Adcock R, et al. - As HPV testing affords a much more sensitive method of detection for high-grade lesions than cytology, but with low specificity, researchers examined the extent to which specificity could be improved with full HPV genotyping, viral load and multiplicity of types. Thirteen high-risk HPV genotypes were tested in a population-based sample of 47,120 women undergoing cervical screening. For HPV genotype and viral load, they estimated positive predictive values (PPV) for CIN grade 2 or worse (CIN2+; N = 3,449) and CIN3 or worse (CIN3+; N = 1,475) over 3 years of follow-up. A hierarchy of HPV genotypes based on sequentially maximizing PPVs for CIN3+ revealed HPV16>33>31 as the most predictive, followed sequentially by HPV18>35>58>45>52>59>51>39>56>68. Findings suggest a significant predictive value of HPV genotype and viral load, but not of the multiplicity of HPV infections for CIN2+ and CIN3+. These findings may assist in individualizing triage plans, particularly as HPV becomes the primary screening test.