High load for most high risk human papillomavirus genotypes is associated with prevalent cervical cancer precursors but only HPV16 load predicts the development of incident disease
Open Access
- 23 August 2007
- journal article
- research article
- Published by Wiley in International Journal of Cancer
- Vol. 121 (12), 2787-2793
- https://doi.org/10.1002/ijc.23012
Abstract
Cervicovaginal human papillomavirus (HPV) viral load has been purported as a potential marker for the detection of high‐grade cervical intraepithelial neoplasia or cancer (≥CIN2). To examine disease association with type‐specific viral load for the full‐range of anogenital HPV infections, we conducted cross‐sectional and prospective analyses of ∼2,000 HPV‐infected women from a 10,000‐woman population‐based study in Guanacaste, Costa Rica with 7 years of follow‐up. Cervical specimens were tested for >40 HPV types using a MY09/MY11 L1 consensus primer PCR method with type‐specific dot blot hybridization and PCR signal intensity as a measure of viral load. A positive association was observed between prevalent ≥CIN2 and high viral load compared to low viral load for women with baseline single HPV16 infections (OR = 19.2, 95% CI = 4.4–83.2) and single non‐16 carcinogenic infections (OR = 9.2, 95% CI = 2.1–39.9). Inclusion of women with multiple HPV types did not substantially change these associations. In prospective follow‐up, only women infected with HPV16 alone (OR = 27.2, 95% = 3.5–213.5) had a strong association between high viral load and incident ≥CIN2; non‐16 carcinogenic high viral load was not associated with incident ≥CIN2 (OR = 0.7, 95% CI = 0.2–1.9). Single noncarcinogenic type viral load was not associated with increased risk of prevalent or incident ≥CIN2 (OR = 1.2 and 1.1, respectively). In conclusion, carcinogenic high viral load was associated with prevalent ≥CIN2; however HPV16 was uniquely associated with incident ≥CIN2. The extent to which these observations can be translated into clinical practice must be rigorously examined in the context of the method of viral load measurement and the type‐specific differences observed for incident ≥CIN2.Keywords
This publication has 32 references indexed in Scilit:
- Cross‐sectional analysis of oncogenic HPV viral load and cervical intraepithelial neoplasiaInternational Journal of Cancer, 2005
- Semiquantitative Human Papillomavirus Type 16 Viral Load and the Prospective Risk of Cervical Precancer and CancerCancer Epidemiology, Biomarkers & Prevention, 2005
- Determination of Human Papillomavirus (HPV) Load and Type in High-Grade Cervical Lesions Surgically Resected from HIV-Infected Women during Follow-up of HPV InfectionClinical Infectious Diseases, 2005
- A Study of the Impact of Adding HPV Types to Cervical Cancer Screening and Triage TestsJNCI Journal of the National Cancer Institute, 2005
- Hybrid capture 2 viral load and the 2-year cumulative risk of cervical intraepithelial neoplasia grade 3 or cancerAmerican Journal of Obstetrics and Gynecology, 2004
- Type‐specific associations of human papillomavirus load with risk of developing cervical carcinoma in situInternational Journal of Cancer, 2004
- Description of a seven-year prospective study of human papillomavirus infection and cervical neoplasia among 10 000 women in Guanacaste, Costa RicaRevista Panamericana de Salud Pública, 2004
- Host genetic control of HPV 16 titer in carcinoma in situ of the cervix uteriInternational Journal of Cancer, 2002
- Association Between Human Papillomavirus Type and Clonal Status of Cervical Squamous Intraepithelial LesionsJNCI Journal of the National Cancer Institute, 1996
- Prevalence of Human Papillomavirus in Cervical Cancer: a Worldwide PerspectiveJNCI Journal of the National Cancer Institute, 1995