Diagnostic value of high-risk human papillomavirus viral load on cervical lesion assessment and ASCUS triage.

This study aims to evaluate HR-HPV viral load in the cervical lesion assessment and its diagnostic value on the triage of ASCUS. The three-step protocol for cervical cancer screening was carried out in 5171 patients from June 2017 to August 2019, and 1620 histopathological results were obtained. The positive rate of HR-HPV and TCT increased with the aggravation of pathological grades of cervical lesions. The sensitivity and specificity of HR-HPV (DH3) to detect CIN II+ were 91.91% and 84.46%, respectively. In comparison, the corresponding results of the cytology test were 80.51% and 83.12%. HPV16/18 viral load was positively correlated with the grade of cervical lesions (p < 0.001, r = 0.321). The diagnostic efficiency of AUC by applying HPV16/18 viral load was 0.682 for the diagnosis of CIN II+. The optimal HPV16/18 viral load for predicting CIN II+ was 6.80 RLU/CO (relative light units/cut-off), with corresponding sensitivity of 48.6%, specificity of 79.7%, and Youden index of 0.283. In the ASCUS population, viral loads were statistically different in HPV16/18 and the other 12 HR-HPV when compared cervicitis group with CIN I group and CIN II+ group (all p < 0.05). Statistical differences were detected concerning HPV16/18 viral load, contact bleeding status, and smoking status when compared cervicitis group with CIN I group and CIN II+ group (p < 0.05), with a corresponding odds ratio of 1.004, 1.533, and 5.513, respectively. Our findings suggest that HR-HPV viral load can be regarded as a useful tool to predict the grade of cervical lesions for ASCUS triage. ClinicalTrials.gov ID: NCT03178136.

Disseminated intravascular coagulation as an unusual presentation of an Epstein-Barr virus infection.

Epstein-Barr viral (EBV)-infection usually presents as fever, sore throat, fatigue, lymphadenopathy and atypical lymphocytosis. We describe a patient with disseminated intravascular coagulation as the presenting symptom caused by a primary EBV infection.

[Study on the relationship between uterine bleeding with intrauterine device and viral infection].

OBJECTIVE: To study the relationship between uterine bleeding with intrauterine device (IUD) and virus infection. METHODS: Virus isolation from endometrium samples both with IUD and without IUD was performed with rabbit kidney cell. The cell pathogen effect (CPE) directed the positive isolation. All isolated viruses were further identified by polymerase chain reaction (PCR) for human cytomegalovirus (HCMV) and by neutralizing test for herpes simplex virus type II (HSV-II). RESULTS: The endometrial samples were obtained from four groups: 113 patients with uterine bleeding with IUD; 109 healthy women, without uterine bleeding with IUD; 24 healthy women without IUD and 11 patients with uterine bleeding without IUD. The rates of virus isolation in four groups mentioned above were 59.29%, 19.27%, 16.67% and 63.64% respectively. The positive rates for HCMV and HSV-II in the four groups were 38.81%, 19.05%, 1/4, 3/7 and 23.88%, 23.87%, 1/4, 0.00% respectively. The unidentified viruses were 37.31%, 57.14%, 2/4 and 4/7 respectively. CONCLUSIONS: These results showed that some endometrial samples from both the bleeding groups and the controls were infected by HCMV and HSV-II. The incidence of virus infection in women with uterine bleeding with IUD was much higher than that of the controls, but similar to that is the patients with uterine bleeding without IUD. The results suggested that IUD could activate latent viruses (HCMV, HSV-II) infection and induce bleeding in certain conditions.