Viral load in the natural history of human papillomavirus type 16 infection: A nested case-control study

Long Fu Xi, James P. Hughes, Philip E. Castle, Zoe R. Edelstein, Chunhui Wang, Denise A. Galloway, Laura A. Koutsky, Nancy B. Kiviat, Mark Schiffman

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Background. Viral load may influence the course of human papillomavirus type 16 (HPV-16) infection. Methods. This case-control study was nested within the 2-year Atypical Squamous Cells of Undetermined Significance and Low-Grade Squamous Intraepithelial Lesion Triage Study, in which women were followed semiannually for HPV and cervical intraepithelial neoplasia (CIN). Case patients (n=62) were women diagnosed with CIN3 following HPV-16-positive detection at a follow-up visit. HPV-16-positive controls (n=152) without CIN2 or CIN3 were matched to cases based on the follow-up visit in which viral load was measured. Real-time polymerase chain reaction was used for HPV-16 DNA quantification. Results. The risk of CIN3 increased with increasing HPV-16 DNA load at the follow-up visit (odds ratio, 1.63; 95% confidence interval, 1.33-1.99 per 1 log10 unit increase); the association was not affected by whether HPV-16 was present at enrollment. When HPV-16 was present at both enrollment and follow-up, viral load remained high among cases (P=.77) but decreased substantially among controls (P=.004). Among women with HPV-16 found initially during follow-up, viral load in the first HPV-16-positive sample was associated with shortterm persistence; load was higher in those with infection, compared with those without infection, 1 visit after the initial positivity (P=.001). Conclusions. Viral load of newly detected infections and changes in viral load predict persistence and progression of HPV-16 infections.

Original languageEnglish (US)
Pages (from-to)1425-1433
Number of pages9
JournalJournal of Infectious Diseases
Volume203
Issue number10
DOIs
StatePublished - May 15 2011
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Xi, L. F., Hughes, J. P., Castle, P. E., Edelstein, Z. R., Wang, C., Galloway, D. A., Koutsky, L. A., Kiviat, N. B., & Schiffman, M. (2011). Viral load in the natural history of human papillomavirus type 16 infection: A nested case-control study. Journal of Infectious Diseases, 203(10), 1425-1433. https://doi.org/10.1093/infdis/jir049