Correlation between viral load and cervical squamous lesion severity in single and multiple infections: a large-scale...

Area of Science:

• Gynecology
• Oncology
• Virology

Background:

• Cervical cancer screening relies on detecting high-risk human papillomavirus (hr-HPV) infections.
• Quantifying HPV viral load may improve risk assessment beyond simple detection.

Purpose of the Study:

• To examine the association between hr-HPV viral load and cervical squamous lesions.
• To evaluate HPV viral load as an indicator for identifying cervical intraepithelial neoplasia grade 2 or higher (CIN2+).
• To analyze the impact of multiple HPV infections on viral load and disease risk.

Main Methods:

• 3,838 women underwent hr-HPV testing using the Cobas 4800 assay.
• Cycle threshold (Ct) values served as indirect measures of viral load.
• Ct values were correlated with histopathological diagnoses (normal, CIN1, CIN2/3, SCC).

Main Results:

• HPV16 Ct values decreased with increasing lesion severity.
• HPV18 and other hr-HPV types showed no clear correlation with lesion grade.
• A Ct threshold of 32.25 for HPV16 single infections identified CIN2+ with 80.7% sensitivity and 54.4% specificity.

Conclusions:

• HPV16 viral load correlates with cervical squamous lesions, regardless of single or multiple infections.
• HPV16 viral load may serve as a biomarker for cervical lesion occurrence.
• Viral load assessment can enhance individualized risk stratification and patient management.