant women from Latin America in Spain

OBJECTIVES: To estimate prevalence and determinants of high risk (HR) human papillomavirus (HPV) by country of origin in women attending a family planning centre (FPC) in Alicante, Spain. METHODS: Cross sectional study of all women attending a FPC from May 2003 to January 2004. An ad hoc questionnaire was designed and data were collected prospectively. HR HPV infection was determined through the Digene HPV test, Hybrid Capture II, and positive samples for PCR were directly sequenced. Data were analysed through multiple logistic regression. RESULTS: HR HPV prevalence in 1011 women was 10% (95% CI: 8.2 to 12). Compared to Spaniards (prevalence 8.2%) HR HPV prevalence in Colombians was 27.5% (OR: 4.24 95% CI: 2.03 to 8.86), 23.1% in Ecuadoreans (OR: 3.35 95% CI: 1.30 to 8.63), and 22.73% in women from other Latin American countries (OR: 3.29 95% CI: 1.17 to 9.19). Women with more than three lifetime sexual partners had an increased risk of HR HPV infection (OR 3.21 95% CI: 2.02 to 5.10). The higher risk of HR HPV infection was maintained in Latin American women in multivariate analyses that adjusted for age, number of lifetime sexual partners, and reason for consultation. The commonest HPV types in women with normal cervical smears were HPV-18 (20%), HPV-16 (14%) and HPV-33 (11%). CONCLUSIONS: Prevalence of HR HPV is more than three times higher in Latin Americans than in Spaniards. Latin American women's HPV prevalence resembles more that of their countries of origin. It is essential that health service providers identify these women as a priority group in current cervical screening programmes.     

Prevalence of human papillomavirus infection among women in Concordia,Argentina: a population-based study

BACKGROUND: Preparing for HPV vaccine programs, studies are needed of HPV infection in different populations. GOAL: The goal was to evaluate HPV prevalence and determinants in Concordia, Argentina. STUDY DESIGN: A stratified random sample of 1786 households was obtained. Consenting women aged > or =15 years were interviewed and underwent examination, including colposcopy. Cells were collected for a Papanicolaou smear and HPV DNA testing with GP5+/6+ primer-mediated PCR-EIA. RESULTS: PCR was performed on specimens from 987 women. Prevalence among women reporting no previous sexual activity was 3%, and among sexually active women it was 17.7%, peaking at <25 years of age and decreasing to a minimum at > or =65 years of age. However, low-risk types had similar prevalence (approximately 5%) in all age groups. HPV16 (4.0%), HPV35 (2.6%), and other high-risk types were the most common. Almost half of infections were multiple. Younger women initiated sexual activity earlier and had more partners. The main determinants of HPV detection were lifetime number of sex partners and vaginal discharge. CONCLUSION: A clear pattern of decreasing prevalence of HPV with age was observed. This could be explained by development of immunity against specific types over time or related to a cohort effect associated with a recent spread of HPV in this population after recent changes in sexual behavior.     

Risk factors for genital HPV DNA in men resemble those found in women: a study of male attendees at a Danish STD clinic

OBJECTIVES: Genital infection with certain types of human papillomavirus (HPV) is the most important risk factor for cervical cancer. The male sexual partner is supposed to be the vector of the infection. However, the knowledge of risk factors for genital HPV DNA in men is limited. The objective of this paper is to study the risk factors for HPV infection in men and to compare them with those found in women, including the study of whether there are different risk profiles for oncogenic and non-oncogenic HPV types. METHODS: From a sexually transmitted diseases (STD) clinic in Denmark, 216 men were consecutively included. A personal interview was done and material for genital HPV DNA detection was obtained with swabs. HPV DNA was detected by polymerase chain reaction (PCR). Odds ratios (OR) for HPV as well as for oncogenic and non-oncogenic types separately were computed with a 95% confidence interval (CI) by means of unconditional multiple logistic regresssion. RESULTS: The most important predictors of any HPV were lifetime number of sex partners (OR = 4.3; 95% CI 1.4 to 13.1 for 25-39 v 1-9 partners), young age, and being uncircumcised. The most important risk factor for oncogenic HPV types was lifetime number of partners, whereas number of partners in the past year and ever having genital warts were risk factors for the non-oncogenic HPV types. Young age predicted risk of both oncogenic and non-oncogenic HPV types. CONCLUSIONS: Most risk factors for HPV DNA detection in men resemble those found in women. As in women, the risk factor profile for the oncogenic HPV types was different from that of the non-oncogenic HPV types.     

Determinants of low-risk and high-risk cervical human papillomavirus infections in Montreal University students

BACKGROUND: Previous studies have been inconsistent about the degree of sexual transmissibility of cervical human papillomavirus (HPV) infection. The authors hypothesize that risk factors for HPV infection vary according to HPV type. GOAL: To estimate the prevalence of HPV infection in asymptomatic women and to identify risk factors for overall HPV infection and HPV infection by oncogenic and nononcogenic type. STUDY DESIGN: A cross-sectional survey was conducted at the McGill University clinic in Montreal. Cervical specimens were collected from 489 female students presenting at the clinic for a routine Papanicolaou test. Data on potential risk factors was obtained by questionnaire. Human papillomavirus DNA was detected by the polymerase chain reaction using consensus primers (MY09/11) followed by hybridization with generic and type-specific probes using Southern blot and dot blot techniques. RESULTS: The overall HPV prevalence was 21.8%. A low-risk HPV infection was found in 6.2% of the women, 11.8% had a high-risk HPV infection (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58), 7.1% had an unknown HPV type, and 2.7% had a multiple type infection. Two profiles emerged for sexual activity and risk of HPV infection according to oncogenic risk after multivariate analysis. Lifetime frequency of sexual intercourse and lifetime number of oral sex partners was associated with high-oncogenic-risk HPV infections; however, HPV infection with low-oncogenic-risk types was invariant with respect to markers of sexual activity. CONCLUSION: These results suggest that there are differences in epidemiologic correlates of transmission between low-risk and high-oncogenic-risk HPV types based on oncogenicity. This finding has important implications for primary prevention of HPV infection and cervical cancer precursors.