The interaction of high and low‐risk human papillomavirus genotypes increases the risk of developing genital warts: A population‐based cohort study

Cervical cancer is among the most common type of cancers in women and is associated with human papillomavirus (HPV) infection. Genital warts are also reported to be linked with HPV infection types 11 and 6. In turn, clinical characteristics and morphological features of warts may be useful in the prediction of prognosis and in making treatment decisions. Thus, we have investigated the association of high and low‐risk HPVs genotype with genital wart risk, as well as pathological and cytological information in cases recruited from a population‐based cohort study of 1380 patients. Patients infected with HPV genotype 6 or 11 had an increased risk of having warts, with OR of 2.34 (95% CI: 0.955‐5.737, P = 0.06). Also, this association was enhanced in the presence of high plus low‐risk HPV for having genital wart (OR: 2.814; 95%: 1.208‐6.55, P = 0.017) and cases having high‐risk HPV (OR: 2.329; 95% CI: 1.029‐5.269, P = 0.042). Moreover, we observed patients with genital warts having CIN2/3, indicating the importance of informing the physician to the patient to prevent more severe lesions. Our data demonstrated that patients with both low/high‐risk HPV types had an increased risk of developing genital warts and persistent infection with HPV was a necessary precursor for the increase in cervical lesions. Risks of genital wart for different human papillomavirus (HPV) category infection patterns of 16/18, non‐16/18 high‐risk, and low‐risk only and 6/11, singly and in combination, observed in the first diagnosis, obtained using logistic regression modeling. All statistical tests were two‐sided. Reference level: negative HPV group. LR = low‐risk; HR = high‐risk.