Reviewer’s report
Title: 
Outcomes of HPV type-specific serostatus do not associate with oral or
genital HPV-carriage in non-vaccinated women followed for three years
Version: 
0 
Date: 
29 Nov 2021
Reviewer's report:
The Finnish Family HPV study is an important resource which has already
resulted in significant publications, but the numbers of samples applicable to any
particular study are relatively small (267 in this case). This is recognised by the
authors in the Discussion, where ORs could rarely be assessed because of the
small numbers in every category. It is perhaps disappointing that no significant
role was found for acquired natural HPV antibodies, even when persistent or
high titre, as determinants of genital or oral HPV infection outcomes in this
cohort. However, this may be associated with the groupings selected, while at the
individual level there might well have been some protection from acquisition.
The first sentence under Results in the Abstract states 'Genital HPV16 infections
were most prevalent at the end of the follow-up (24- and 36- month visit) among
women who tested always seronegative for HPV16'. This is clear. The
manuscript would be better balanced if there was more on women who acquired
HPV infection during the 3 years of follow-up and changes to their serological
status. 
Perhaps it is not possible to assess acquisition/reinfection from the
samples and timings available - this should be explained. The Discussion does
cover the relatively weaker response from natural than from vaccine-induced
antibodies in general terms, but comments should be related more to this study
and acknowledge better its limitations, particularly in linking serological
response to HPV acquisition. 
P5 lines 49-51 'Logistic regression with its Odd Ratio (OR) was calculated as a
likelihood of the above serostatus to predict HPV persistence or clearance' Can
acquisition be added to this analysis? See above.
P7 lines 12-27 This part is not clear and should be re-written e.g. lines 15-17 this
sentence is confusing, as are sentences between Lines 22 and 27 with one talking
about follow-up and other about any other follow-up. This needs clarification
and re-phrasing. The sentence in the abstract is much clearer.
Tables 1 &2. Complex data but not easily interpreted. Is the % is in each column
the % of HPV infections? The figures don't always add up to 100% and I doubt
if they add anything to the ability to interpret the Table. 
Typos: 
P5 line 10 
- define MFI
P9 line 55 'some of these' women
P10 line 17 It has been hypothesised........ 
P01 line 49 'highest titres of……. Also note English spelling of titre
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