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Write a short summary of the research’s main findings and how this work has moved the field forward.

This preprint reviews evidence onon mitochondrial DNA (mtDNA) alterations in HPV-associated cancers, and specifically on copy number alterations, point mutations, and deletions. The alterations are explained relative to oxidative stress, apoptosis avoidance, and metabolic reprogramming, and are suggested to involve mitochondrial dysfunction in a supporting function in HPV-driven oncogenesis alongside viral oncogenes E6/E7. The study contributes to the literature by putting mtDNA on a potential foundation for biomarkers and targets for therapy in HPV-related cancers.

Major issues

All of these findings are correlative and cannot clearly establish the causal participation of mtDNA compared to a side effect in HPV oncogenesis.

Sparse explanation for why mtDNA changes are different between HPV-positive and HPV-negative cancers, that would resolve if such observations are virus-specific.

While biomarkers for mtDNA are proposed, the preprint omits clearly presenting the practicability, technique-related problems, and verification required for use in the bedside

Minor issues

The paper is written more descriptively; a more formalized or critical reviews format (tables, figures, effect size) would make it more distinct.

Competing interests

The author declares that they have no competing interests.