Genotype-specific HPV persistence

Genotype-specific HPV persistence is the most important determinant of cervical cancer risk in women who test HPV-positive, regardless of HPV genotype1-4
If a woman tests positive for HPV during routine screening, there are three possible outcomes for her next HPV test result:
If the immune system does not clear the infection, it is important to determine if it is a “type switch” or “type persistence”, because studies have found that women who switch HPV genotype are at a reduced risk of developing cervical cancer as compared to women who have genotype-specific persistence.2
Cumulative proportion of ≥CIN2 among women with genotype-specific HPV persistence*
Adapted from Elfgren et al. Am J Obstet Gynecol. 2017;216:264.e1-7.
*12,527 women aged 32-38 years with follow up of 195 women attending colposcopy who were cytologically normal but persistently HPV positive for at least 1 year.
However, not all HPV assays allow for tracking of genotype-specific persistence.
Monitoring genotype-specific HPV persistence is key to identifying your patients at most risk for developing cervical disease.2,4,6
Extended genotyping provides individual results for at least 5 hr-HPV genotypes7 meaning that from one HPV test to the next, it is possible to get the specific HPV genotype result and therefore determine if it is genotype-specific HPV persistence or type switch.
Partial genotyping
cannot identify genotype-specific persistence beyond HPV 16 & 18
Extended genotyping
can identify genotype-specific persistence beyond HPV 16 & 18, and type switch
CIN, cervical intraepithelial neoplasia; HPV, human papillomavirus; hr, high risk
1. Bonde JH et al. J Low Genit Tract Dis. 2020;24(1):1–13.
2. Elfgren et al. Am J Obstet Gynecol. 2017;216:264.e1–7.
3. Radley D et al. Hum Vaccin Immunother. 2016;12(3):768–72.
4. Bodily J, Laimins LA. Trends Microbiol. 2011;19(1):33–9.
5. Mitra A et al. Microbiome. 2016;4:58.
6. Perkins RB et al. J Low Genit Tract Dis. 2020;24:102–31.
7. Bonde J et al. J Clin Virol. 2018;108:64–71.