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Gustavsson, Inger M.
Alternative names
Publications (10 of 33) Show all publications
Hermansson, R. S., Olovsson, M., Gustavsson, I. M., Gyllensten, U. B., Lindkvist, O., Hedlund Lindberg, J., . . . Lindström, A. K. (2022). Incidence of oncogenic HPV and HPV-related dysplasia five years after a negative HPV test by self-sampling in elderly women. Infectious Agents and Cancer, 17(42)
Open this publication in new window or tab >>Incidence of oncogenic HPV and HPV-related dysplasia five years after a negative HPV test by self-sampling in elderly women
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2022 (English)In: Infectious Agents and Cancer, E-ISSN 1750-9378, Vol. 17, no 42Article in journal (Refereed) Published
Abstract [en]

Purpose: Cervical cancer prevention for older women can be challenging since there are no specific guidelines for this group. This study aimed to determine the incidence of oncogenic HPV and HPV-related dysplasia in elderly women 5 years after being HPV negative.

Methods: Invited women participated five years earlier in a study where self-sampling for HPV testing was applied, at this time, they were all HPV negative. The women were now, five years later invited to perform self-sampling for HPV testing. Women with a positive result performed a repeat HPV test. Those with a positive repeat HPV test were examined by colposcopy, biopsy and cytology.

Results: Of the 804 invited women, 634 (76.9%) agreed to participate in the study and a self-sampling kit was sent to them. Of these, 99.6% (632/634) sent a sample to the HPV laboratory. The participation rate in each age group was 93.3% at age 65, 74.0% at age 70, 80.7% at age 75 and 64.6% at age 80. Overall 18 women (2.8%, 95% CI 3.2 to 6.0) were HPV positive in the first test and 8 (1.3%, 95% CI 0.6 to 2.6) in the second test. Sampling for the second test was done on average 5.4 months after the first test. Fifty per cent (4/8) of the women with a positive repeat test had dysplasia in histology.

Conclusions: The incidence of HPV in previously HPV-negative elderly women was low. Among women who were HPV positive in a repeat test, there was a high prevalence of low grade dysplasia.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Cervix, HPV, cervical intraepithelial neoplasia, elderly, incidence, self-sampling
National Category
Clinical Medicine Obstetrics, Gynecology and Reproductive Medicine
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-432932 (URN)10.1186/s13027-022-00453-z (DOI)000835677600002 ()35922825 (PubMedID)
Available from: 2021-01-25 Created: 2021-01-25 Last updated: 2024-03-14Bibliographically approved
Runow Stark, C., Gustavsson, I., Horal, P., Kotopouli, M., Gyllensten, U. & Hirsch, J.-M. (2021). Brush Samples of Oral Lesions to FTA Elute Card for High-risk Human Papilloma Virus Diagnosis. Anticancer Research, 41(1), 269-277
Open this publication in new window or tab >>Brush Samples of Oral Lesions to FTA Elute Card for High-risk Human Papilloma Virus Diagnosis
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2021 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 41, no 1, p. 269-277Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate the level of agreement between three non-invasive methods for hrHPV diagnosis in oral and oropharyngeal squamous cell carcinoma (OSCC, OPSCC) and in oral mucosal lesions.

MATERIALS AND METHODS: For hrHPV DNA FTA Elute card™ and Anyplex II HPV28™ were used and for hrHPV mRNA PreTect SEE™ in tumour patients (n=60), non-tumour lesions (n=51), immunosuppression or previous hrHPV-infection (n=32).

RESULTS: The level of agreement between the DNA-methods was 82.2% (k=0.54, p=0.001). Pair-wise comparison for the FTA Elute card were close to the reference (AUC=0.83, 95% CI=0.73-0.90). hrHPV mRNA was diagnosed in 50% of the tumours, with an agreement level of 58.3%, compared to Anyplex II (k=0.17, p=0.04). The hrHPV positivity in oral lesions was 3.9% for immunosuppression and for previous HPV infection 9.4%.

CONCLUSION: The FTA card is reliable for hrHPV DNA diagnosis while mRNA gives an insight into viral activity and correlates with severity of the lesion.

Keywords
DNA, FTA Elute card, hrHPV, human papillomavirus, mRNA, oral- and oropharyngeal cancer, potentially malignant oral disorders, real-time PCR
National Category
Cancer and Oncology Microbiology in the medical area
Identifiers
urn:nbn:se:uu:diva-430547 (URN)10.21873/anticanres.14773 (DOI)000608664500003 ()33419821 (PubMedID)
Funder
Region UppsalaRegion Stockholm, SOF 4640/2016
Available from: 2021-01-11 Created: 2021-01-11 Last updated: 2021-03-01Bibliographically approved
Aarnio, R., Isacson, I., Sanner, K., Gustavsson, I. M., Gyllensten, U. B. & Olovsson, M. (2021). Comparison of vaginal self-sampling and cervical sampling by medical professionals for the detection of HPV and CIN2+: a randomized study. International Journal of Cancer, 148(12), 3051-3059
Open this publication in new window or tab >>Comparison of vaginal self-sampling and cervical sampling by medical professionals for the detection of HPV and CIN2+: a randomized study
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2021 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 148, no 12, p. 3051-3059Article in journal (Refereed) Published
Abstract [en]

Primary screening with human papillomavirus (HPV) test is more effective in reducing cervical cancer incidence than cytology and it also offers the opportunity to self-sample. We conducted a randomized study to compare vaginal self-sampling with cervical sampling by medical professionals for HPV testing concerning prevalence of HPV and detection of cervical intraepithelial neoplasia (CIN) of grade 2 or worse (CIN2+) or grade 3 or worse (CIN3+) in primary screening. In total, 11 951 women aged 30-60 years were randomized into two groups, 5961 for self-sampling (SS arm) and 5990 for sampling by medical professionals (SMP arm). Sampling was performed with a RoversViba-brush in the SS arm and a cytobrush in the SMP arm. All samples were applied to an indicating FTA elute card and analyzed for HPV using a clinically validated real-time PCR test (hpVIR). All HPV-positive women performed repeated sampling about 6 months later using the same procedure as used initially. All HPV-positive women in the second sampling were referred to colposcopy. The prevalence of HPV in the first test did not differ between the SS arm (6.8%, 167/2466) and the SMP arm (7.8%, 118/1519) (P = .255). The prevalence of CIN2+ per 1000 screened women was 17 (43/2466 × 1000) (95%CI 13-24) in the SS arm and 21 (32/1519 × 1000) (95%CI 15-30) in the SMP arm. For CIN3+, the prevalence per 1000 screened women was 14 (35/2466 × 1000) (95%CI 10-20) in the SS arm and 15 (23/1519 × 1000) (95%CI 10-23) in the SMP arm. In conclusion, self-sampling and sampling by medical professionals showed the same prevalence of HPV and detection rate of CIN2+ and CIN3+ in histology.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
Self-sampling, HPV test, Primary cervical screening
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-405547 (URN)10.1002/ijc.33482 (DOI)000618718900001 ()33497465 (PubMedID)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-01-15Bibliographically approved
Lara Gutiérrez, A., Hedlund Lindberg, J., Shevchenko, G., Gustavsson, I., Bergquist, J., Gyllensten, U. & Enroth, S. (2021). Identification of Candidate Protein Biomarkers for CIN2+ Lesions from Self-Sampled, Dried Cervico-Vaginal Fluid Using LC-MS/MS. Cancers, 13(11), Article ID 2592.
Open this publication in new window or tab >>Identification of Candidate Protein Biomarkers for CIN2+ Lesions from Self-Sampled, Dried Cervico-Vaginal Fluid Using LC-MS/MS
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2021 (English)In: Cancers, ISSN 2072-6694, Vol. 13, no 11, article id 2592Article in journal (Refereed) Published
Abstract [en]

Molecular screening programs for cervical cancer detect the presence of human papilloma virus (HPV) in cell material or vaginal fluids. Persistent infection with high-risk HPV is a necessary pre-requisite, but the majority of infections do not lead to pathological states. Additional biomarkers are needed to increase the specificity of the molecular tests. Here, we have investigated the possibility of detecting protein biomarkers using mass spectrometry from dried self-sampled cervico-vaginal fluid deposited on FTA cards. We found significant intra-individual correlations (p < 2.2 × 10-16), although heterogenous protein profiles were obtained between individuals. Out of 3699 proteins found in total, 169 were detected in at least 95% of the samples. Using a discovery/replication design, 18 proteins were found to be significant in the discovery cohort, with higher values in those cases compared to controls. All of these were found to also have higher levels among the cases in the replication cohort, with one protein (DEAD-Box Helicase) remaining statistically significant. Finally, a predictive 7-protein multivariate model was developed with a sensitivity and specificity of 0.90 and 0.55, respectively. Our results demonstrate that robust measurements of protein biomarkers can be obtained from self-sampled dried CVF and that these could be used to predict cervical cancer pre-stages.

Place, publisher, year, edition, pages
MDPI, 2021
Keywords
FTA-cards, biomarkers, cervical cancer pre-stages, cervico–vaginal fluid, mass spectrometry, proteomics
National Category
Obstetrics, Gynecology and Reproductive Medicine Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-447135 (URN)10.3390/cancers13112592 (DOI)000659620100001 ()34070587 (PubMedID)
Funder
Swedish Cancer SocietySwedish Foundation for Strategic Research Swedish Research CouncilErik, Karin och Gösta Selanders Foundation
Available from: 2021-06-23 Created: 2021-06-23 Last updated: 2024-01-15Bibliographically approved
Taku, O., Meiring, T. L., Gustavsson, I. M., Phohlo, K., Garcia-Jardon, M., Mbulawa, Z. Z. A., . . . Williamson, A.-L. (2020). Acceptability of self- collection for human papillomavirus detection in the Eastern Cape, South Africa. PLOS ONE, 15(11), Article ID e0241781.
Open this publication in new window or tab >>Acceptability of self- collection for human papillomavirus detection in the Eastern Cape, South Africa
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2020 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 11, article id e0241781Article in journal (Refereed) Published
Abstract [en]

Human papillomavirus (HPV) testing on vaginal self-collected and cervical clinician-collected specimens shows comparable performance. Self-sampling on FTA cards is suitable for women residing in rural settings or not attending regular screening and increases participation rate in the cervical cancer screening programme. We aimed to investigate and compare high-risk (HR)-HPV prevalence in clinician-collected and self-collected genital specimens as well as two different HPV tests on the clinician collected samples. A total of 737 women were recruited from two sites, a community health clinic (n = 413) and a referral clinic (n = 324) in the Eastern Cape Province. Cervical clinician-collected (FTA cards and Digene transport medium) and vaginal self-collected specimens were tested for HR-HPV using the hpVIR assay (FTA cards) and Hybrid Capture-2 (Digene transport medium). There was no significant difference in HR-HPV positivity between clinician-collected and self-collected specimens among women from the community-based clinic (26.4% vs 27.9%, p = 0.601) or the referral clinic (83.6% vs 79.9%, p = 0.222). HPV16, HPV35, and HPV33/52/58 group were the most frequently detected genotypes at both study sites. Self-sampling for HPV testing received a high positive response of acceptance (77.2% in the community-based clinic and 83.0% in referral clinic). The overall agreement between hpVIR assay and HC-2 was 87.7% (k = 0.754). The study found good agreement between clinician-collected and self-collected genital specimens. Self-collection can have a positive impact on a cervical screening program in South Africa by increasing coverage of women in rural areas, in particular those unable to visit the clinics and women attending clinics where cytology-based programs are not functioning effectively.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2020
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-429058 (URN)10.1371/journal.pone.0241781 (DOI)000592383400035 ()33170891 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2020-12-22 Created: 2020-12-22 Last updated: 2021-06-14Bibliographically approved
Aarnio, R., Östensson, E., Olovsson, M., Gustavsson, I. M. & Gyllensten, U. B. (2020). Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized study. BMC Cancer, 20(1), Article ID 645.
Open this publication in new window or tab >>Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized study
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2020 (English)In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 20, no 1, article id 645Article in journal (Other academic) Published
Abstract [en]

Background

Human papillomavirus (HPV) testing is recommended in primary cervical screening to improve cancer prevention. An advantage of HPV testing is that it can be performed on self-samples, which could increase population coverage and result in a more efficient strategy to identify women at risk of developing cervical cancer. Our objective was to assess whether repeated self-sampling for HPV testing is cost-effective in comparison with Pap smear cytology for detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) in increasing participation rate in primary cervical screening.

Methods

A cost-effectiveness analysis (CEA) was performed on data from a previously published randomized clinical study including 36 390 women aged 30–49 years. Participants were randomized either to perform repeated self-sampling of vaginal fluid for HPV testing (n = 17 997, HPV self-sampling arm) or to midwife-collected Pap smears for cytological analysis (n = 18 393, Pap smear arm).

Results

Self-sampling for HPV testing led to 1633 more screened women and 107 more histologically diagnosed CIN2+ at a lower cost vs. midwife-collected Pap smears (€ 228 642 vs. € 781 139). 

Conclusions

This study projected that repeated self-sampling for HPV testing increased participation and detection of CIN2+ at a lower cost than midwife-collected Pap smears in primary cervical screening. Offering women a home-based self-sampling may therefore be a more cost-effective alternative than clinic-based screening.

 

Keywords
Self-sampling, HPV testing, primary cervical screening, cost-effectiveness, CIN2+, precancerous lesion, cervical cancer
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-405549 (URN)10.1186/s12885-020-07085-9 (DOI)000552814200003 ()32660432 (PubMedID)
Funder
The Royal Swedish Academy of Sciences, 2015-02711Swedish Cancer Society, 19 0008Pj 01 H
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2020-10-01Bibliographically approved
Berggrund, M., Gustavsson, I. M., Aarnio, R., Lindberg, J. H., Sanner, K., Wikström, I., . . . Gyllensten, U. B. (2020). Temporal changes in the vaginal microbiota in self-samples and its association with persistent HPV16 infection and CIN2+. Virology Journal, 17, Article ID 147.
Open this publication in new window or tab >>Temporal changes in the vaginal microbiota in self-samples and its association with persistent HPV16 infection and CIN2+
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2020 (English)In: Virology Journal, E-ISSN 1743-422X, Vol. 17, article id 147Article in journal (Refereed) Published
Abstract [en]

Background

The vaginal microbiota has been reported to be associated with HPV infection and cervical cancer. This study was performed to compare the vaginal microbiota at two timepoints in women performing self-sampling and had a persistent or transient HPV16 infection. The women were tested for 12 high-risk HPV (hrHPV) types but only women with single type (HPV16) were included to reduce confounding variables.

Methods

In total 96 women were included in this study. Of these, 26 were single positive for HPV16 in the baseline test and HPV negative in the follow-up test and 38 were single positive for HPV16 in both tests and diagnosed with CIN2+ in histology. In addition, 32 women that were negative for all 12 HPV tested were included. The samples of vaginal fluid were analyzed with the Ion 16S™ Metagenomics Kit and Ion 16S™ metagenomics module within the Ion Reporter™ software.

Results

K-means clustering resulted in two Lactobacillus-dominated groups, one with Lactobacillus sp. and the other specifically with Lactobacillus iners. The two remaining clusters were dominated by a mixed non-Lactobacillus microbiota. HPV negative women had lower prevalence (28%) of the non-Lactobacill dominant cluster in the baseline test, as compared to women with HPV16 infection (42%) (p value = 0.0173). Transition between clusters were more frequent in women with persistent HPV16 infection (34%) as compared in women who cleared the HPV16 infection (19%) (p value = 0.036).

Conclusions

The vaginal microbiota showed a higher rate of transitioning between bacterial profiles in women with persistent HPV16 infection as compared to women with transient infection. This indicate an instability in the microenvironment in women with persistent HPV infection and development of CIN2+.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-406976 (URN)10.1186/s12985-020-01420-z (DOI)000578546900004 ()33028395 (PubMedID)
Funder
Swedish Research CouncilSwedish Cancer SocietySwedish Foundation for Strategic Research
Available from: 2020-03-17 Created: 2020-03-17 Last updated: 2023-12-12Bibliographically approved
Gustavsson, I. M., Aarnio, R., Myrnäs, M., Lindberg, J. H., Taku, O., Meiring, T., . . . Gyllensten, U. B. (2019). Clinical validation of the HPVIR high-risk HPV test on cervical samples according to the international guidelines for human papillomavirus DNA test requirements for cervical cancer screening. Virology Journal, 16(1), Article ID 107.
Open this publication in new window or tab >>Clinical validation of the HPVIR high-risk HPV test on cervical samples according to the international guidelines for human papillomavirus DNA test requirements for cervical cancer screening
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2019 (English)In: Virology Journal, E-ISSN 1743-422X, Vol. 16, no 1, article id 107Article in journal (Refereed) Published
Abstract [en]

Background

The indicating FTA card is a dry medium used for collection of cervical samples. HPVIR is a multiplex real-time PCR test that detects 12 high-risk human papillomavirus types (hrHPV) and provides single genotype information for HPV16, − 31, − 35, − 39, − 51, − 56, and − 59 and pooled type information for HPV18/45 and HPV33/52/58. The aim of this study was to evaluate whether a strategy with cervical samples collected on the FTA card and subsequently analysed with the HPVIR test complies with the criteria of the international guidelines for a clinically validated method for cervical screening.

Methods

We performed a non-inferiority test comparing the clinical sensitivity and specificity of the candidate test (FTA card and HPVIR) with a clinically validated reference test (Cobas® HPV test) based on liquid-based cytology (LBC) samples. Two clinical samples (LBC and FTA) were collected from 896 participants in population-based screening. For evaluation of the specificity we used 799 women without ≥ CIN2, and for clinical sensitivity we used 67 women with histologically confirmed ≥ CIN2. The reproducibility was studied by performing inter- and intra-laboratory tests of 558 additional clinical samples.

Results

The clinical sensitivity and specificity for samples collected on the FTA card and analysed using the HPVIR test were non-inferior to samples analysed with the Cobas® HPV test based on LBC samples (non-inferiority test score, p = 1.0 × 10− 2 and p = 1.89 × 10− 9, respectively). Adequate agreement of > 87% was seen in both the intra- and inter-laboratory comparisons.

Conclusions

Samples collected on the indicating FTA card and analysed with HPVIR test fulfil the requirements of the international guidelines and can therefore be used in primary cervical cancer screening.

Keywords
HPV, DNA testing, Primary cervical cancer screening, International guidelines
National Category
Microbiology in the medical area
Identifiers
urn:nbn:se:uu:diva-394268 (URN)10.1186/s12985-019-1216-7 (DOI)000483382500001 ()31438976 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Cancer Society
Available from: 2019-10-09 Created: 2019-10-09 Last updated: 2023-12-12Bibliographically approved
Aarnio, R., Wikström, I., Gustavsson, I. M., Gyllensten, U. B. & Olovsson, M. (2019). Diagnostic excision of the cervix in women over 40 years with human papilloma virus persistency and normal cytology. European journal of obstetrics & gynecology and reproductive biology: X, 3, Article ID 100042.
Open this publication in new window or tab >>Diagnostic excision of the cervix in women over 40 years with human papilloma virus persistency and normal cytology
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2019 (English)In: European journal of obstetrics & gynecology and reproductive biology: X, ISSN 2590-1613, Vol. 3, article id 100042Article in journal (Refereed) Published
Abstract [en]

Objective: Persistent infection with human papillomavirus (HPV) is recognized as the main risk factor of cervical cancer. Investigation via cytology and colposcopy have lower sensitivity than HPV testing in the diagnosis of high-grade cervical intraepithelial neoplasia (CIN2+). Despite normal cytology and colposcopy findings women with persistent HPV infection have an increased risk of CIN2+. The aim of the study was to evaluate the proportion of histologically confirmed CIN2+ in women with persistent HPV infection and normal Pap smears.

Study design: From April 2013 until March 2016 we prospectively recruited 91 women over 40 years with persistent HPV infection without any abnormalities in cytology. Of these, 40 women attended a gynecological examination including an HPV test, Pap smear, endocervical cytology, colposcopy with biopsies and diagnostic loop electrosurgical excision procedure (LEEP). Biopsy and LEEP samples were subjected to histological examination.

Results: CIN2+ was verified by histological examination of the LEEP sample in 6/40 (15%) of the women. All the cytological samples were normal and none of the biopsies confirmed CIN2+. Only 19/40 women still had a persistent HPV infection at the study visit. None of the 21/40 women who had cleared their HPV infection at the study visit had CIN2+ in histology of the LEEP sample.

Conclusions: A persistent HPV infection needs to be monitored despite normal Pap smears, since 6/40 (15%) women older than 40 years, was revealed to have an undiagnosed CIN2+ when LEEP was performed. Counseling women regarding the risk of cervical cancer and the expected effect of an eventual LEEP can help them to make an optimal informed choice.

Keywords
Cervical intraepithelial neoplasia, Colposcopy, Human papillomavirus, Loop electrical excision procedure, Transformation zone
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-400770 (URN)10.1016/j.eurox.2019.100042 (DOI)31404426 (PubMedID)
Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-03-18Bibliographically approved
Berggrund, M., Gustavsson, I. M., Aarnio, R., Lindberg, J. H., Sanner, K., Wikström, I., . . . Gyllensten, U. B. (2019). HPV viral load in self-collected vaginal fluid samples as predictor for presence of cervical intraepithelial neoplasia.. Virology Journal, 16, Article ID 146.
Open this publication in new window or tab >>HPV viral load in self-collected vaginal fluid samples as predictor for presence of cervical intraepithelial neoplasia.
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2019 (English)In: Virology Journal, E-ISSN 1743-422X, Vol. 16, article id 146Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: This study was performed to evaluate the use of high-risk HPV (hrHPV) viral load in screening tests for cervical cancer to predict persistent infection and presence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+).

METHODS: We followed women between 30 and 60 years of age who performed self-sampling of vaginal fluid and subsequently a hrHPV test. Women who were hrHPV positive in their screening test repeated the hrHPV test 3-6 months later and were included in the present study.

RESULTS: Our results show that women with a persistent HPV16 infection had higher HPV viral load in their primary screening test than women with transient infections (p = 5.33e-03). This was also true for sum of viral load for all hrHPV types in the primary screening test (p = 3.88e-07). 48% of women with persistent HPV16 infection and CIN2+ had an increase in HPV16 titer in the follow-up test, as compared to only 20% of women with persistent infection but without CIN2+ lesions. For the sum of all hrHPV types, 41% of women with persistent infection and CIN2+ had an increase in titer as compared to 26% of women without CIN2 + .

CONCLUSIONS: The results show that hrHPV viral load in the primary screening HPV test is associated with the presence of CIN2+ and could be used in triaging hrHPV positive women for different follow-up strategies or recall times. Serial testing of hrHPV viral load has the potential to distinguish women with CIN2+ lesions from women with persistent infection but without CIN2+ lesions.

Keywords
CIN2+, Cervical cancer, HPV viral load, Self-sampling, hrHPV
National Category
Obstetrics, Gynecology and Reproductive Medicine Immunology in the medical area
Identifiers
urn:nbn:se:uu:diva-406972 (URN)10.1186/s12985-019-1253-2 (DOI)000513831600002 ()31771594 (PubMedID)
Funder
Swedish Cancer SocietySwedish Foundation for Strategic ResearchSwedish Research Council
Available from: 2020-03-17 Created: 2020-03-17 Last updated: 2023-12-12Bibliographically approved
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