Abstract
BackgroundHigh-risk human papillomavirus (HR-HPV) load is thought to be influenced by many factors, and the relationship between viral load and the degree of cervical lesion is controversial. This study explored the possible influencing factors of HR-HPV viral load in the uterine cervix.MethodsA total of 605 women who needed colposcopic evaluation for abnormal cervical screening at the Affiliated Hospital of Weifang Medical University, China, between November 2017 and September 2018 were enrolled. Cervical specimens were collected from the endo- and ectocervix separately using two different cervical brushes. The hybrid capture II test was used to measure HR-HPV load. Age, histological severity, number of viral types, and area and location of cervical lesions were recorded. The correlations between viral load and influencing factors were analysed using univariate and multivariate analyses.ResultsHR-HPV load was positively correlated with age, histological severity, multiple HPV types and area of cervical lesions (P < 0.05). Viral load with the combination of endo- and ectocervical sampling was significantly higher than simple endocervical sampling (P < 0.001). Multivariate analysis showed that age, multiple HPV types and area of cervical lesions were independent factors for HR-HPV load with a combination of endo- and ectocervical sampling (P < 0.05). However, only age and area of cervical lesions were independent factors for viral load with simple endocervical sampling (P < 0.05). No significant association was found between viral load and lesion severity in multivariate analysis (P > 0.05).ConclusionHR-HPV load is influenced by age, histological severity, multiple viral types, area of cervical lesion and sampling methods. Age and area of cervical lesions are independent factors for viral load.
Highlights
High-risk human papillomavirus (HR-HPV) load is thought to be influenced by many factors, and the relationship between viral load and the degree of cervical lesion is controversial
It is well established that almost all precancerous and cancerous lesions of the cervix are caused by persistent oncogenic high-risk human papillomavirus (HR-HPV) infection
Correlation of HR‐HPV load and histological severity Based on the colposcopy and pathology findings, 90 of the women were pathologically negative, and 93 were diagnosed with Low-grade squamous intraepithelial lesion (LSIL), 72 with High-grade squamous intraepithelial lesion (HSIL) and 18 with CC
Summary
High-risk human papillomavirus (HR-HPV) load is thought to be influenced by many factors, and the relationship between viral load and the degree of cervical lesion is controversial. It is well established that almost all precancerous and cancerous lesions of the cervix are caused by persistent oncogenic high-risk human papillomavirus (HR-HPV) infection. HPV DNA testing was recently recommended as an alternative to cytology-based cervical cancer screening by the American updated screening guidelines [1]. It is less specific and has low positive predictive value, which is incapable of differentiating transient and persistent infections [2], resulting in excessive management of women with innocuous HPV infections [3]. Many epidemiologic studies have provided strong and consistent evidence that persistent infection with HR-HPV is responsible for the development, maintenance and progression of cervical intraepithelial lesions
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