title: 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 > or =CIN1 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 HPV-negative 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 > or =CIN3 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.
authors.affiliation: Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Building CS 917, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
authors.forename: Hsiu-Ting
authors.initials: HT
authors.lastname: Tsai
authors.forename: Ching-Hu
authors.initials: CH
authors.lastname: Wu
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Lai
authors.forename: Ruei-Nian
authors.initials: RN
authors.lastname: Li
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Tung
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chuang
authors.forename: Trong-Neng
authors.initials: TN
authors.lastname: Wu
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Lin
authors.forename: Chi-Kung
authors.initials: CK
authors.lastname: Ho
authors.forename: Hon-Wein
authors.initials: HW
authors.lastname: Liu
authors.forename: Ming-Tsang
authors.initials: MT
authors.lastname: Wu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics* / Q000472:pathogenicity; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications*; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000209:etiology* / Q000821:virology*; D014626:Vaginal Smears; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000209:etiology* / Q000821:virology*
chemical_list: D004279:DNA, Viral