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Viral load of episomal and integrated forms of human papillomavirus type 33 in high‐grade squamous intraepithelial lesions of the uterine cervix
Author(s) -
Khouadri Soraya,
Villa Luisa L.,
Gag Simon,
Koushik Anita,
Richardson Harriet,
Matlashewski Greg,
Roger Michel,
Ferenczy Alex S.,
Franco Eduardo L.,
Coutlée François
Publication year - 2007
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.23006
Subject(s) - quartile , viral load , odds ratio , cervix , confidence interval , gynecology , medicine , biology , virology , andrology , cancer , virus
The association between total and integrated HPV‐33 DNA loads and high‐grade squamous intraepithelial lesions (HSIL) of the uterine cervix was investigated. Of 5,347 women recruited in 4 studies, 89 (64 without SIL, 7 low‐grade SIL (LSIL), 15 HSIL, 3 unknown grade) were infected by HPV‐33. HPV‐33 E6, HPV‐33 E2 and β‐globin DNA were measured with real‐time PCR that allowed to assess total (E6), episomal (E2) and integrated (E6–E2) HPV‐33 viral loads. HPV‐33 E6/E2 ratios ≥≥2.0 suggesting the presence of integrated HPV‐33 were obtained for 28.6% ( n = 18) of women without SIL and 21.4% ( n = 3) of women with HSIL ( p = 0.74). Although median viral loads were similar, there was a trend toward having a greater proportion of women with HSIL in the fourth quartile (≥≥10 6.69 copies/μg DNA) of total HPV‐33 viral loads compared to normal women. Controlling for age, site, ethnicity and LCR polymorphism by logistic regression, HPV‐33 total loads in the fourth quartile {odds ratio (OR) 4.5 [95% confidence interval (CI) 1.2–17.3]; p = 0.03} and episomal loads in the fourth quartile (≥≥10 6.64 copies/μg DNA) [OR 3.9 (95% CI 1.1–13.2); p = 0.05] but not integrated HPV‐33 load in the fourth quartile [OR 1.0 (95% CI 0.3–3.3); p = 0.50] were associated with HSIL. Controlling for age, study site and SIL grade, HPV‐33 episomal load [OR 0.2 (95% CI 0.1–0.5), p = 0.0004] was associated with the presence of HPV‐33 integration. High episomal loads in HSIL and the presence of integration in women without SIL are likely to weaken the usefulness of HPV load of integrated forms in clinical practice. © 2007 Wiley‐Liss, Inc.