Association between high-risk human papillomavirus DNA load which detection by Hybrid Capture2 and different grades of cervical neoplasia

Objective:To determine the association between viral load of high risk human papillomavirus (HR-HPV) which detected by Hybrid Capture2 and different grades of cervical neoplasia.Methods:Totally 963 patients who had received a dual screening with thinprep cytologic test (TCT) or traditional pap smear and HR-HPV in department of gynecology,the first affiliated hospital school of Shihezi medicine university.HR-HPV was detected by the Hybrid Capture 2 (hc2) system,and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC).RLU/PC was categorized for analysis into four groups:negative (0,1.00),low viral load (1.0,10.00),moderate viral load (10.00,100.00),and high viral load≥100.00.244 patients received biopsy,cervical lesions were diagnosed by biopsies as cervicitis 105 cases,cervical intraepithelial neoplasia (CIN) l 35 cases,CIN2 29 cases,CIN3 40 cases and cervical cancer 35 cases.Association between HR-HPV viral load,age and different grades of cervical neoplasia was evaluated by unconditional multinomial logistic regression.Results:The HR-HPV infection rate of the population was 74.6% (182 /244),88.6% (31/35) of cervical cancer,97.5% (39/40) of CIN3,96.6% (28/29) CIN2,74.3% (26/35) of CIN1 and 55.2% (58/105) of chronic cervicitis women,were positive for HR-HPV DNA.The median RLUs for the HR-HPV viral load with cervical cancer,CIN3,CIN2,CIN1 and chronic cervicitis were 197.13,77.78,47.63,15.11 and 1.13 respectively.There were significant differences among the distributions of viral loads in each lesion (χ2=42.82,P 0.05) ;The severity of lesion increased with the viral loads (χ2=66.49,P 0.05).Compared with the risks of different grades of cervical neoplasia in HR-HPV negative population,the risks of CIN2 and CIN3 in low,moderate and high viral loads were increased gradually [OR (95% CI):18.11 (1.60-205.28),36.49 (2.72-490.09) and 39.35 (3.91-396.16) ]and there were obvious dose-response relationships.The risk of CIN 2 and CIN3 were high among the women aged 35-and 45-with high viral load [OR (95% CI):4.5 (1.52-13.30),7.75 (2.74-21.96) ].Conclusion:There is strong correlation between the HR-HPV viral load and the severity of different grades of cervical neoplasia.High viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN2 and CIN3,and there is a higher risk in the women aged 45 or older than the younger ones.Considering both the age and viral load could help the doctors to manage the screening women more effectively.