title: Determination of human papillomavirus (HPV) load and type in high-grade cervical lesions surgically resected from HIV-infected women during follow-up of HPV infection.
abstract: BACKGROUND
  The role of human papillomavirus (HPV) load and the importance of multiple-strain HPV infections as biomarkers for the development of cervical disease were evaluated in human immunodeficiency virus (HIV)-positive women.
  
  
  METHODS
  A total of 108 samples were analyzed, 64 of which were obtained from 16 HIV-positive women who underwent surgical resection of the cervical cone for treatment of a histologically confirmed high-grade cervical intraepithelial neoplasm (cases) and 44 of which were obtained from 22 HIV-positive women who had high-risk HPV but a negative colposcopy result (controls). Each patient underwent periodic examinations at 6-12-month intervals that included colposcopy, Papanicolaou testing, biopsy (if indicated), and cervical brushing for HPV testing. Viral typing was performed by reverse dot-blot hybridization and quantification of viral load by in-house real-time PCR and commercial assays.
  
  
  RESULTS
  Analysis of the cervical-brush samples collected when high-grade squamous intraepithelial lesions were diagnosed revealed that all cases had HPV loads that were significantly higher than those of controls (P=.0004 and P=.0003, by PCR and the Hybrid Capture 2 index [Digene], respectively). Decreasing concentrations of HPV load were observed when comparing samples obtained before and after treatment (P<.0001). The number and type of HPV strains that were detected were not statistically different between cases and controls.
  
  
  CONCLUSIONS
  The significantly higher HPV load detected in women with high-grade cervical dysplasia, as well as the dramatic decrease in the load after surgical removal of the lesion, suggest that HPV load is a possible prognostic marker of high-grade SIL.
authors.affiliation: Laboratory of Virology, Scientific Institute San Raffaele, Milan, Italy. lillo.flavia@hsr.it
authors.forename: Flavia B
authors.initials: FB
authors.lastname: Lillo
authors.forename: Sara
authors.initials: S
authors.lastname: Lodini
authors.forename: Davide
authors.initials: D
authors.lastname: Ferrari
authors.forename: Carol
authors.initials: C
authors.lastname: Stayton
authors.forename: Gianluca
authors.initials: G
authors.lastname: Taccagni
authors.forename: Laura
authors.initials: L
authors.lastname: Galli
authors.forename: Adriano
authors.initials: A
authors.lastname: Lazzarin
authors.forename: Caterina
authors.initials: C
authors.lastname: Uberti-Foppa
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002294:Carcinoma, Squamous Cell / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000821:virology*; D012189:Retrospective Studies; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D019562:Viral Load