Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment

Human papillomavirus (HPV) is a major cause of cervical cancer, a significant health concern worldwide. Despite advances in screening methods, including the Pap test and the HPV DNA test, limitations remain in accurately predicting which HPV infections will progress to cervical intraepithelial neopl...

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Main Authors: Serena Varesano, Giulia Ciccarese, Michele Paudice, Katia Mazzocco, Gabriele Gaggero, Simone Ferrero, Giancarlo Icardi, Valerio Gaetano Vellone
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/2/153
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author Serena Varesano
Giulia Ciccarese
Michele Paudice
Katia Mazzocco
Gabriele Gaggero
Simone Ferrero
Giancarlo Icardi
Valerio Gaetano Vellone
author_facet Serena Varesano
Giulia Ciccarese
Michele Paudice
Katia Mazzocco
Gabriele Gaggero
Simone Ferrero
Giancarlo Icardi
Valerio Gaetano Vellone
author_sort Serena Varesano
collection DOAJ
description Human papillomavirus (HPV) is a major cause of cervical cancer, a significant health concern worldwide. Despite advances in screening methods, including the Pap test and the HPV DNA test, limitations remain in accurately predicting which HPV infections will progress to cervical intraepithelial neoplasia (CIN) and, eventually, invasive cancer. This study evaluates the usefulness in real life of assessing HPV viral load and the presence of multiple HPV genotypes in enhancing the diagnostic accuracy of triage in cervical cancer screening. A retrospective analysis was performed on 55 formalin-fixed paraffin-embedded cervical samples collected from women who underwent colposcopy with a biopsy or conization at San Martino Hospital, Genova, Italy, between January and June 2021. Histological diagnoses were compared with molecular analyses (HPV genotyping, viral load quantification and co-infection) using a multiplex real-time PCR platform. Of the samples analyzed, 56.4% were HPV DNA positive, while 40% tested negative. The molecular analysis identified more HPV-negative cases than the histological analysis (<i>p</i> < 0.05). Higher viral loads and HPV co-infections were more frequent in high-grade CIN lesions. These markers may help identify patients at an elevated risk for persistent infections and cancer progression. These findings support the potential of integrating HPV viral load and genotype co-infection assessments into routine cervical cancer screening protocols to improve early detection and reduce overtreatment and unnecessary interventions.
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spelling doaj-art-cf0b26ebee9b412eaaff2fecf3fd8a7e2025-08-20T02:03:25ZengMDPI AGLife2075-17292025-01-0115215310.3390/life15020153Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based AssessmentSerena Varesano0Giulia Ciccarese1Michele Paudice2Katia Mazzocco3Gabriele Gaggero4Simone Ferrero5Giancarlo Icardi6Valerio Gaetano Vellone7Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, ItalySection of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, ItalyDepartment of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Viale Benedetto XV 14, 16132 Genoa, ItalyPathology Unit, IRCCS Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genoa, ItalyPathology Unit, IRCCS Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genoa, ItalyObstetrics and Gynecology University Unit, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, ItalyHygiene Unit, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Viale Benedetto XV 14, 16132 Genoa, ItalyHuman papillomavirus (HPV) is a major cause of cervical cancer, a significant health concern worldwide. Despite advances in screening methods, including the Pap test and the HPV DNA test, limitations remain in accurately predicting which HPV infections will progress to cervical intraepithelial neoplasia (CIN) and, eventually, invasive cancer. This study evaluates the usefulness in real life of assessing HPV viral load and the presence of multiple HPV genotypes in enhancing the diagnostic accuracy of triage in cervical cancer screening. A retrospective analysis was performed on 55 formalin-fixed paraffin-embedded cervical samples collected from women who underwent colposcopy with a biopsy or conization at San Martino Hospital, Genova, Italy, between January and June 2021. Histological diagnoses were compared with molecular analyses (HPV genotyping, viral load quantification and co-infection) using a multiplex real-time PCR platform. Of the samples analyzed, 56.4% were HPV DNA positive, while 40% tested negative. The molecular analysis identified more HPV-negative cases than the histological analysis (<i>p</i> < 0.05). Higher viral loads and HPV co-infections were more frequent in high-grade CIN lesions. These markers may help identify patients at an elevated risk for persistent infections and cancer progression. These findings support the potential of integrating HPV viral load and genotype co-infection assessments into routine cervical cancer screening protocols to improve early detection and reduce overtreatment and unnecessary interventions.https://www.mdpi.com/2075-1729/15/2/153cervical cancerhuman papillomavirusHPV screeningsecond-level cervical cancer screeningviral loadco-infection
spellingShingle Serena Varesano
Giulia Ciccarese
Michele Paudice
Katia Mazzocco
Gabriele Gaggero
Simone Ferrero
Giancarlo Icardi
Valerio Gaetano Vellone
Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment
Life
cervical cancer
human papillomavirus
HPV screening
second-level cervical cancer screening
viral load
co-infection
title Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment
title_full Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment
title_fullStr Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment
title_full_unstemmed Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment
title_short Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment
title_sort evaluating hpv viral load and multiple infections for enhanced cervical cancer risk based assessment
topic cervical cancer
human papillomavirus
HPV screening
second-level cervical cancer screening
viral load
co-infection
url https://www.mdpi.com/2075-1729/15/2/153
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