Antibodies to HPV are biomarkers for current and past infections. Our aim was to investigate the correlates of antibodies to multiple (≥3) HPV types.
2024 women participating in the organized cervical screening program in Slovenia were enrolled. They were tested for HPV DNA in cervical smears and for HPV antibodies in serum. 1848 of these women also attended a second round of screening 3 years later and had complete data on HPV antibodies and HPV DNA on both visits. Antibodies to HPV types 6, 11, 16, 18, 31, 33, 35, 39, 45, 52, 56, 58, 59, 68 and 73 were determined using pseudovirion-luminex and HPV DNA typed with Linear Array. At baseline we also tested for antibodies to non-genital types (HPV 3, 5, 15, 32, 38 and 76). Women were stratified into three groups according to their HPV antibody status at baseline: seronegatives (N= 642), antibodies to 1-2 HPV types (N= 687) and ≥3 HPV types (N= 519). Associations between seropositivity and HPV DNA presence at different time-points/seropostivity to non-genital HPVs/association with cervical lesions were estimated with a chi square (χ2 ) test for linear trend.
We found a strong positive trend between the baseline number of HPV types by serology and the baseline presence of HPV DNA in cervix (χ2 = 68.8; p<0.0001). Baseline multiple seropositivity to HPV also strongly associated with baseline multiple HPV DNA positivity (χ2= 58.6; p<0.0001), with HPV DNA positivity at follow-up (χ2= 22.9; p<0.0001) and with baseline seropositivity to non-genital HPV types (χ2= 37.4; p<0.0001). Seropositivity to multiple HPV types also associated with presence of cervical lesions (χ2=9.8; p=0.0017). Baseline antibodies to multiple HPV types appeared to correlate with clearance as baseline multiple HPV antibodies was not significantly associated with multiple HPV DNA types at follow-up (χ2= 2.9; p<0.0866). Presence of antibodies to ≥3 HPVs tended to persist over time: 75% of these women still had multiple HPV type positivity 3 years later.
Seropositivity to at least 3 genital HPV types associates with current multiple infection and presence of cervical dysplasia.