+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Human papillomavirus viral load as a useful triage tool for non-16/18 high-risk human papillomavirus positive women: A prospective screening cohort study



Human papillomavirus viral load as a useful triage tool for non-16/18 high-risk human papillomavirus positive women: A prospective screening cohort study



Gynecologic Oncology 148(1): 103-110



ASCCP cervical cancer screening guidelines recommend triaging high-risk human papillomavirus (hrHPV) positive women with cytology and genotyping, but cytology is often unavailable in resource-limited areas. We compared the long-term risk of cervical cancer and precancers among type-specific hrHPV-positive women triaged by viral load to cytology and visual inspection with acetic acid (VIA). A cohort of 1742 Chinese women was screened with cytology, VIA, and Hybrid Capture 2 (HC2) test and followed for ten years. All HC2-positive samples were genotyped. Viral load was measured by HC2 relative light units/cutoff (RLU/CO). Ten-year cumulative incidence rate (CIR) of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) for type-specific hrHPV viral load was estimated using Kaplan-Meier methods. Baseline hrHPV viral load stratified by specific genotypes was positively correlated with prevalent cytological lesions. Ten-year CIR of CIN2+ was associated with cytological lesions and viral load. Among HPV 16/18-positive women, ten-year CIR of CIN2+ was high, even with normal cytology (15.3%), normal VIA (32.4%), viral load with RLU/CO<10 (23.6%) or RLU/CO<100 (33.8%). Among non-16/18 hrHPV positive women, ten-year CIR of CIN2+ was significantly stratified by cytology grade of atypical squamous cell of undetermined significance or higher (2.0% VS. 34.6%), viral load cutoffs at 10 RLU/CO (5.1% VS. 27.2%), at 100 RLU/CO (11.0% VS. 35.5%), but not by VIA (19.1% VS. 19.0%). Our findings support the guidelines in referring all HPV16/18 positive women to colposcopy and suggest triaging non-16/18 hrHPV positive women using viral loads in resource-limited areas where cytology screening was inaccessible.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059814734

Download citation: RISBibTeXText

PMID: 29169614

DOI: 10.1016/j.ygyno.2017.11.016


Related references

HLA-DP is the cervical cancer susceptibility loci among women infected by high-risk human papillomavirus: potential implication for triage of human papillomavirus-positive women. Tumour Biology 37(6): 8019-8025, 2017

Evaluation of Viral Load as a Triage Strategy With Primary High-Risk Human Papillomavirus Cervical Cancer Screening. Journal of Lower Genital Tract Disease 21(1): 12-16, 2016

High-risk human papillomavirus genotypes distribution in a cohort of HIV-positive women living in Europe: epidemiological implication for vaccination against human papillomavirus. Aids 30(3): 425-433, 2016

DNA methylation markers as a triage test for identification of cervical lesions in a high risk human papillomavirus positive screening cohort. International Journal of Cancer 2018, 2018

Combined promoter methylation analysis of CADM1 and MAL: an objective triage tool for high-risk human papillomavirus DNA-positive women. Clinical Cancer Research 17(8): 2459-2465, 2011

Value of high risk human papillomavirus viral load in predicting cervical lesions and triaging for high risk (HR)-HPV-positive women. Zhonghua Zhong Liu Za Zhi 36(4): 316-320, 2014

Comparison of the AdvanSure human papillomavirus screening real-time PCR, the Abbott RealTime High Risk human papillomavirus test, and the Hybrid Capture human papillomavirus DNA test for the detection of human papillomavirus. Annals of Laboratory Medicine 32(3): 201-205, 2012

Viral load and short-term natural history of type-specific oncogenic human papillomavirus infections in a high-risk cohort of midadult women. International Journal of Cancer 134(8): 1889-1898, 2014

Triage of high-risk human papillomavirus-positive women by methylated POU4F3. Clinical Epigenetics 7: 85, 2015

A promising DNA methylation signature for the triage of high-risk human papillomavirus DNA-positive women. Plos One 9(3): E91905, 2015

Human papillomavirus testing in young women: clinical outcomes of human papillomavirus triage in a UK cervical screening program. Cancer Cytopathology 122(9): 702-710, 2014

High-risk human papillomavirus viral load and persistence among heterosexual HIV-negative and HIV-positive men. Sexually Transmitted Infections 90(4): 337-343, 2014

Type-specific high-risk human papillomavirus viral load as a viable triage indicator for high-grade squamous intraepithelial lesion: a nested case- control study. Cancer Management and Research 10: 4839-4851, 2018

Increased alpha-9 human papillomavirus species viral load in human immunodeficiency virus positive women. Bmc Infectious Diseases 14: 51, 2014

Clinical Value of Human Papillomavirus E6/E7 mRNA Detection in Screening for Cervical Cancer in Women Positive for Human Papillomavirus DNA or. Clinical Laboratory 64(9): 1363-1371, 2018