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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Genital human papillomaviruses (primarily HPV 16 and 18) are causally related to the development of cervical cancer, and most genital warts are positive for HPV 6. While HPV is highly prevalent among sexually active young women, the majority of infections are asymptomatic and only a small proportion will actually progress to cervical cancer. Viral load is one cofactor that has been investigated as a risk factor for progression to cervical cancer, but studies to date have been inconclusive, and more data from prospective studies that employ sensitive, type-specific viral load measurements are needed. The long-term goals of the proposed study are to characterize risk factors for high HPV viral loads and to define the time-dependent relationships between viral loads and HPV-related genital abnormalities. The specific aims are to use E7 mRNA quantitative real time reverse transcription PCR measures of HPV 6, 16, and 18 viral loads to 1) determine the relationships between viral loads and a) cervical intraepithelial neoplasia grade 2 or 3 (CIN 2-3), b) cervical squamous intraepithelial lesions (SIL), and c) genital warts, and 2) define partner and partnership characteristics that are associated with high viral loads among women with incident HPV infection. The study will be conducted as part of an ongoing study of the acquisition and natural history of HPV, and approximately 900 female University students between the ages of 18 and 20 will be enrolled and followed at 4 month intervals for up to 4 years over the course of the study. The proposed study is likely to provide information that will have important clinical and public health implications, including the clinical utility of using HPV viral loads as diagnostic predictors of cervical cancer risk, and the synthesis of accurate and informative messages on the effectiveness of condoms in reducing the risk of HPV-related genital neoplasias.