Persistent Human Papillomavirus Infection as a Predictor of Cervical Intraepithelial Neoplasia

Schlecht, Nicolas F.

doi:10.1001/jama.286.24.3106

Cited by 492 publications

(362 citation statements)

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“…Persistent HPV infection is identified by a patient having more than one positive test for the same high-risk HPV type, but repeated type-specific HPV testing would be too cumbersome to apply in clinical practice and may not distinguish persistent infection from reinfection. 3 Expression of p16 INK4a may provide a surrogate marker for persistent HPV infection. Recently, we compared p16 INK4a immunostaining with Hybrid Capture high-risk HPV DNA testing using liquidbased cytology and found that 16 INK4a immunostaining detected high-grade CIN better than the HPV DNA testing.…”

Section: Discussionmentioning

confidence: 99%

“…9-11 It was the repeated positive high-risk HPV test results, reflecting persistent infection that predicted a likelihood of having a high-grade CIN. 3,9 In susceptible adolescents, either repeated exposure or an inability to suppress immunologically an infection may promote the oncogenic potential of …”

mentioning

confidence: 99%

“…Only 0.12-3% of adolescents known to be infected with high-risk HPV develop high-grade CIN, and cervical carcinoma is extremely rare. [1][2][3][4][5] Woodman et al 4 reported that adolescents infected with HPV 16,18, and 31 had a higher risk of developing high-grade CIN than persons infected with other oncogenic HPV types. Moscicki et al 6 observed that persistently positive high-risk HPV testing precedes the development of high-grade CIN.…”

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confidence: 99%

“…[9][10][11] It was the repeated positive high-risk HPV test results, reflecting persistent infection that predicted a likelihood of having a high-grade CIN. 3,9 In susceptible adolescents, either repeated exposure or an inability to suppress immunologically an infection may promote the oncogenic potential of the virus. 6 The cyclin-dependent kinase (CDK) inhibitor p16 INK4a overexpression in high-grade CIN and cervical cancer appears to be related to viral integration during the neoplastic transformation of cervical cells.…”

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confidence: 99%

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Human papillomavirus genotyping and p16INK4a expression in cervical intraepithelial neoplasia of adolescents

Guo

et al. 2005

Modern Pathology

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Adolescents have high rates of human papillomavirus (HPV) infection, and persistent high-risk HPV infection can lead to the development of cervical cancer. The cyclin-dependent kinase inhibitor, p16 INK4a is overexpressed in cervical intraepithelial neoplasia (CIN), probably due to a persistent and integrated HPV infection. This study investigated p16 INK4a expression, grades of CIN, and high-risk HPV infection in adolescent cervical biopsies. Biopsies were immunohistochemically stained for p16 INK4a . The presence of wide-spectrum, low-risk, or highrisk HPV was determined by amplifying DNA extracted from the cervical biopsies. Early sexual activity with multiple partners places many female adolescents at high risk for the future development of cervical cancer. The prevalence of human papillomavirus (HPV) infection in adolescents ranges from 19 to 46%, but the cervical intraepithelial neoplasia (CIN) in adolescents are predominantly low-grade and in the great majority of cases they resolve spontaneously. Only 0.12-3% of adolescents known to be infected with high-risk HPV develop high-grade CIN, and cervical carcinoma is extremely rare. 1-5 Woodman et al 4 reported that adolescents infected with HPV 16, 18, and 31 had a higher risk of developing high-grade CIN than persons infected with other oncogenic HPV types. Moscicki et al 6 observed that persistently positive high-risk HPV testing precedes the development of high-grade CIN.High-risk HPV DNA can be detected in almost all high-grade CIN and cervical cancers. 7,8 From a screening study of 7932 women aged 21-30 years, Clavel et al 9 reported that 23% had high-risk HPV infections. For the majority of women, the infections are transient and last 8-10 months. 9-11 It was the repeated positive high-risk HPV test results, reflecting persistent infection that predicted a likelihood of having a high-grade CIN. 3,9 In susceptible adolescents, either repeated exposure or an inability to suppress immunologically an infection may promote the oncogenic potential of

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Human papillomavirus genotyping and p16INK4a expression in cervical intraepithelial neoplasia of adolescents

Guo

et al. 2005

Modern Pathology

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“…8,9 The LudwigMcGill cohort 10 involved 2528 women who were followed prospectively for evidence of HPV infection using polymerase chain reaction (PCR) detection. The group was comprised of a high-risk population of women from Sao Paulo, Brazil, who attended a maternal and child health clinic.…”

mentioning

confidence: 99%