Carcopino X, Bolger N, Henry M, Mancini J, Boubli L, Olive D, Cleary S, Prendiville W, Tamalet C.
The persistence of high-risk HPV (HR-HPV) infection is necessary for the development of cervical intraepithelial neoplasia. The aim of this study was to evaluate if HR-HPV typing and HPV16, 18, 31, and 33 quantitation are predictive for type-specific infection persistence and/or the development of CIN in women under 30 with normal cervical cytology. Young women (under 30) attending a family planning clinic who were HPV positive with normal cervical cytology were included. HPV genotyping was assessed by MY09/MY11 PCR, sequencing, phylogenetic analysis, and cloning when necessary. HR-HPV viral load was quantified using duplex real-time PCR. Study patients were offered for a second smear and HR-HPV detection and quantitation after 12 months. HR-HPV was identified in 43 (21.9%) of the 199 included women. Of these, 39 patients had a second cervical sample taken within a mean interval of 11.7 months (8.8-18.3 months). The mean HR-HPV 16, 18, 31, and 33 initial viral load was 1.9 × 10(6) copies/million cells. The level of viral load did not reveal any significant association with type-specific HR-HPV persistence or the subsequent development of cervical intraepithelial neoplasia. Only HPV16 infection was significantly more likely to persist (91.7% vs. 33.1%, P = 0.001) and to develop CIN (33.3% vs. 3.7%, P = 0.025). In women under 30 with normal cytology, HR-HPV viral load is common and is not predictive of HPV persistence or the development of cervical intraepithelial neoplasia. HPV16 positive women are significantly more likely to have persistent infection and to develop cervical intraepithelial neoplasia. J. Med. Virol. 83:637-643, 2011. © 2011 Wiley-Liss, Inc.
[Note from SaneVax: How is this study relevant to medical consumers? We need a sensitive and specific HPV test to detect persistent HPV infections to ensure true negative results (an HPV-negative result indicates no risk for cervical cancer). But we need Pap cytology to follow and refer the patients with persistent HPV infection to colposcopic biopsy, to avoid unnecessary harmful procedures.]