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Ma B, Zhou J, Zhou W, Ma Z, Chen J, Hu H. Nonlinear relationship between viral load and TCT in single/multiple HPV52 infection. Virol J 2024; 21:90. [PMID: 38654353 PMCID: PMC11036758 DOI: 10.1186/s12985-024-02356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE To determine the correlation between HPV (human papillomavirus) 52 viral load, multiple infections and ThinPrep cytology test (TCT), to inform clinical management of HPV52-positive women after cervical cancer screening. METHODS A total of 1,882 female patients who had positive quantitative HPV tests at Yuebei People's Hospital from January 2020 to December 2022, of whom 533 tested positive for HPV52. We excluded patients who combined HPV16 and/or HPV 18 positivity and whom HPV52 viral load could not be calculated. The final enrollment was 488 patients, including 400 NILM, 48 ASC-US, 28 LSIL and 12 HSIL. The HPV test is a quantitative multiplexed fluorescent PCR assay that provides both HPV genotyping and viral load. RESULTS In our study, there were differences in the median distribution of viral loads among various cytological class categories. The risk of TCT results (LSIL or worse) was increased with the increase of HPV52 viral load, for every LOG unit increase in HPV52 viral load, the risk increased by 26.6%. More importantly, we found a nonlinear relationship between HPV52 viral load and TCT results (LSIL or worse) in both single and multiple infections. When the viral load reaches a threshold, the risk of abnormal cytological results increases significantly. CONCLUSION HPV52 viral load is an independent risk factor for TCT results (LSIL or worse). The relationship between HPV52 viral load and TCT results (LSIL or worse) is not linear. Viral load may be used as a triage indicator for HPV52-positive patients, thus improving the post-screening clinical management of HPV52-positive women.
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Affiliation(s)
- Bingbing Ma
- Department of Gynecology, Yuebei People's Hospital affiliated to Shantou University Medical College, Shaoguan, China
| | - Jie Zhou
- Department of Gynecology, Yuebei People's Hospital affiliated to Shantou University Medical College, Shaoguan, China
| | - Weijuan Zhou
- Department of Gynecology, Yuebei People's Hospital affiliated to Shantou University Medical College, Shaoguan, China
| | - Zhanzhong Ma
- Reproductive Medicine Center, Yuebei People's Hospital Affiliated to Shantou University Medical College, Shaoguan, China
| | - Juan Chen
- Department of Gynecology, Yuebei People's Hospital affiliated to Shantou University Medical College, Shaoguan, China
| | - Hongbo Hu
- Department of Gynecology, Yuebei People's Hospital affiliated to Shantou University Medical College, Shaoguan, China.
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Duan Y, Bai H, Li X, Wang D, Wang Y, Cao M, Zhang N, Chen H, Wang Y. Oncolytic adenoviral H101 synergizes with radiation in cervical cancer cells. Curr Cancer Drug Targets 2021; 21:619-630. [PMID: 33687882 DOI: 10.2174/1568009621666210308103541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/13/2021] [Accepted: 01/31/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND A major challenge in cervical cancer radiotherapy is to tailor the radiation doses efficiently to both eliminate malignant cells and to reduce the side effects to normal tissue. Oncolytic adenoviral drug H101 is recently tested and approved for topical adjuvant treatment of several malignancies. OBJECTIVE This study is to evaluate the potential neoadjuvant radiotherapy benefits of H101 by testing the inhibitory function of H101 combined with radiation in different cervical cancer cells. METHODS Human cervical cancer cells C33a, SiHa, CaSki, and Hela were treated with varying concentrations of H101 alone or combined with radiation (2Gy or 4Gy). Cell viability and apoptosis were measured at indicated time intervals. HPV16 E6 and cellular p53 mRNA expression alteration were measured by qRT-PCR. RNA scope in-situ detect HPV E6 status. P53 protein alteration are detected by Western blot. RESULTS Cell viability and apoptosis show the combination of a high dose of H101 (MOI=1000, 10000) with radiation yielded a synergistic anti-cancer effect in all tested cervical cancer cell lines (P<0.05), with the greatest effect achieved in HPV negative C33a cells (P<0.05). Low HPV16 viral load SiHa cell was more sensitive to combination therapy than high HPV16 viral load CaSki cell (P<0.05). The combined treatment could reduce HPV16 E6 expression and increase cellular P53 level compared to radiation alone in SiHa and CaSki (P<0.05). CONCLUSIONS Oncolytic adenoviral H101 effectively enhances the antitumor efficacy of radiation in cervical cancer cells and may serve as a novel combination therapy for cervical cancer.
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Affiliation(s)
- Yixin Duan
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Haixia Bai
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Xiang Li
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Depu Wang
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Yin Wang
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Meng Cao
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Nana Zhang
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Hongwei Chen
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
| | - Yili Wang
- Institute of Molecular Radiobiology of Cancer, Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian. China
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Oyervides-Muñoz MA, Pérez-Maya AA, Sánchez-Domínguez CN, Berlanga-Garza A, Antonio-Macedo M, Valdéz-Chapa LD, Cerda-Flores RM, Trevino V, Barrera-Saldaña HA, Garza-Rodríguez ML. Multiple HPV Infections and Viral Load Association in Persistent Cervical Lesions in Mexican Women. Viruses 2020; 12:E380. [PMID: 32244347 PMCID: PMC7232502 DOI: 10.3390/v12040380] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/18/2020] [Accepted: 03/22/2020] [Indexed: 12/04/2022] Open
Abstract
Persistent high-risk human papillomavirus (HR-HPV) infections play a major role in the development of invasive cervical cancer (CC), and screening for such infections is in many countries the primary method of detecting and preventing CC. HPV typing can be used for triage and risk stratification of women with atypical squamous cells of undetermined significance (ASC-US)/low-grade cervical lesions (LSIL), though the current clinical practice in Mexico is to diagnose CC or its preceding conditions mainly via histology and HR-HPV detection. Additional information regarding these HPV infections, such as viral load and co-infecting agents, might also be useful for diagnosing, predicting, and evaluating the possible consequences of the infection and of its prevention by vaccination. The goal of this follow-up hospital case study was to determine if HPV types, multiple HPV infections, and viral loads were associated with infection persistence and the cervical lesion grade. A total of 294 cervical cytology samples drawn from patients with gynecological alterations were used in this study. HPV types were identified by real-time PCR DNA analysis. A subset of HPV-positive patients was reevaluated to identify persistent infections. We identified HPV types 16, 18, and 39 as the most prevalent. One hundred five of the patients (59%) were infected with more than one type of HPV. The types of HPV associated with multiple HPV infections were 16, 18, and 39. In the follow-up samples, 38% of patients had not cleared the initially detected HPV infection, and these were considered persistent. We found here an association between multiple HPV infections and high viral loads with and infection persistence. Our findings suggest there are benefits in ascertaining viral load and multiple HPV infections status of HR-HPV infections for predicting the risk of persistence, a requirement for developing CC. These findings contribute to our understanding of HPV epidemiology and may allow screening programs to better assess the cancer-developing risks associated with individual HR-HPV infections.
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Affiliation(s)
- Mariel A. Oyervides-Muñoz
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Antonio A. Pérez-Maya
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Celia N. Sánchez-Domínguez
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Anais Berlanga-Garza
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Mauro Antonio-Macedo
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Lezmes D. Valdéz-Chapa
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Ricardo M. Cerda-Flores
- Facultad de Enfermería, Universidad Autónoma de Nuevo León, Av. Dr. José Eleuterio González 1500, Mitras Centro, 64460 Nuevo León, Mexico;
| | - Victor Trevino
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, 3000 Av. Morones Prieto, Colonia Los Doctores, 64710 Nuevo León, Mexico;
| | - Hugo A. Barrera-Saldaña
- Vitagénesis SA. Blvd. Puerta del Sol 1005. Colinas de San Jerónimo. Monterrey, 64630 Nuevo León, Mexico
| | - María L. Garza-Rodríguez
- Centro Universitario contra el Cancer, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico
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Berggrund M, Gustavsson I, Aarnio R, Hedlund-Lindberg J, Sanner K, Wikström I, Enroth S, Olovsson M, Gyllensten U. HPV viral load in self-collected vaginal fluid samples as predictor for presence of cervical intraepithelial neoplasia. Virol J 2019; 16:146. [PMID: 31771594 PMCID: PMC6880361 DOI: 10.1186/s12985-019-1253-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/13/2019] [Indexed: 12/19/2022] Open
Abstract
Objective This study was performed to evaluate the use of high-risk HPV (hrHPV) viral load in screening tests for cervical cancer to predict persistent infection and presence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Methods We followed women between 30 and 60 years of age who performed self-sampling of vaginal fluid and subsequently a hrHPV test. Women who were hrHPV positive in their screening test repeated the hrHPV test 3–6 months later and were included in the present study. Results Our results show that women with a persistent HPV16 infection had higher HPV viral load in their primary screening test than women with transient infections (p = 5.33e-03). This was also true for sum of viral load for all hrHPV types in the primary screening test (p = 3.88e-07). 48% of women with persistent HPV16 infection and CIN2+ had an increase in HPV16 titer in the follow-up test, as compared to only 20% of women with persistent infection but without CIN2+ lesions. For the sum of all hrHPV types, 41% of women with persistent infection and CIN2+ had an increase in titer as compared to 26% of women without CIN2 + . Conclusions The results show that hrHPV viral load in the primary screening HPV test is associated with the presence of CIN2+ and could be used in triaging hrHPV positive women for different follow-up strategies or recall times. Serial testing of hrHPV viral load has the potential to distinguish women with CIN2+ lesions from women with persistent infection but without CIN2+ lesions.
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Affiliation(s)
- Malin Berggrund
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Inger Gustavsson
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Riina Aarnio
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Julia Hedlund-Lindberg
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Karin Sanner
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Ingrid Wikström
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Stefan Enroth
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Ulf Gyllensten
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden.
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Menon S, Luchters S, Rossi R, Callens S, Kishor M, Bogers J, vanden Broeck D. Human papilloma virus correlates of high grade cervical dysplasia in HIV-infected women in Mombasa, Kenya: a cross-sectional analysis. Virol J 2018; 15:54. [PMID: 29587796 PMCID: PMC5870930 DOI: 10.1186/s12985-018-0961-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 03/12/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Women living with HIV are at increased risk to be co-infected with HPV, persistent high-risk (HR) human papillomavirus (HPV) infection and increased HR HPV viral load, which make them more at risk for cervical cancer. Despite their inherent vulnerability, there is a scarcity of data on potential high risk (pHR) and HR HPV genotypes in HIV- infected women with cervical dysplasia and HPV-type specific viral load in this population in Sub Saharan Africa. The aim of this analysis of HIV-infected women was to explore the virological correlates of high-grade cervical dysplasia (CIN 2+) in HIV-infected women, thereby profiling HPV genotypes. METHOD This analysis assesses baseline data obtained from a cohort study of 74 HIV-infected women with abnormal cytology attending a Comprehensive Care Centre for patients with HIV infection in Mombasa, Kenya. Quantitative real-time PCR was used for HPV typing and viral load. RESULTS CIN 2 was observed in 16% (12/74) of women, CIN 3 in 23% (17/74), and, invasive cervical carcinoma (ICC) in 1% (1/74) of women. In women with CIN 3+, HPV 16 (44%), HPV 56 (33%), HPV 33 and 53 (HPV 53 (28%) were the most prevalent genotypes. HPV 53 was observed as a stand-alone HPV in one woman with ICC. A multivariate logistic regression adjusting for age, CD4 count and HPV co-infections suggested the presence of HPV 31 as a predictor of CIN 2+ (adjusted odds ratio [aOR]:4.9; p = 0.05; 95% (Confidence Interval) [CI]:1.03-22.5). Women with CIN2+ had a significantly higher viral log mean of HPV 16, (11.2 copies/ 10,000 cells; 95% CI: 9.0-13.4) than with CIN 1. CONCLUSION The high prevalence of HPV 53 in CIN 3 and as a stand-alone genotype in the patient with invasive cervical cancer warrants that its clinical significance be further revisited among HIV-infected women. HPV 31, along with elevated means of HPV 16 viral load were predictors of CIN 2 + .
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Affiliation(s)
- Sonia Menon
- International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
| | - Stanley Luchters
- International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- Burnet Institute, Melbourne, VIC Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
| | - Rodolfo Rossi
- Primary Health Care Services, International Committee of the Red Cross (ICRC), Geneva, Switzerland
| | - Steven Callens
- International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- Department of Internal Medicine & Infectious diseases, University Hospital, Ghent, Belgium
| | | | - Johannes Bogers
- International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- Faculty of Medicine and Health Sciences, AMBIOR (Applied Molecular Biology Research Group), Laboratory of Cell Biology & Histology, University of Antwerp, Melbourne, Belgium
| | - Davy vanden Broeck
- International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- Faculty of Medicine and Health Sciences, AMBIOR (Applied Molecular Biology Research Group), Laboratory of Cell Biology & Histology, University of Antwerp, Melbourne, Belgium
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Ding Z, Li Y, Chen A, Song M, Zhang Y. Punch biopsy guided by both colposcopy and HR-HPV status is more efficient for identification of immediate high-grade squamous intraepithelial lesion or worse among HPV-infected women with atypical squamous cells of undetermined significance. Eur J Obstet Gynecol Reprod Biol 2016; 207:32-36. [PMID: 27816739 DOI: 10.1016/j.ejogrb.2016.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/11/2016] [Accepted: 10/10/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To investigate the accuracy of colposcopy for diagnosing high-grade squamous intraepithelial lesion (HSIL) or worse (HSIL+) in human papillomavirus (HPV)-infected patients with atypical squamous cells of undetermined significance (ASCUS) cytology, and determine whether genotyping and viral load quantitation can be useful for detecting immediate HSIL+ risk in these patients. STUDY DESIGN This study included 620 cases with ASCUS and positive for high-risk (HR)-HPV within 1 month before or after cervical cytology at Qilu Hospital between February 2013 and February 2014. Based on the colposcopic impression, lesion-targeted punch biopsy, endocervical curettage biopsy or random cervical punch biopsy in four quadrants was performed on these patients within 1 month. The accuracy of colposcopy for diagnosing HSIL+ was evaluated through comparison with the biopsy results. HR-HPV status determined by Hybrid Capture 2 or HPV genotyping was analysed retrospectively as a possible predictor of HSIL+. RESULTS Agreement between colposcopic impression and cervical pathology was matched perfectly in 89.2% of cases (553/620), and the strength of agreement with the κ statistic was 0.698 (p<0.001). Colposcopy had high specificity (96.9%) but low sensitivity for detecting HSIL+ (67.5%). The risk of HSIL+ was significantly higher in patients with HPV-16 infection (52.3%) than in patients infected with other types of HPV (17.9%, p<0.001). HSIL+ and virus load was correlated at cut-offs (CO) of 50 relative light units (RLU)/CO and 100 RLU/CO (p=0.024 and 0.044, respectively). If considering HPV16 infection or high virus load (at 50 RLU/CO) as a diagnostic standard of HSIL+ when colposcopic impression was negative, sensitivity was improved to 74.7% and 81.0%, respectively. CONCLUSIONS Good agreement was found between colposcopic and pathologic diagnosis. HR-HPV genotyping or virus load is relevant to the detection of HSIL+ among HPV-infected patients with ASCUS cytology. In these patients, biopsies considering HPV-16 infection or virus load ≥50 RLU/CO may be helpful for increasing the HSIL+ detection rate.
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Affiliation(s)
- Z Ding
- Qilu Hospital, Shandong University, Jinan, Shandong, China; The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Y Li
- The Second People's Hospital of Liao Cheng, Liao Cheng, Shandong, China
| | - A Chen
- The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - M Song
- Qingdao Tumour Hospital, Qingdao, Shandong, China
| | - Y Zhang
- Qilu Hospital, Shandong University, Jinan, Shandong, China.
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Maia LB, Marinho LC, Carneiro MV, Bocca AL, Neto F, Motoyama AB, Muniz Junqueira MI, Ferreira V, Carneiro FP, de Oliveira PG. HPV load and anal cytological abnormalities. HIV Med 2015; 17:467-70. [PMID: 26344207 DOI: 10.1111/hiv.12317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the association between estimated human papillomavirus (HPV) viral load and abnormal cytology on anal samples. METHODS Anal cytological samples of 42 HIV-positive patients were analysed by conventional cytology and Hybrid Capture II. RESULTS On cytology, 30.95% (13 of 42) anal samples were positive for cytological abnormalities, 47.61% (20 of 42) were negative and 21.42% (nine of 42) were unsatisfactory. High-risk HPV infection was more frequent in anal samples with cytological abnormalities than in negative samples (P = 0.0002, Fisher's exact test), it was detected in all samples with cytological abnormalities and in 35% (seven of 20) of the negative samples. On samples with cytological abnormalities, the median of the relative light unit/cutoff (RLU/CO) value (viral load estimate) was 10.39 (1.02-572.6) and in negative samples it was 0.51 (0.26-51.70). The median of the RLU/CO value was higher in samples with cytological abnormalities when compared with the median in negative samples (P = 0.0001, Mann-Whitney U-test) and only samples with cytological abnormalities showed RLU/CO values > 100. CONCLUSIONS The estimated high-risk HPV viral load is significantly higher in samples with cytological abnormalities than in negative anal samples and may be useful as an adjunct to anal cytology for triage of patients to high-resolution anoscopy and biopsy.
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Affiliation(s)
- L B Maia
- Department of Pathology, University Hospital of Brasilia, Brasilia, Brazil
| | - L C Marinho
- Department of Pathology, University Hospital of Brasilia, Brasilia, Brazil
| | - M V Carneiro
- Gastroenterology Service of Base Hospital of Brasilia, Brasilia, Brazil
| | - A L Bocca
- Department of Pathology, University Hospital of Brasilia, Brasilia, Brazil
| | - Ffc Neto
- Department of Pathology, University Hospital of Brasilia, Brasilia, Brazil
| | - A B Motoyama
- Department of Pathology, University Hospital of Brasilia, Brasilia, Brazil
| | | | - Vmm Ferreira
- Department of Pathology, University Hospital of Brasilia, Brasilia, Brazil
| | - F P Carneiro
- Department of Pathology, University Hospital of Brasilia, Brasilia, Brazil
| | - P G de Oliveira
- Coloproctology Service of University Hospital of Brasilia, Brasilia, Brazil
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Thomsen LT, Frederiksen K, Munk C, Junge J, Iftner T, Kjaer SK. Long-term risk of cervical intraepithelial neoplasia grade 3 or worse according to high-risk human papillomavirus genotype and semi-quantitative viral load among 33,288 women with normal cervical cytology. Int J Cancer 2014; 137:193-203. [PMID: 25471319 DOI: 10.1002/ijc.29374] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 10/29/2014] [Accepted: 11/24/2014] [Indexed: 11/11/2022]
Abstract
In this prospective cohort study, we estimated the long-term risk of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) by high-risk human papillomavirus (hrHPV) genotype and semi-quantitative viral load at baseline among 33,288 women aged 14-90 years with normal baseline cytology. During 2002-2005, residual liquid-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark. Samples were HPV-tested with Hybrid Capture 2 (HC2) and genotyped with INNO-LiPA. Semi-quantitative viral load was measured by HC2 relative light units in women with single hrHPV infections. The cohort was followed in a nationwide pathology register for up to 11.5 years. In women aged ≥30 years at baseline, the 8-year absolute risk for CIN3+ following baseline detection of HPV16 was 21.8% (95% confidence interval [CI]: 18.0-25.6%). The corresponding risks for HPV18, HPV31, HPV33, and other hrHPV types, respectively, were 12.8% (95% CI: 7.6-18.0%), 11.3% (95% CI: 7.7-14.9%), 12.9% (95% CI: 7.0-18.8%) and 3.9% (95% CI: 2.7-5.2%). Similar absolute risk estimates were observed in women aged <30 years. Higher HPV16-viral load was associated with increased risk of CIN3+ (hazard ratio = 1.34, 95% CI: 1.10-1.64, per 10-fold increase in viral load). A similar trend, although statistically nonsignificant, was found for viral load of HPV18. The 8-year absolute risk of CIN3+ in women with HPV16-viral load ≥100.0 pg/ml was 30.2% (95% CI: 21.9-38.6%). Our results support that hrHPV genotyping during cervical cancer screening may help identify women at highest risk of CIN3+.
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Affiliation(s)
- Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
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