Dynamics of Human Papillomavirus Infection between Biopsy and Excision of Cervical Intraepithelial Neoplasia: Results from the ZYC101a Protocol

Background. Little is known about the dynamics of human papillomavirus (HPV) during the follow-up of cervical intraepithelial neoplasia (CIN) 2/3 after biopsy. Methods. A total of 127 women with biopsy-confirmed CIN2/3 were enrolled in a phase 2 double-blinded, randomized, placebo-controlled clinica...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of infectious diseases 2004-04, Vol.189 (8), p.1348-1354
Main Authors: Crum, Christopher P., Beach, Kathleen J., Hedley, Mary L., Yuan, Liping, Lee, Kenneth R., Wright, Thomas C., Urban, Robert G.
Format: Article
Language:English
Subjects:
Antiviral Agents - therapeutic use
Biological and medical sciences
Biopsies
Biopsy
Centroids
Cervical intraepithelial neoplasia
Cervical Intraepithelial Neoplasia - drug therapy
Cervical Intraepithelial Neoplasia - pathology
Cervical Intraepithelial Neoplasia - virology
Clinical Trials, Phase II as Topic
DNA - therapeutic use
DNA, Viral - chemistry
DNA, Viral - genetics
Double-Blind Method
Female
Fundamental and applied biological sciences. Psychology
Health outcomes
Histology
Human papillomavirus
Humans
Infections
Infectious diseases
Lesions
Medical sciences
Microbiology
Miscellaneous
Neoplasia
Nucleic Acid Hybridization
Papillomaviridae - genetics
Papillomaviridae - growth & development
Papillomaviridae - metabolism
Papillomavirus Infections - drug therapy
Papillomavirus Infections - pathology
Papillomavirus Infections - virology
Polymerase Chain Reaction
Randomized Controlled Trials as Topic
Treatment Outcome
Uterine Cervical Neoplasms - drug therapy
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - virology
Viral Load
Virology
Viruses
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background. Little is known about the dynamics of human papillomavirus (HPV) during the follow-up of cervical intraepithelial neoplasia (CIN) 2/3 after biopsy. Methods. A total of 127 women with biopsy-confirmed CIN2/3 were enrolled in a phase 2 double-blinded, randomized, placebo-controlled clinical trial of ZYC101a. Colposcopic, cytologic, and HPV testing were performed over the course of 6 months, before a loop electrical surgical excision procedure was performed at study exit. Results. Of the women tested, 99% were found to be HPV positive at study entry, 50% were found to be HPV type 16 positive at study entry, 22% were found to be positive for multiple HPV types at study entry, and 37% were found to be positive for additional HPV types during follow-up. Of those with a histologic outcome of CIN1 at study exit, 78% were found to be positive for additional HPV types; in 39%, the original type was replaced with a new HPV type. Virus load at study entry did not predict outcome, but pre-study-exit virus load correlated with a histologic outcome of any CIN, and changes in virus load correlated with risk for an outcome of CIN2/3 at study exit. Conclusions. The type and number of HPVs at study entry, detection of additional viral types, and virus load changes during follow-up influence histologic outcome at study exit. An outcome of CIN1 at study exit is most likely due to additional HPV infections, rather than morphologic reversion of CIN2/3 to CIN1. Knowledge of the dynamics of HPV infection during the biopsy-to-excision period is critical to understanding the natural history of HPV infection, its contribution to disease outcome, and interpretations of drug efficacy.
ISSN:0022-1899
1537-6613
DOI:10.1086/382956