Clinical Report: Multivariable Prediction Model for Persistent HR-HPV Infection

Overview

This study developed and validated a prediction model for persistent high-risk HPV (HR-HPV) infection using vaginal microecological and clinical characteristics.

Background

Persistent HR-HPV infection is a significant risk factor for cervical cancer. This study explores the integration of vaginal microecology into risk prediction models.

Data Highlights

Key Findings

• 354 out of 1,186 women (29.8%) had persistent/recurrent HR-HPV positivity at 12 months.
• Seven predictors were identified: age, smoking status, HPV16/18 infection, vaginal pH, non-Lactobacillus-dominant microbiota, bacterial vaginosis, and moderate-to-severe local inflammation.
• The final model showed an AUC of 0.892 in the training cohort and 0.821 in the validation cohort.
• Calibration was acceptable with Hosmer–Lemeshow P-values of 0.149 and 0.296 for the training and validation cohorts, respectively.
• Decision curve analysis indicated net clinical benefit across a range of threshold probabilities.

Clinical Implications

External validation in independent cohorts is necessary before implementation in clinical practice.

Conclusion

The study presents a multivariable prediction model for persistent HR-HPV infection based on vaginal microecology.

Related Resources & Content

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5. Self‐collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline - Perkins - 2026 - CA: A Cancer Journal for Clinicians - Wiley Online Library
6. Bacterial vaginosis in microscopic examination of Pap smears in patients with high-risk HPV is associated with viral persistence and cytological progression in a longitudinal study | Infectious Agents and Cancer | Springer Nature Link
7. Self‐collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline - Perkins - 2026 - CA: A Cancer Journal for Clinicians - Wiley Online Library
8. Bacterial vaginosis in microscopic examination of Pap smears in patients with high-risk HPV is associated with viral persistence and cytological progression in a longitudinal study | Infectious Agents and Cancer | Springer Nature Link