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Int J Clin Exp Pathol 2(2),169-175;2009.

Original Article
High Grade Cervical Intraepithelial Neoplasia and Viral Load of High-Risk Human
Papillomavirus: Significant Correlations in Patients of 22 Years Old or Younger

Yuanchun Xu, Jorge Dotto, Yiang Hui, Kara Lawton, Kevin Schofield and Pei Hui

Department of Gynecology and Obstetrics, Beijing Aero-space General Hospital, Beijing, 100076, P. R. China; Department of Pathology,
Brigham and Woman’s Hospital, Harvard University School of Medicine, Boston, MA, United States; Programs in Microbiology and Immunology,
Faculty of Medicine, McGill University, Montreal, Quebec, Canada and Department of Pathology, Yale University School of Medicine, New Haven,
CT, United States

Received 2 July 2008; Accepted 18 July 2008; Available online 25 July 2008

Abstract: High-risk human papillomavirus (HR-HPV) is recognized as the primary cause for the development of cervical cancers and their
precursor lesions. We investigated whether high-grade cervical dysplasia correlates with high viral load of HR-HPV in an age-dependent
manner. Cases were retrospectively selected to include patients with a prior cytological diagnosis of ASCUS or higher grade squamous
intraepithelial lesions, and a positive Digene Hybrid Capture II (HC-II) HR-HPV testing within 2 months before or after cervical biopsy. The
quantitative viral load data was classified as negative, low, moderate and high according to the manufacturer’s instruction. Cases were then
stratified into 4 age groups: ≤22 years, 23-30 years, 31-40 years and >40 years. Chi-Square analysis and logistic regression were performed
where appropriate. A total of 995 patients were identified. Age categories were significantly associated with HPV loads (p=0.046). Moderate to
high viral loads of HPV were significantly related to the histological grade of dysplasia (p=0.029). Logistic regression analysis further confirmed
the association of HPV with histological grades, even after adjusting for age factor. In particular, high-grade dysplasia (p=0.011) but not low
grade dysplasia (p=0.140) was significantly associated with moderate to high HPV loads. Patients of 22 years old or younger were the only
group found significantly correlated with high viral loads of HPV (p=0.015). In conclusion, high-grade squamous intraepithelial lesions and
patients’ age of 22 years old or younger are significantly associated with a moderate to high viral load of HR-HPV. (IJCEP806010 ).

Key Words: High-risk human papillomavirus (HR-HPV), age, viral load, cervical intraepithelial neoplasia (CIN)

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Address all correspondence to: Dr. Pei Hui, Programs in Women’s Health and Molecular Diagnostics, Department of Pathology, Yale
University School of Medicine, BML 250, 310 Cedar Street, New Haven, CT 06520-8023. Tel: 203-785-6498; Fax: 203-737-1064; Email: