# Human Papillomavirus Viral Load as Triage Biomarker for High‐Grade Cervical Lesions and Invasive Cervical Carcinoma: A Cross‐Sectional Study

## TL;DR

This study shows that higher HPV viral load in cervical tissue can help distinguish between precancerous lesions and invasive cervical cancer.

## Contribution

The study demonstrates that HPV viral load is a novel triage biomarker for cervical lesions and cancer.

## Key findings

- HPV viral load was significantly higher in invasive cervical cancer than in high-grade precancerous lesions.
- Cumulative viral load showed good discriminatory ability between CIN2/3 and ICC with defined cutoffs.
- HPV viral load in tissue could serve as a triage tool for aggressive cervical cancer.

## Abstract

We herein evaluated whether intra‐tissue HPV viral load may constitute a triage biomarker to differentiate between high‐grade precancerous cervical lesions from intra cervical cancer (ICC).

50 biopsy samples prospectively obtained from women living in Mauritania suffering from high‐grade cervical intraepithelial neoplasia (CIN2/3), adenocarcinoma (ADC) or squamous cell carcinoma (SCC) were analysed for HPV genotyping and quantitation carried out using Bioperfectus Multiplex Real Time Human Papillomavirus Genotyping Real Time PCR assay.

HPV‐positive results were detected in 47 biopsies (12 CIN2/3 and 35 ICC, including 4 ADC and 31 SCC). The cumulative HPV viral loads of any HPV and high risk‐HPV (HR‐HPV) in ICC were significantly higher than those in CIN2/3 (p < 0.002 for any HPV;  0.02 for HR‐HPV). The cumulative viral loads of any HPV and HR‐HPV possessed a good discriminatory ability to differentiate between CIN2/3 and ICC, with optimal cutoffs ranging from 4.38 (any HPV) to 4.85 (HR‐HPV) copies per 10,000 cells.

Our observations show that cumulative HPV viral load in cervical tissue may constitute a relevant biomarker associated with the severity of HPV‐related cervical lesions. HPV viral load in cervical tissue could be used as a triage tool for aggressive ICC in advanced cervical lesions.