title: The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia.
abstract: OBJECTIVE
  We evaluated the human papillomavirus (HPV) DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia (VAIN).
  
  
  METHODS
  A retrospective review of the medical records of patients with a pathological diagnosis of VAIN was performed. Eligible women (N=48) were followed for cytology and HPV DNA test, and colposcopic biopsies were taken at 3- to 6-month intervals. Thirty-seven patients were followed for more than 6 months; their HPV DNA test results were compared to the cytology results for the prediction of disease prognosis.
  
  
  RESULTS
  The degree of VAIN was more severe in patients with a high initial HPV DNA load (p=0.009). Patients with VAIN 2 and VAIN 3 were older than those with VAIN 1 (p=0.005 and 0.008, respectively). In 26 out of 37 patients (70.3%), the VAIN resolved. The other patients had persistent lesions with no progression to invasive vaginal carcinoma. The last follow-up HPV DNA load was significantly higher in the group with persistent VAIN compared to the group with resolved VAIN (p<0.0001). Negative cytology was observed in 25 out of 26 patients in the VAIN resolved group and in nine out of 11 patients in the VAIN persistent group (p=0.205).
  
  
  CONCLUSIONS
  These results suggest that the HPV DNA test, especially for viral load, was more effective for the diagnosis and prediction of persistent VAIN than cytology.
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kyeong A
authors.initials: KA
authors.lastname: So
authors.forename: Jin-Hwa
authors.initials: JH
authors.lastname: Hong
authors.forename: Jong Ha
authors.initials: JH
authors.lastname: Hwang
authors.forename: Seung-Hun
authors.initials: SH
authors.lastname: Song
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Lee
authors.forename: Nak Woo
authors.initials: NW
authors.lastname: Lee
authors.forename: Kyu Wan
authors.initials: KW
authors.lastname: Lee