What are the high-risk genes for HPV testing?

  HPV, or human papillomavirus vaccination (HPV), is a large family with more than 100 subtypes, distributed in the skin and mucous membranes of many parts of the human body, both male and female, the most common is the oropharynx, anogenital tract. HPV infects humans through direct or indirect contact with contaminated objects or sexual transmission. . HPV can only infect human skin and mucosal epithelial cells, causing a variety of papillomas or warts on human skin and proliferative epithelial lesions in the genital tract. HPV is divided into high-risk and low-risk types. Persistent high-risk HPV infection is the most important pathogenic factor leading to squamous cervical cancer and its precancerous lesions, with high-risk viral infection present in almost all (>99.7%) lesions.  Various research institutions have given reference to HPV cervical cancer high-risk and low-risk types, and the reference here is the “Guidelines for Human Papilloma Virus (HPV) Nucleic Acid Testing and Genotyping, and Technical Review of Reagents”, which was just released this year. Based on the research results of the WHO International Agency for Research on Cancer (IARC) and other international organizations, this guideline recommends that 13 genotypes, including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68, be classified as high-risk types, and 5 genotypes, including 26, 53, 66, 73 and 82, be classified as medium-risk types. Therefore, it is not recommended for the above-mentioned intended use alone. It is worth mentioning that the current international mainstream HPV testing reagents mostly detect 14 types, in addition to 13 high-risk types, plus a more harmful type 66.  For example, HPV 6 and HPV 11 are associated with 90% of genital warts and 96% of condyloma acuminata, but they do not cause cancer and are benign lesions, so there is no need to use HPV testing as a bull’s-eye to “kill the chicken”.  Therefore, for HPV testing for cervical cancer screening, there should be at least 13 types and at most no more than 18 types. This practice is suspected of over-screening when more than 20 to 30 types of tests are available. The good news is that HPV testing is now being regulated, and the release of the HPV testing guidelines is a good start.