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Significance of HPV 16 and 18 viral load quantitation in women referred for colposcopy

Authors

  • Xavier Carcopino MD,

    Corresponding author
    1. Department of Obstetrics and Gynecology, Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Marseille, France
    2. Faculty of Medicine, Aix-Marseille University, Marseille, France
    3. Laboratory of Tumor Immunology, Institut Paoli Calmettes, Marseille, France
    • Department of Obstetrics and Gynaecology, Hôpital Nord, Chemin des Bourrely, 13915 Cedex 20 Marseille, France.
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  • Mireille Henry,

    1. Department of Bacteriology and Virology, Assistance Publique des Hôpitaux de Marseille, Hôpital de la Timone, Marseille, France
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  • Julien Mancini,

    1. Faculty of Medicine, Aix-Marseille University, Marseille, France
    2. APHM, Department of Public Health and Epidemiology, Hôpital de la Timone, Marseille, France
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  • Sophie Giusiano,

    1. Faculty of Medicine, Aix-Marseille University, Marseille, France
    2. Department of Histology, Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Marseille, France
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  • Léon Boubli,

    1. Department of Obstetrics and Gynecology, Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Marseille, France
    2. Faculty of Medicine, Aix-Marseille University, Marseille, France
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  • Daniel Olive,

    1. Faculty of Medicine, Aix-Marseille University, Marseille, France
    2. Laboratory of Tumor Immunology, Institut Paoli Calmettes, Marseille, France
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  • Catherine Tamalet

    1. Faculty of Medicine, Aix-Marseille University, Marseille, France
    2. Department of Bacteriology and Virology, Assistance Publique des Hôpitaux de Marseille, Hôpital de la Timone, Marseille, France
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  • Conflict of interest: All authors have no conflict of interest to declare.

Abstract

The clinical utility of HPV 16 and 18 viral loads remains debated. The aim of this study was to assess the clinical significance of HPV 16 and 18 viral load and to determine a cut-off for optimal prediction of grade 2 or higher cervical intraepithelial neoplasia among patients referred to colposcopy. A total of 186 cervico-vaginal specimens harboring HPV 16 and/or 18 obtained at the time of colposcopy from patients without previous cervical neoplasia were tested for HPV 16 and 18 detection and quantitation using quantitative duplex real-time PCR method. Grade 2 or higher cervical intraepithelial neoplasia was diagnosed in 87 (46.8%) cases. Only HPV 16 median viral load increased significantly with the lesion grade: 9.1 × 104 in normal cervix or grade 1 cervical intraepithelial lesion versus 4.0 × 106 copies per million cells in grade 2 or higher cervical intraepithelial lesion (P < 0.001). The highest predictive value for grade 2 or higher cervical intraepithelial lesion was observed with a HPV 16 viral load cut-off of 3.0 × 106 copies per million cells (91% specificity, 58.2% sensitivity). Using this cut-off, the highest predictive value of HPV 16 viral load was observed among those referred for previous low-grade abnormal cervical cytology (96.4% specificity, 88% sensitivity). HPV 18 quantitation showed very poor predictive value. Specific attention should be given when performing colposcopic examination of women with an HPV 16 viral load higher than 3.0 × 106 copies per million cells, especially among those referred after a low-grade abnormal cytology. J. Med. Virol. 84:306–313, 2012. © 2011 Wiley Periodicals, Inc.

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