Prospective serial study of viral change in the cervix and correlation with human papillomavirus genome status.

OBJECTIVE

To observe in serial fashion the histological changes of human papilloma virus (HPV) infection of the cervix and to correlate these with the detection of HPV genomes.

DESIGN

A prospective longitudinal study to perform colposcopy and at 0, 9 and 18 months to obtain a smear, a biopsy for histology and HPV-16 genome detection by DNA/DNA hybridization.

SETTING

Glasgow Family Planning Centre.

SUBJECTS

Eighty-two women recruited on the basis of a routine smear showing viral change without dyskaryosis.

INTERVENTIONS

Women found to have CIN 3 were treated with laser.

MAIN OUTCOME MEASURES

Cytology and cervical biopsy results and HPV-16 DNA detection by Southern blotting obtained serially from individual subjects.

RESULTS

Of 82 women recruited, 10% were positive for HPV-16 detection by Southern blotting. Detection of HPV-16 genomes did not correlate with either CIN or viral infection assessed histologically and serial hybridizations in a given individual showed fluctuation in HPV-16 detection. Polymerase chain reaction in a subset of samples revealed 46% positive for HPV DNA.

CONCLUSION

No clear correlation exists between HPV genome detection and the histological appearance. HPV-16 genome detection alone may not be a useful predictor of precancerous progression.