ArticleFrontiers in oncology2026
Association between HPV-16 and HPV-18 viral loads and severity of cervical pre-invasive lesions in women with and without HIV in Botswana.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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10 authors.
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Abstract
Background: Cervical cancer is an important global health problem, including in Botswana. Human papillomavirus (HPV) and human immunodeficiency virus (HIV) are responsible for a considerable burden of the disease globally. The significance of HPV viral load in the detection of pre-invasive cervical lesions in patients with and without HIV is still controversial. The present study aimed to explore the correlation between HPV-16 and HPV-18 genotype viral loads and the severity of cervical lesions in pre-cervical cancer patients with and without HIV in Botswana. Methods: A cross-sectional convenience sampling was adopted using 109 archived residual tissue blocks collected from pre-cervical cancer patients in Gaborone, Botswana, during 2017-2019. Viral load for HPV-16 and HPV-18 has been quantified in pre-invasive cervical lesions using quantitative PCR to evaluate its potential as a predictor of disease severity, and examined correlations with HIV status and pre-cancer stage. Results: Of the 109 patients, HPV-16 was detected in 33.94% and HPV-18 in 14.68%. Only 3 (2.75%) patients were co-infected with both genotypes, while the remaining patients 56 (48.6%) tested negative for both genotypes. In this study 70.6% of the 109 samples were infected with HIV while 29.4% were HIV-uninfected. For HPV-16, higher cervical intraepithelial neoplasia (CIN) grade was associated with increased HPV viral load, while HPV-18 exhibited a more variable pattern, with the highest HPV viral load observed in CIN II. The presence of HPV-16 and elevated HPV-16 viral load were significant risk factors for CIN III. In contrast, the presence of HPV-18 and higher HPV-18 viral load were associated with increased risk for CIN II, but did not have a significant impact on the risk for CIN III. HIV status did not have a significant impact on viral load of these HPV genotypes. Conclusions: Higher HPV-16 viral loads are linked to more severe cervical lesions while HPV-18 is more associated with CIN II than CIN III. However, HIV status was not associated with higher viral loads. Larger studies are needed to confirm these findings and improve screening.
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