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Abstract

BackgroundStudies of viral load–associated persistence of human papillomavirus (HPV) infection are rare, with inconsistent results reported

MethodsThe study subjects were 741 and 289 women who were positive for HPV type 16 (HPV-16) and HPV type 18 (HPV-18), respectively, at the time of enrollment into in the ASCUS-LSIL (Atypical Squamous Cells of Undetermined Significance–Low-Grade Squamous Intraepithelial Lesion) Triage Study and who returned 1 or more times for HPV testing during a biannual 2-year follow-up. The numbers of HPV-16 and HPV-18 copies per nanogram of cellular DNA at baseline were measured by use of real-time polymerase chain reaction

ResultsWomen with, compared with women without, persistent infection at month 6 of follow-up had a higher viral load at enrollment (P<.001, for HPV-16; P=.01, for HPV-18). The association of each 1-log10 increase in viral load with persistence of HPV-16 or HPV-18 during the first 6 months of the study was statistically significant among women with multiple HPV types at enrollment (for HPV-16: odds ratio [OR], 1.53 [95% confidence interval {CI}, 1.29–1.82]; for HPV-18: OR, 1.35 [95% CI, 1.09–1.68]) but not among women with monotype infections (in tests assessing the interaction between viral load and coinfection, P=.002 for HPV-16 and P=.34 for HPV-18). Among women who continued to have positive results at month 6, 12, or 18, persistence of infection for another 6 months was unassociated with the viral load at baseline

ConclusionPrevalent infection with a higher viral load of HPV-16 or HPV-18 was associated with short- but not long-term persistence

© 2009 by the Infectious Diseases Society of America
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