Study For The Association Between High-Risk Human Papillomavirus And Cervical Lesions

Objective:To investigate the association between viral load of high-risk human papillomavirus (HR-HPV) and cervical lesions. Then to observe the distribution of HPV genotypes and to investigate the association between HPV genotypes and cervical lesions in screening samples.Methods:1. A retrospective analysis of 1908 women detected by HC2 test and TCT. The association between viral load of HR-HPV and cervical lesions was evaluated by unconditional multinomial logistic regression.2.602 cervical samples detected as HPV positive by HC2 test were reported, and among them 344 participated in TCT. The HPV genotypes were determined by PCR-RDB. The association between HPV genotypes and cervical lesions was evaluated by unconditional multinomial logistic regression.Results:1. The prevalences of HPV in NILM, ASCUS, LSIL, HSIL were 18.5%,39.0%, 74.4%,78.3%, respectively, with an overall positive rate of 23.6%.2. Much higher HPV prevalences were generally found below age 25 and 41-45 years old. The prevalences were 25.0% and 26.7%, respectively.3. Compared with 30.5% in NILM, the rates of high viral load were 44.2% (OR=31.65) and 47.8%(OR=40.31) in LSIL and HSIL, respectively. The median lg(RLU/CO) were 1.44,2.12,2.55,2.65 in NILM, ASCUS, LSIL, HSIL, respectively (P<0.05).4.569(94.5%) out of 602 samples were successfully amplified. The most common HPV genotypes were HPV16,52,58,56,39,33,51,18.24 samples suggested single HPV infection with untargeted genotypes of HC2 test.5. According to the decrement of HPV positive rate, the most common five genotypes in NILM were HPV52,16,53,56,58; ASCUS group were HPV 16, 52,58,39,51; LSIL group were HPV16,58,52,56,18; HSIL group were HPV16,33,31,68,58.6. HPV16 infection was significantly related to ASCUS, LSIL and HSIL. The odds ratio (OR) increased with the severity of cervical lesions. HPV16/18 infection also had a similar trend.7. Single and multiple infection rates were 70.1% and 29.9%, respectively. Double infection was the main model of multiple infection, the most common model was HPV16/52.Conclusions:1. HPV is significantly associated with cervical lesions. The positive rates of HPV increase with the severity of the cervical lesions.2. The viral load of HR-HPV is significantly associated with cervical lesions. The viral load of HR-HPV has a predictive value for the severity of cervical lesions.3. The most common HPV genotype is HPV16, followed by HPV52 and 58. Then HPV52 and 58 are dominant genotypes in China. HPV52 and 58 genotypes should be thought highly of, when the prophylactic HPV vaccine adapting to China will be developed.4. The multiple infection could not increase the risk of severe cervical lesions.5. The distribution of HPV varies in different severity of cervical lesions.6. HPV16 is a good index for the progression of HSIL.7. HC2 test has cross-reactivity with untargeted HPV genotypes. Our data demonstrates the pseudo-positivity of HC2 test is 0.17%-4.0%.8. There is a good concordance between PCR-RDB and HC2 test.