title: High levels of HPV-16 DNA are associated with high-grade cervical lesions in women at risk or infected with HIV.
abstract: OBJECTIVE
  To examine associations between levels of episomal and integrated human papillomavirus (HPV) 16 DNA and the grade of cervical disease.
  
  
  METHODS
  Cross-sectional data were obtained from a cohort of women with and without HIV infection and with high-risk sexual behaviour.
  
  
  METHODS
  Episomal and integrated HPV-16 DNA loads were measured in cervicovaginal lavages collected from 75 women (58 HIV seropositive, 17 HIV seronegative) using real-time polymerase chain reaction assays, controlling for cell content and the presence of inhibitors.
  
  
  RESULTS
  HPV-16 viral loads were significantly higher in women with high-grade squamous intraepithelial lesions (n = 6) than in women with normal cytology (n = 44), whether total (10(8.28) versus 10(5.10) HPV-16 DNA copies/microg DNA), episomal (10(7.99) versus 10(4.61)) or integrated (10(7.95) versus 10(4.77)) HPV-16 viral loads were measured (P < 0.02 for each comparison). Thirty-nine women had colposcopy [11 normal cervix, 16 cervical intraepithelial neoplasia (CIN) 1, six CIN 2, six CIN 3] and 24 additional women had three consecutive normal cytology smears. Controlling for age, race, CD4 cell count and HIV status, total (OR 3.5, 95% CI 1.2-10.4; P = 0.02), episomal (OR 2.9, 95% CI 1.2-7.4; P = 0.02,) and integrated (OR 1.6, 95% CI 1-2.6; P = 0.05) HPV-16 DNA loads were significantly associated with CIN 2,3, but the differences between CIN 1 and CIN 2,3 were not significant (P > 0.06). A greater amount of cellular DNA was collected from women with CIN 2,3 (P = 0.007).
  
  
  CONCLUSIONS
  Higher HPV-16 DNA loads are associated with cervical lesions detected by either histology or cytology. No additional information is gained by measuring integrated or episomal over total HPV-16 DNA loads.
authors.affiliation: Laboratoire de Virologie Moléculaire, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Fontaine
authors.forename: Catherine
authors.initials: C
authors.lastname: Hankins
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Mayrand
authors.forename: Jonas
authors.initials: J
authors.lastname: Lefevre
authors.forename: Deborah
authors.initials: D
authors.lastname: Money
authors.forename: Simon
authors.initials: S
authors.lastname: Gagnon
authors.forename: Anita
authors.initials: A
authors.lastname: Rachlis
authors.forename: Karina
authors.initials: K
authors.lastname: Pourreaux
authors.forename: Alex
authors.initials: A
authors.lastname: Ferenczy
authors.forename: François
authors.initials: F
authors.lastname: Coutlée
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000821:virology; D003127:Colposcopy; D003430:Cross-Sectional Studies; D015344:DNA Probes, HPV; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D015658:HIV Infections / Q000821:virology*; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000821:virology*; D016133:Polymerase Chain Reaction; D012309:Risk-Taking; D014412:Tumor Virus Infections / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000821:virology*; D014626:Vaginal Smears; D019562:Viral Load
chemical_list: D015344:DNA Probes, HPV; D004279:DNA, Viral