Introduction/Background*Cervical cancer is the fourth most common cancer, worldwide. Persistent infection with high-risk (HR) human papillomavirus (HPV) types is necessary for cervical cancer development. However, little is known about the influence of multiple HPV infections on cervical lesion risk. The aim of this study was to see the prevalence and pattern of multiple HPV infections in cervical cancer patients from Bangladesh.

Methodology Histopahologically diagnosed 100 cervical cancer patients were enrolled in this study. HPV DNA testing was done by polymerase chain reaction (PCR) using SPF-10 broad-spectrum primers followed by genotyping by reverse hybridization using the INNO-LIPA genotyping Extra (Fujirebio, Belgium) at the Department of Virology, Bangabandhu Sheikh Mujib Medical University.

Result(s)*22.0% of cervical cancer patients were associated with multiple HPV infections whereas overall prevalence of single HPV infections was 78%. Overall, 11 different HPV types [9 HR, 2 intermediate risk (IR) and 1 low risk (LR)] were detected in this study. Among them, the most prevalent genotype was HPV 16, followed by HPV 18,45,56,58,39,31,73,53,66,62. Among the single infection HPV 16 was more prevalent (69%) followed by HPV 18 (6%) and HPV 45 (3%), later eight genotypes were found only in multiple infections. Genotype 16 and 18 alone and as co-infection were detected in 84% cases. Among the multiple infections the most common was by HR-HR HPV types (77.27%), whereas infections by HR-IR and HR-LR HPV types were identified in 13.64% and 9.09%, respectively. Dual, triple and quadruple infection were observed in this study. Overall prevalence of HPV dual infection (16%) was more in multiple infection. Genotypes 16/18 co-infection was more among the dual infection. Among the triple and quadruple infection 16/45/56, 16/18/53/73, 16/18/45/66, and 16/31/56/58 were prevalent.

Conclusion*Thus this study concluded that HPV multiple infection (22%) is prevalent along with the single HPV infection among the cervical cancer patients from Bangladesh. Dual, triple and quadruple infection were observed in this study. Genotype 16 and 18 alone and as co-infection were detected in 84% cases. Thus the vaccination with Cervarix against HPV 16 and HPV 18 can prevent 84% of cervical cancer in Bangladesh.