Persistently high HPV load predicts precancerous cervical lesions

Women who repeatedly test positive for high-risk human papillomavirus (HR-HPV) have an increased risk of developing high-grade cervical lesions, according to a report in the September 1st issue of the International Journal of Cancer.

“Oncogenic HPV types are the major cause of worldwide cervical cancer, but only a small proportion of infected women will develop high-grade cervical intraepithelial neoplasia or cancer (CIN 2/3+),” note Dr. Christiane Mougin and colleagues from Centre Hospitalier Universitaire in Besancon, France. The researchers prospectively examined 781 women with cytology results showing either normal, or atypical squamous cells of unidentified significance (ASCUS), or low-grade squamous intraepithelial lesion (LGSIL), with or without HR-HPV. They followed the women every 6 months for a median of 22 months. Of the 257 HR-HPV-positive women at baseline, 130 (50.6%) cleared their virus in a median of 7.5 months. Women with low viral loads had a greater clearance rate than those with high loads. The clearance rate was also higher in women with an initial ASCUS/LGSIL smear than in those with normal cytology. “The incidence of cytologic abnormalities strongly depended on baseline viral load and HR-HPV persistence,” Dr. Mougin and colleagues report. “Maintenance of cytologic abnormalities was associated with the outcome of HR-HPV status (negativeOnly women with persistent HR-HPV infection developed CIN 2/3+, and initially viral high loads (at least 100 pg/mL) increased the risk for progressing to CIN 2/3+. In fact, “a high viral load could be used as a short-term marker of progressions toward precancerous lesions,” the investigators write, “although lower load does not inevitably exclude progressive disease.”(Source: Int J Cancer 2003;106:396-403: Reuters Health: August 29, 2003: Oncolink)