Abstract
BackgroundAnalysing human papillomavirus (HPV) viral load is important in determining the risk of developing cervical cancer (CC); most knowledge to date regarding HPV viral load and cervical lesions has been related to HPV-16. This study evaluated the association between the viral load of the six most prevalent high-risk viral types in Colombia and cervical intraepithelial neoplasia (CIN) frequency.Methods114 women without CIN and 59 women having CIN confirmed by colposcopy, all of them positive by conventional PCR for HPV infection in the initial screening, were included in the study. Samples were tested for six high-risk HPV types to determine viral copy number by real-time PCR. Crude and adjusted odds ratios (ORa) were estimated for evaluating the association between each viral type’s DNA load and the risk of cervical lesions occurring.ResultsThe highest viral loads were identified for HPV-33 in CIN patients and for HPV-31 in patients without lesions (9.33 HPV copies, 2.95 interquartile range (IQR); 9.41 HPV copies, 2.58 IQR). Lesions were more frequent in HPV-16 patients having a low viral load (3.53 ORa, 1.16–10.74 95%CI) compared to those having high HPV-16 load (2.62 ORa, 1.08–6.35 95%CI). High viral load in HPV-31 patients was associated with lower CIN frequency (0.34 ORa, 0.15–0.78 95%CI).ConclusionsAn association between HPV DNA load and CIN frequency was seen to be type-specific and may have depended on the duration of infection. This analysis has provided information for understanding the effect of HPV DNA load on cervical lesion development.
Highlights
Analysing human papillomavirus (HPV) viral load is important in determining the risk of developing cervical cancer (CC); most knowledge to date regarding HPV viral load and cervical lesions has been related to HPV-16
This meant that 114 women were classified as negative for intraepithelial lesions (92.98% having normal cytology) and 59 women having cervical intraepithelial neoplasia (CIN) identified by colposcopy (56 women having CIN 1 and 3 having CIN 2+) were included in the analysis (Figure 1)
According to the diagnostic algorithm, a biopsy was taken from 59 women having colposcopy-defined cervical lesions; results were only obtained for 45 women as the samples taken for pathology regarding the remaining 14 women were unsatisfactory or had been lost. 23.73% (n = 14) of the women had confirmation of CIN 1 by biopsy
Summary
Analysing human papillomavirus (HPV) viral load is important in determining the risk of developing cervical cancer (CC); most knowledge to date regarding HPV viral load and cervical lesions has been related to HPV-16. This study evaluated the association between the viral load of the six most prevalent high-risk viral types in Colombia and cervical intraepithelial neoplasia (CIN) frequency. The main factor for developing cervical cancer (CC) lies in persistent infection by at least one viral type of highrisk human papillomavirus (HR-HPV). Fifteen types of HR-HPV have been described, 99.7% being associated with cases of CC and/or cervical intraepithelial neoplasia (CIN) [1,2,3]. Prior studies have determined the association between viral load and CC severity, progression and development, whilst others have found that the
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