Recombination in Papillomavirus: Controversy and Possibility

Virus Res. 2022 Jun;314:198756. doi: 10.1016/j.virusres.2022.198756. Epub 2022 Mar 30.


Papillomaviruses (PV) have a wide distribution of hosts, among which human papillomavirus (HPV) has been recognized as the major cause of cervical cancer. HPV is characterized by its high genetic variability with more than 200 genotypes identified, and numerous variants exist within the same genotype. Though phylogenetic incongruence between early gene and late gene of PVs was observed, the recombination in HPV was not taken seriously until the last two decades. The first report of evidence on HPV recombination was published in 2006, in which only intertypic ancient recombination events were identified. Since then, several publications on recombination in HPV provided evidence for intertypic as well as intratypic recombination. Recombination may create challenges on HPV genotyping and vaccination that could cause a great impact in screening and prevention of cervical cancer. Here, we review the literature on recombination and summarize the reasons underlying the difficulties for detecting recombination in HPV. In addition, we analyze the potential consequences of HPV recombination and make further prospects for clinical practice in the future.

Keywords: Human papillomavirus; multiple infections; phylogenetic congruence; recombination; vaccine.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alphapapillomavirus*
  • Female
  • Genotype
  • Humans
  • Papillomaviridae / genetics
  • Papillomavirus Infections*
  • Papillomavirus Vaccines* / genetics
  • Phylogeny
  • Recombination, Genetic
  • Uterine Cervical Neoplasms*
  • Viruses, Unclassified*


  • Papillomavirus Vaccines