The role of human papillomavirus in cervical pre-neoplastic lesions: The relationship between virus genotype and persistence or clearance of the infection

Human papilloma virus (HPV) infection persistence is responsible for modifications that will lead to progression to a pre-neoplastic cervical lesion. This study examined persistence or clearance of HPV infection related to genotypes and to risk factors, like patients' age, smoking habit, and use of oral contraceptives. The data of 90 patients, who had a positive high risk-HPV (HR-HPV) test for more than 18 months irrespective of the genotype, were taken from the pathology database of the Colposcopy Clinic and the presence of HPV was assessed by the linear array test which utilized amplification of target DNA by polymerase chain reaction (PCR) and nucleic acid hybridization. During the first visit a careful anamnesis was taken, with information about lifestyle. Clearance was observed in 25% of infections by low risk genotypes and in 43% of which by high risk and, among high oncogenic risk genotypes, HPV 16, 31, 33, 35, 39, 45, 51, and 59 were mostly associated to persistence of infection. Among persistent HPV infections, progression occurred with HPV16 in 50% of cases, with HPV18 in 44.4% of cases, with HPV31 and HPV35 in 33.3% of cases, with HPV33 in 28.5% of cases, with HPV45 in 41.7% of cases, with HPV51 in 25% of cases, and with HPV59 in 20%. There was no statistically significant difference between persistence of high risk and low risk genotypes and a significant association with the cited risk factors. A long period of follow- up, HPV-DNA detection by PCR, and the study of risk factors could lead to improve the diagnosis of persistent HPV infections.