The Correlation Between HPV-16 Viral Load and Cytological Grades In Anbar

Abstract

Background: Human papilloma virus 16 (HPV-16) is the most oncogenic type of HPV and it is in the centre of oncogenesis of cervical cancer. The HPV-16 viral load measured in real-time by the cycle threshold (Ct) values of PCR has been suggested as a potential disease severity biomarker.

Material and Methods: A cross-sectional study was conducted 121 females who attended gynecology clinics. The research was conducted in the obstetrics and gynecology units of Fallujah teaching hospitals and the outpatient clinics in Fallujah city. The research was done in the period between September 2025 and January 2026. Assessment of cervical cytology was based on the Bethesda system 2014. The viral load of the virus and HPV-16 were detected using the multiplex real-time PCR of E6/E7 oncogenes. The correlation was tested using GraphPad Prism software.

Results: HPV-16 was found to be most frequently detected with 15.7 (19/121) in general. The statistical significance between HPV-16 positivity and the severity of cytological grade was found to be statistical (p < 0.001). Prevalence of HPV-16 slowly rises to 4.5% in Negative intraepithelial Lesion or Malignancy (NILM) to 67.9% in High-Grade Squamous Intraepithelial Lesions (HSIL). The quantitative analysis demonstrated that such negative correlation of lesion grade and viral load was significant; mean of Ct of HSIL and Atypical Glandular Cells (AGC) were significantly lower than that of NILM (28.42 and 28.16, respectively). High grade lesions could be differentiated well with a Ct cut off of 30 or below.

Conclusion: HPV-16 viral load is a good discriminant against the degree of lesions in the cervix. A large viral load is an excellent indicator of high-grade pathology, which means that quantitative PCR can be used to supplement cytology in the risk stratification.