Detection by Polymerase Chain Reaction and Its Association with Acquisition and

Human papillomavirus (HPV)±16 causes about half the cases of cervical cancer worldwide and is the focus of HPV vaccine development efforts. Systematic data are lacking as to whether the prevention of HPV-16 could affect the equilibrium of infection with other HPV types and thus alter the predicted impact of vaccination on the occurrence of cervical neoplasia. There-fore, the associations of HPV-16 detection with subsequent acquisition of other HPV types and with the persistence of concomitantly detected HPV types were examined prospectively among 1124 initially cytologically normal women. Preexisting HPV-16 was generally associ-ated with an increased risk for subsequent acquisition of other types. HPV-16 did not affect the persistence of concomitant infections, regardless of type. These ®ndings suggest that the prevention or removal of HPV-16 is not likely to promote the risk of infection with other types, a theoretical concern with current vaccination efforts. Infection with oncogenic genital human papillomaviruses (HPV) has been established as the main etiologic agent for cervical neoplasia [1]. Among the>30 genital types of HPV, HPV-16 is the predominant type found in women with a di