title: Human papillomavirus 16 load in normal and abnormal cervical scrapes: an indicator of CIN II/III and viral clearance.
abstract: The relation between human papillomavirus type 16 (HPV 16) viral load in cervical scrapes and development of high-grade cervical intraepithelial neoplasia (CIN II or III) was studied in a nested case-control study of women with normal cytology (group A) and in a cohort of women with abnormal cytology (group B). HPV 16 DNA load was determined using a quantitative real-time PCR assay. In group A, case women (women with CIN II/III, n = 12) had a significantly higher viral load than control women (women with CIN < or = I, n = 47). This resulted in an increased relative risk of women with the 50% highest viral load for development of CIN II/III (OR 7.7; CI 1.6-33). In group B, women with CIN II/III (n = 38) had a significantly higher viral load than women with CIN < or = I (n = 25). Women with the 50% highest viral load had an increased relative risk of CIN II/III (OR 3.2; CI 1.1-9.3) and a decreased chance of both viral clearance and cytologic regression. Our data suggest that in women with normal cytology an increased HPV 16 load confers an increased risk of developing a CIN lesion. A sustained high viral load is subsequently informative for progression to a high-grade CIN lesion.
authors.affiliation: Department of Pathology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: van Duin
authors.forename: Peter J F
authors.initials: PJ
authors.lastname: Snijders
authors.forename: Henri F J
authors.initials: HF
authors.lastname: Schrijnemakers
authors.forename: Feja J
authors.initials: FJ
authors.lastname: Voorhorst
authors.forename: Lawrence
authors.initials: L
authors.lastname: Rozendaal
authors.forename: Marielle A E
authors.initials: MA
authors.lastname: Nobbenhuis
authors.forename: Adriaan J C
authors.initials: AJ
authors.lastname: van den Brule
authors.forename: René H M
authors.initials: RH
authors.lastname: Verheijen
authors.forename: Theo J
authors.initials: TJ
authors.lastname: Helmerhorst
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000821:virology*; D013997:Time Factors; D014407:Tumor Cells, Cultured; D014412:Tumor Virus Infections / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology