HPV DNA patterns and disease implications in the follow-up of patients treated for HPV16 high-grade carcinoma in situ

Twenty-five patients with high-grade cervical lesions associated with HPV16 infection were studied at the time of surgical treatment and followed up after conization. Before surgical treatment, the following parameters were analyzed: (1) physical status of HPV16 DNA, (2) viral load, (3) cytological presentation confirmed by histological diagnosis, and (4) colposcopy. At the time of conization, (5) margin presentation, and (6) cone biopsy were evaluated. At each stage of the follow-up (7) physical status of HPV16 DNA, (8) viral load, (9) cytological test, and (10) colposcopy were repeated. The correlation between the different parameters was examined. Significant differences in the viral loads were observed between integrated and episomal forms and between the coexisting integrated/episomal forms and the only episomal form, while no statistically significant differences were observed between integrated and coexisting forms. At the first stage of follow-up, 11 of 25 patients analyzed (44%) were negative to HPV DNA cytology and colposcopy tests, 13 of the 25 (52%) were HPV16 DNA negative, 17 (68%) cytology negative, and 20 (80%) colposcopy negative. At the closing stage, 15 of 25 subjects (60%) were negative to all three tests, 16 of the 25 (64%) were HPV16 DNA negative, 19 (76%) cytology negative, and 20 colposcopy negative (80%). These observations suggest that in surgery treated patients the viral clearance at the closing stage of follow-up was unrelated to the HPV DNA physical status and to the viral load before treatment, but was associated significantly with the effectiveness of surgery treatment, in particular with margin cone presentation.