Multiple HPV Infections and Viral Load Association in Persistent Cervical Lesions in Mexican Women

Abstract

Persistent high-risk human papillomavirus (HR-HPV) infections play a major role in the development of invasive cervical cancer (CC), and screening for such infections is in many countries the primary method of detecting and preventing CC. HPV typing can be used for triage and risk stratification of women with atypical squamous cells of undetermined significance (ASC-US)/low-grade cervical lesions (LSIL), though the current clinical practice in Mexico is to diagnose CC or its preceding conditions mainly via histology and HR-HPV detection. Additional information regarding these HPV infections, such as viral load and co-infecting agents, might also be useful for diagnosing, predicting, and evaluating the possible consequences of the infection and of its prevention by vaccination. The goal of this follow-up hospital case study was to determine if HPV types, multiple HPV infections, and viral loads were associated with infection persistence and the cervical lesion grade. A total of 294 cervical cytology samples drawn from patients with gynecological alterations were used in this study. HPV types were identified by real-time PCR DNA analysis. A subset of HPV-positive patients was reevaluated to identify persistent infections. We identified HPV types 16, 18, and 39 as the most prevalent. One hundred five of the patients (59%) were infected with more than one type of HPV. The types of HPV associated with multiple HPV infections were 16, 18, and 39. In the follow-up samples, 38% of patients had not cleared the initially detected HPV infection, and these were considered persistent. We found here an association between multiple HPV infections and high viral loads with and infection persistence. Our findings suggest there are benefits in ascertaining viral load and multiple HPV infections status of HR-HPV infections for predicting the risk of persistence, a requirement for developing CC. These findings contribute to our understanding of HPV epidemiology and may allow screening programs to better assess the cancer-developing risks associated with individual HR-HPV infections.

The Concurrent Detection of Chelonid Alphaherpesvirus 5 and Chelonia mydas Papillomavirus 1 in Tumoured and Non-Tumoured Green Turtles

“…No similar undertaking could be done for the CmPV1 results as there are no comparable datasets in marine turtles. However, the results are consistent with human cervical intraepithelial neoplasia (CIN) I, II, III caused by human papillomavirus (HPV) 16, 18, 33 and 58 [ 48 , 49 , 50 ].…”

“…While the mean ChHV5 load results obtained in this study were consistent with other reports [ 23 , 25 , 45 , 46 ], such comparisons could not be made for CmPV1 as there are no other comparable datasets in marine turtles. However, the CmPV1 viral loads are in the same range reported for human cervical malignancies caused by HPV 16, 18, 33 and 58 where the mean HPV copies per 10,000 cells were reported to be ~log3–5 in CIN I, II and III [ 48 , 49 , 50 ].…”

The Concurrent Detection of Chelonid Alphaherpesvirus 5 and Chelonia mydas Papillomavirus 1 in Tumoured and Non-Tumoured Green Turtles

“…While the mean ChHV5 load results obtained in this study were consistent with other reports [24,44,45], such comparisons could not be made for CmPV1 as there are no other comparable datasets in marine turtles. However, the CmPV1 viral loads are in the same range reported for human cervical malignancies caused by HPV 16, 18, 33 and 58 where the mean HPV copies per 10,000 cells were reported to be ~log3-5 in CIN I, II and III [47][48][49]. Additional molecular surveys targeting both ChHV5 and CmPV1 from other regions would be hugely beneficial to understanding the role of CmPV1 in FP, and in marine turtle health as a whole.…”

Analysis of HPV Integrations in Mexican Pre-Tumoral Cervical Lesions Reveal Centromere-Enriched Breakpoints and Abundant Unspecific HPV Regions

“…The PAP smear result was re-interpreted from transcripts in all but two samples. All the patients included were previously detected as HPV-positive [ 63 ].…”