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We performed a prospective study including 781 women with normal, atypical squamous cells of undetermined significance (ASCUS) or low\u2010grade squamous intraepithelial lesion (LGSIL) cytology, and infected or not by high\u2010risk (HR) HPV tested by Hybrid Capture II. Women were followed up every 6 months for a median period of 22 months. Among the HR\u2010HPV\u2010positive women at entry, more than half cleared their virus in 7.5 months; the clearance rate was greater for low viral loads than for high loads and also was higher in women with an initial ASCUS\/LGSIL smear than in women with normal cytology. The incidence of cytologic abnormalities strongly depended on baseline viral load and HR\u2010HPV persistence. Maintenance of cytologic abnormalities was associated with the outcome of HR\u2010HPV status (negative&lt;transient&lt;persistent) but not with baseline load. Progression to CIN2\/3+ was achieved only in women with persistent HR\u2010HPV infection. The risk of CIN2\/3+ also was increased with initial high loads (\u2265100 pg\/mL). Conversely, women who were consistently HR\u2010HPV negative or transiently HR\u2010HPV positive, whatever the cytology at baseline was, did not develop CIN2\/3+ during follow\u2010up. Age seemed to affect only the rate of incident HR\u2010HPV infection. In conclusion, our data suggest that women repeatedly tested positive for HR\u2010HPV are at risk of developing CIN2\/3+, even when initial cytology is normal. A high viral load could be used as a short\u2010term marker of progression toward precancerous lesions, although lower load does not inevitably exclude progressive disease. \u00a9 2003 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ijc.11222","type":"journal-article","created":{"date-parts":[[2003,7,2]],"date-time":"2003-07-02T06:03:46Z","timestamp":1057125826000},"page":"396-403","source":"Crossref","is-referenced-by-count":357,"title":["Persistence and load of high\u2010risk HPV are predictors for development of high\u2010grade cervical lesions: A longitudinal French cohort 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