Determination of Human Papillomavirus (HPV) Load and Type in High-Grade Cervical Lesions Surgically Resected from HIV-Infected Women during Follow-up of HPV Infection

• Published in: Clinical infectious diseases 2005-02, Vol.40 (3), p.451-457
• Main Authors: Lillo, Flavia B., Lodini, Sara, Ferrari, Davide, Stayton, Carol, Taccagni, Gianluca, Galli, Laura, Lazzarin, Adriano, Uberti-Foppa, Caterina
• Format: Article
• Language: English
• Subjects: Adult; Antiretroviral Therapy, Highly Active; Biological and medical sciences; Carcinoma, Squamous Cell - virology; Disease risk; Female; Female genital diseases; Genetic markers; Gynecology. Andrology. Obstetrics; Histology; HIV; HIV Infections - complications; HIV/AIDS; Human immunodeficiency virus; Human viral diseases; Humans; Infections; Infectious diseases; Lesions; Medical sciences; Morbidity; Papillomaviridae - isolation & purification; Papillomavirus Infections - complications; Papillomavirus Infections - diagnosis; Papillomavirus Infections - virology; Polymerase chain reaction; Retrospective Studies; Risk factors; Specimens; Time Factors; Tumors; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Uterine Cervical Neoplasms - virology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Virology; Viruses
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/427032

Background. The role of human papillomavirus (HPV) load and the importance of multiple-strain HPV infections as biomarkers for the development of cervical disease were evaluated in human immunodeficiency virus (HIV)–positive women. Methods. A total of 108 samples were analyzed, 64 of which were obtained from 16 HIV-positive women who underwent surgical resection of the cervical cone for treatment of a histologically confirmed high-grade cervical intraepithelial neoplasm (cases) and 44 of which were obtained from 22 HIV-positive women who had high-risk HPV but a negative colposcopy result (controls). Each patient underwent periodic examinations at 6–12-month intervals that included colposcopy, Papanicolaou testing, biopsy (if indicated), and cervical brushing for HPV testing. Viral typing was performed by reverse dot-blot hybridization and quantification of viral load by in-house real-time PCR and commercial assays. Results. Analysis of the cervical-brush samples collected when high-grade squamous intraepithelial lesions were diagnosed revealed that all cases had HPV loads that were significantly higher than those of controls (P = .0004 and P = .0003, by PCR and the Hybrid Capture 2 index [Digene], respectively). Decreasing concentrations of HPV load were observed when comparing samples obtained before and after treatment (P < .0001). The number and type of HPV strains that were detected were not statistically different between cases and controls. Conclusions. The significantly higher HPV load detected in women with high-grade cervical dysplasia, as well as the dramatic decrease in the load after surgical removal of the lesion, suggest that HPV load is a possible prognostic marker of high-grade SIL.