Background: High viral load has inconsistently been associated with cervical disease.

Objectives: The aim of the study was to examine if a higher viral load measured as RLU (HC2) was correlated with prevalent cytological abnormalities. We considered only women with single type HPV infection.

Methods: During 3 years consecutive liquid-based cytology samples (SurePath®) were collected in the Greater Copenhagen area. After cytological examination, the samples were HPV tested by Hybrid Capture II and HC2-positive samples were genotyped using a PCR-based assay (INNO-LiPa). We included 40,382 women (14-95 years) in the study. By linkage with the nationwide Pathology Data Bank the HPV test results were linked to cytological diagnoses made from the same samples. Associations were computed as odds ratios (OR).

Results: In total, 8,274 women were HC2-positive (20.5%). Among those, 3,163 had one HR HPV and 188 had one LR HPV type detected. Overall, 77.8% had normal cytology, 13.5% LSIL and 8.7% had HSIL. A higher RLU (> 250) compared to a lower RLU (1-5) was associated with an OR of 8.0 for LSIL versus normal cytology and 11.8 for HSIL. Considering individual HR types showed that for HPV16 high viral load was strongly associated with HSIL (OR=79.9; 95% CI 10.8 - 589.9) and with LSIL (OR=17.5; 95% CI 6.1 - 50.6). Also for HPV18 and the other HR HPV types an association with viral load was seen, but the relationship was less strong, and had the same magnitude for LSIL and HSIL. For LR HPV types no significant association was observed between viral load and cytological abnormalities.

Conclusions: Higher viral load measured as RLU by HC2 was associated with prevalent cytological abnormalities. Only for HPV16 the relationship with viral load was stronger for HSIL than for LSIL. Results in relation to histology and age will be presented.