{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:15:48Z","timestamp":1780064148029,"version":"3.54.0"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Persistent high\u2010risk human papillomavirus (HPV) infection is the primary cause of cervical cancer, with co\u2010factors such as hepatitis B virus (HBV) playing a role in oncogenic progression. This study investigates the interaction of HPV and HBV coinfection with cervical cancer risk. A total of 4488 women undergoing cervical cancer screening and HPV and HBV testing were included in this study, employing multinomial regression to analyze associations between viral infections and cervical intraepithelial neoplasia and cancer, while interaction analysis assessed synergistic effects on cervical carcinogenesis and examined the mediating role of ki67 in co\u2010infections. Co\u2010infection significantly increases the risk of all levels of cervical lesions compared to the reference group, with odds ratios for LSIL, HSIL, and cervical cancer demonstrating substantial elevation (OR\u2009=\u20093.13, 95% CI: 2.25\u20134.35; OR\u2009=\u20093.5, 95% CI: 2.55\u20134.81; and OR\u2009=\u200911.49, 95% CI: 5.85\u201322.57; respectively). On the additive scale, significant positive interactions were observed between HPV and HBV. Specifically, for cervical cancer, there was an attributable proportion (AP) due to interaction of 0.43 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01), and a synergy index (SI) of 1.88 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Similarly, for HSIL, significant positive interactions were noted with AP\u2009=\u20090.28 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01) and SI\u2009=\u20091.65 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Mediation analysis revealed that Ki67+ accounted for 49.39%, 70.44%, and 78.81% of the total effect of HPV and HBV co\u2010infection on cervical cancer, HSIL, and LSIL, respectively (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). HPV and HBV coinfection significantly impacts cervical lesions, enhancing cervical oncogenesis synergistically. Ki67 may be involved in mediating the process of cancer progression caused by viral co\u2010infection, stressing comprehensive screening and molecular interaction research.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70454","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T02:35:08Z","timestamp":1750818908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of HPV\/HBV Coinfection on Cervical Cancer Risk: Potential Mediating Role of Ki67"],"prefix":"10.1002","volume":"97","author":[{"given":"Yulong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou 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Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiling","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanzhao","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangqin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-3912","authenticated-orcid":false,"given":"Haibo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical, Medical for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University Fuzhou China"},{"name":"Department of Epidemiology and Health Statistics, School of Public Health Fujian Medical University Fuzhou 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S.","year":"2007","journal-title":"Journal of Experimental & Clinical Cancer Research: CR"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/ctm2.971"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/153.8.723"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1206528"},{"issue":"7","key":"e_1_2_11_48_1","first-page":"3201","article-title":"Expression of the p16 and Ki67 in Cervical Squamous Intraepithelial Lesions and Cancer","volume":"17","author":"Kanthiya K.","year":"2016","journal-title":"Asian Pacific Journal of Cancer Prevention: APJCP"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14005"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/life11040336"},{"issue":"2","key":"e_1_2_11_51_1","first-page":"228","article-title":"[Expression of Ki\u201067 and P53 Protein in Oral Squamous Cell Carcinoma and Its Clinical Significance]","volume":"24","author":"He W.","year":"2015","journal-title":"Shanghai Kou Qiang Yi Xue = Shanghai Journal of Stomatology"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.01.030"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.70454","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.70454","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.70454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:53:20Z","timestamp":1780062800000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.70454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,24]]},"references-count":51,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/jmv.70454"],"URL":"https:\/\/doi.org\/10.1002\/jmv.70454","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,24]]},"assertion":[{"value":"2024-11-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70454"}}