Association between quantitative high-risk human papillomavirus DNA load and cervical intraepithelial neoplasm risk.
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.
Tsai
Hsiu-Ting
HT
Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Building CS 917, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
Wu
Ching-Hu
CH
Lai
Hsiao-Ling
HL
Li
Ruei-Nian
RN
Tung
Yi-Ching
YC
Chuang
Hung-Yi
HY
Wu
Trong-Neng
TN
Lin
Li-Jen
LJ
Ho
Chi-Kung
CK
Liu
Hon-Wein
HW
Wu
Ming-Tsang
MT
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*
D004279:DNA, Viral