The Relationship Between Metal Exposure and HPV Infection: Evidence from Explainable Machine Learning Methods.

Area of Science:

• Environmental Health
• Epidemiology
• Toxicology

Background:

• Human papillomavirus (HPV) is a major cause of cervical and other cancers globally.
• Existing HPV vaccines do not cover all oncogenic subtypes.
• The role of metal exposure in HPV infection risk and progression is under-researched.

Purpose of the Study:

• To investigate the association between single and mixed metal exposures and HPV infection.
• To evaluate the contribution of metal exposure to HPV infection prevalence.

Main Methods:

• Cross-sectional analysis of 2765 women from the National Health and Nutrition Examination Survey (NHANES) 2007-2016.
• Multivariate logistic regression for single metal exposure (Cobalt [Co], Lead [Pb]).
• Weighted Quantile Sum (WQS) regression for mixed metal exposure.
• XGBoost + SHapley Additive exPlanations (SHAP) for feature importance.

Main Results:

• Elevated Pb concentration was associated with increased HPV infection (OR 1.176).
• Elevated Co concentration was inversely associated with HPV infection (OR 0.891).
• Combined metal exposure (WQS index) showed a positive association with HPV infection (OR 1.249).
• SHAP analysis identified number of sexual partners, marital status, PIR, Co, Pb, and alcohol consumption as key factors.

Conclusions:

• Lead exposure is linked to higher HPV infection rates, while cobalt exposure shows a protective effect.
• Cumulative exposure to multiple metals may increase HPV infection prevalence.
• Environmental metal exposure is a potential factor influencing HPV infection risk.