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. 2025 Mar 13;17(3):409.
doi: 10.3390/v17030409.

The Role of cf-HPV DNA as an Innovative Biomarker for Predicting the Recurrence or Persistence of Cervical Cancer

Márcia Poinho  1 , Laura L M S Dias  2 , Layane S Pinheiro  2 , Flávia Níniver O Gomes  1 , Heidy H M F Rondon  1 , Mikele P de Oliveira  1 , Jhonnatan S Souza  1 , Higino F Figueiredo  3 , Daniel L Lira  3 , José E Levi  4 , Valquíria C A Martins  1   3   5 , Kátia L Torres  1   3   5
Affiliations

The Role of cf-HPV DNA as an Innovative Biomarker for Predicting the Recurrence or Persistence of Cervical Cancer

Márcia Poinho et al. Viruses. .

Abstract

Background: Cervical cancer is highly prevalent among women in Amazonas, Brazil, mainly due to low screening coverage, and is diagnosed at a late stage, which compromises the treatment efficacy and survival rates. After treatment, recurrence is frequent, and there are few follow-up options to detect it. This highlights the urgent need for less-invasive biomarkers to monitor affected patients.

Methods: This study employed real-time PCR, targeting the E7 gene of HPV types 16 and 18 to analyze cell-free DNA from plasma samples from 39 cervical cancer patients treated at the Oncology Control Center Foundation in Amazonas, Brazil.

Results: cf-HPV 16 DNA was detected in 54% of the samples before treatment. The socioeconomic and behavioral data showed that 46.2% of the patients had low educational levels, 77% reported having a low income, 79.5% experienced an early sexual activity onset, and 15.4% had never undergone cytological screening. Persistence or recurrence occurred in 30.8% of cases over 4-33 months of follow-up, with cf-HPV DNA detectable in 75% of these cases.

Conclusions: cf-HPV DNA in plasma is a promising biomarker for post-treatment surveillance, facilitating the earlier detection of persistence/recurrence. Incorporating this biomarker into clinical protocols could enhance outcomes and survival, particularly in underserved regions like the Amazon, where the access to healthcare is limited.

Keywords: Amazonian population; HPV; cell-free DNA; cervical cancer; persistence; post-treatment surveillance; recurrence.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the study’s design, in the collection, analyses, or interpretation of the data, in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Clinical follow-up of 39 patients with cervical cancer treated at FCECON, from August 2020 to September 2022, Manaus—AM, Brazil. Each line corresponds to one patient (n = 39); marks in red (formula image) and green (formula image) correspond to plasma samples positive for circulating HPV DNA and negative for circulating HPV DNA, respectively. The patients with detectable circulating HPV DNA in their samples during treatment are indicated by a black arrow; (formula image) patients died; P/R patients presented persistence/recurrence; (formula image) patients did not have treatment.
Figure 2
Figure 2
Survival analysis of the women (n = 39) monitored through cf-HPV DNA testing (cf-HPV DNA detectable in blue and not detectable in yellow) after the initiation of cervical cancer treatment at FCECON, Manaus, AM, Brazil, from August 2020 to September 2022.
See this image and copyright information in PMC

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