Association between Quantitative High-Risk Human Papillomavirus DNA Load and Cervical Intraepithelial Neoplasm Risk

Abstract

Human papillomavirus (HPV) infection is a high-risk factor for cervical intraepithelial neoplasm (CIN) but the association between the quantitative HPV DNA load and the severity of CIN remains controversial. We conducted a community study to investigate the correlation between the two. Potential study subjects were selected through Pap smear screening in Kaohsiung County, Taiwan. Ninety-one subjects with either their first case of inflammation or zCIN1 by biopsy confirmation were assigned to a case group; 175 normal subjects with negative findings by Pap smears or biopsies were assigned to a control group. Cervical HPV load was detected with Hybrid Capture II assay for high-risk HPV infection, with nested PCR for high-and low-risk HPV infection, and with type-specific PCR for HPV type 16 (HPV-16). Individuals with positive high-risk HPV infection had an increased risk of developing CIN. Compared with HPVnegative subjects, the odds ratios were 32.2 [95% confidence interval (95% CI), 10.4-99.5] for subjects with CIN1, 37.2 (95% CI, 7.4-187.6) for subjects with CIN2, and 68.3 (95% CI, 14.1-328.5) for subjects with zCIN3 after adjusting for other confounding factors. The similar trend was also found among the HPV-16 -negative individuals. In addition, high-risk HPV DNA load levels were highly correlated with the different grades of CINs in the overall population (Spearman's correlation coefficient r = 0.67, P < 0.0001, n = 266) and the HPV-16 -negative population (Spearman's correlation coefficient r = 0.58, P < 0.0001, n = 234). We concluded that high-risk HPV infection, irrespective of HPV-16 infection, was highly and positively associated with the development of CIN. (Cancer Epidemiol Biomarkers Prev 2005;14(11):2544 -9)

Analysis of Human Papillomavirus Type 16 (HPV16) DNA Load and Physical State for Identification of HPV16-Infected Women with High-Grade Lesions or Cervical Carcinoma

“…This trend was further confirmed when histology results were taken into account. Thus, our data confirm previous observations suggesting that the higher the grade of the lesion, the higher is the viral load, even though statistical analyses were not always available (1,9,11,18,24,25,39,50,51,55,56). We would like to point out that a direct comparison between our results and those obtained in previous reports may be difficult because no standardized procedures were reported.…”

“…(ii) Different methods for HPV detection, more or less quantitative, were used: MY09/ MY11 PCR followed by type-specific dot blot hybridization (24), PCR followed by an enzyme-linked immunosorbent assay (56), conventional nested PCR (50), real-time PCR using SYBR green (11,39), real-time PCR using the TaqMan technology (9,18,25,55), and consensus real-time PCR (1). (iii) Results were expressed by different means: copies per cell (1,56), copies per ng of DNA (11,25), copies per sample (39,50), and qualitatively (18,24). Thus, the value of viral load calculated is likely to be dependent on the procedures used to quantify HPV DNA.…”

Semi‐quantitative HPV viral load in patients with ASC‐US cytology: viral load correlates strongly with the presence of CIN but only weakly with its severity

“…2,[15][16][17][18] Similar to previous studies on HPV viral load in cases of ASC-US cytology, 2,11 our study indicates that an increasing HPV viral load in ASC-US cases correlates with the severity of the cervical lesions, although the difference was greater between no CIN and CIN1+ than between CIN1 and CIN2+. This study was performed in patients diagnosed as having ASC-US at one institute.…”

Correlation between hybrid capture II high‐risk human papillomavirus DNA test chemiluminescence intensity from cervical samples with follow‐up histologic results

“…19 In addition, to our knowledge only a few studies to date have examined the relation between the level of hrHPV found in cervical specimens and the incidence of cervical dysplasia detected on follow-up histology. 20,21 Because the HC II is a qualitative as well as semiquantitative test, the RLU/CO value may be used as a surrogate for the hrHPV level (ie, copy number). In this study, we further examined the relation between the hrHPV level and the presence of dysplasia on follow-up histology.…”