A study of viral and immunological markers of human papillomavirus related progression of cervical neoplasia

Abstract

Cervical cancer is the second most common cancer among women worldwide with 493,000 new cases reported and 274,000 deaths in 2002. Eighty three percent of cervical cancer cases occur in the developing countries.1 In India, every year 132,082 new cases of cervical cancer cases are diagnosed and 74,118 women die from the disease. Thus, India has one-fourth of the global burden of cervical cancer. Human papillomavirus (HPV) infection is an identified cause for the development of cervical cancer. This study attempted to evaluate the role of certain HPV markers with prognosis in women with cervical neoplasia. Three groups of women were studied. They were women with cervical neoplasia (Study group I), women without cervical neoplasia (Study group II) and healthy women from the community (Study group III). This study has looked at certain HPV specific viral and immunological markers and their possible association with cervical neoplastic disease progression in Indian patients. These facets of this study have been poorly reported from other parts of India. This study has found a lack of association between HPV 16 and 18 viral load in cervical tissue, HPV 18 plasma viremia, HPV16 and 18 mRNA transcript detection in tissue and PBMCs, T cell responses to HPV 16 E7 peptides and antibody response to HPV 16 E2, E6 and E7 peptides and progression of cervical neoplasia in Indian women. PCR-RFLP and LBA were found to be useful methods of HPV DNA detection and genotyping in cervical tissue. HPV 16 plasma viremia and HPV 16 E6/E7 mRNA transcript quantitation in cervical tissue were useful markers of cervical disease progression. T cell responses to HPV 16 peptides other than E7 need to be further elucidated to completely understand the role of immune responses in HPV infection. Antibody responses to HPV 16 and 18 VLPs were found to be markers of viral exposure but did not show association with disease progression. newline