Copyright © 2017 Wolters Kluwer Health, Inc. Type-specific viral load increase/decrease in three consecutive measurements enabled classification of CIN lesions in clonal HPV-driven transformation (progression/regression) and nonclonal virion-productive (serial transient/transient) processes.
We could clearly demonstrate clonal regressing lesions with a persistent linear decrease in viral load ( R 2≥0.85 −0.003 HPV copies/cell/day) in all CIN categories. Only with three consecutive measurements could a clonal process be identified in all CIN3 cases. Three hundred and seven women with CIN were included 124 had single-type infections and 183 had multiple HPV types. All infections could be classified into one of five categories: (i) clonal progressing process ( R 2≥0.85 positive slope), (ii) simultaneously occurring clonal progressive and transient infection, (iii) clonal regressing process ( R 2≥0.85 negative slope), (iv) serial transient infection with latency, and (v) transient productive infection ( R 2<0.85 slope: ☐.0099 HPV copies/cell/day). Changes in HPV-specific load between measurements were assessed by linear regression, with calculation of coefficient of determination ( R 2) and slope. Before performing cytology, 18 different quantitative PCRs allowed HPV type-specific viral load measurement. A cervical histology database was used to select consecutive women with biopsy-proven CIN in 2012 who had at least two liquid-based cytology samples before the diagnosis of CIN. This retrospective study examined whether human papillomavirus (HPV) type-specific viral load changes measured in two or three serial cervical smears are predictive for the natural evolution of HPV infections and correlate with histological grades of cervical intraepithelial neoplasia (CIN), allowing triage of HPV-positive women.
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