MOLECULAR EPIDEMIOLOGY OF PERSISTENT HPV INFECTION

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DESCRIPTION: This is a competing continuation application for continued study of human papilloma virus (HPV) genital persistent in a large cohort of low income women in Sao Paolo, Brazil, a high risk area for cervical carcinoma. The study focuses on the relationship of oncogenic HPV types on the development of cervical epithelial lesions and carcinoma. Participants undergo a series of questionnaire-based interviews to access sexual behavior and other potentially contributing factors, PAP smears, HPV testing by PCR, HPV serology and cervicography. The objectives are to 1 study incidence and prevalence of persistent cervical HPV in asymptomatic women; 2 verify the hypothesis that persistent HPV increases low and high grade cervical lesions; 3 detect epidemiological determinants of HPV persistence; 4 search for molecular variants associated with cervical lesions; 5 to determine whether HPV viral load is associated with persistence, and low or high grade lesions; and 6 study the role of antibody response to HPV persistence and lesion progression. For the competitive renewal, 2 additional aims are proposed: 7 identity HLA haplotypes associated with HPV persistence and cervical lesions; and 8 test whether p53 polymorphisms confer resistance to HPV persistence and lesion development.