{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:24:03Z","timestamp":1790727843202,"version":"4.1.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer is an important global health problem, including in Botswana. Human papillomavirus (HPV) and human immunodeficiency virus (HIV) are responsible for a considerable burden of the disease globally. The significance of HPV viral load in the detection of pre-invasive cervical lesions in patients with and without HIV is still controversial. The present study aimed to explore the correlation between HPV-16 and HPV-18 genotype viral loads and the severity of cervical lesions in pre-cervical cancer patients with and without HIV in Botswana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional convenience sampling was adopted using 109 archived residual tissue blocks collected from pre-cervical cancer patients in Gaborone, Botswana, during 2017-2019. Viral load for HPV-16 and HPV-18 has been quantified in pre-invasive cervical lesions using quantitative PCR to evaluate its potential as a predictor of disease severity, and examined correlations with HIV status and pre-cancer stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 109 patients, HPV-16 was detected in 33.94% and HPV-18 in 14.68%. Only 3 (2.75%) patients were co-infected with both genotypes, while the remaining patients 56 (48.6%) tested negative for both genotypes. In this study 70.6% of the 109 samples were infected with HIV while 29.4% were HIV-uninfected. For HPV-16, higher cervical intraepithelial neoplasia (CIN) grade was associated with increased HPV viral load, while HPV-18 exhibited a more variable pattern, with the highest HPV viral load observed in CIN II. The presence of HPV-16 and elevated HPV-16 viral load were significant risk factors for CIN III. In contrast, the presence of HPV-18 and higher HPV-18 viral load were associated with increased risk for CIN II, but did not have a significant impact on the risk for CIN III. HIV status did not have a significant impact on viral load of these HPV genotypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher HPV-16 viral loads are linked to more severe cervical lesions while HPV-18 is more associated with CIN II than CIN III. However, HIV status was not associated with higher viral loads. Larger studies are needed to confirm these findings and improve screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1809196","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:35:44Z","timestamp":1782189344000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between HPV-16 and HPV-18 viral loads and severity of cervical pre-invasive lesions in women with and without HIV in Botswana"],"prefix":"10.3389","volume":"16","author":[{"given":"Leabaneng","family":"Tawe","sequence":"first","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership","place":["Gaborone, Botswana"]},{"name":"School of Allied Health Professions, University of Botswana","place":["Gaborone, Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pleasure","family":"Ramatlho","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania Partnership","place":["Gaborone, Botswana"]},{"name":"School of Allied Health Professions, University of Botswana","place":["Gaborone, Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Biostatistics, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zackary","family":"Salem-Bango","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, University of California, Los Angeles","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Ketlametswe","sequence":"additional","affiliation":[{"name":"Botswana-University of Pennsylvania 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