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Tong T, Su D, Yang Q, Yang K, Liu Y, Wang Q, Tian T. Multiple high-risk HPV infections probably associated with a higher risk of low-grade cytological abnormalities but not with high-grade intraepithelial lesions of the cervix. World J Surg Oncol 2024; 22:79. [PMID: 38486308 PMCID: PMC10938671 DOI: 10.1186/s12957-024-03360-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/08/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND For women diagnosed with HR-HPV DNA positivity in community hospitals, the necessity of investigating the potential presence of multiple HR-HPV infections upon referral to tertiary medical institutions remains unclear. METHODS In our cohort, women tested positive for HR-HPV DNA during examinations in community hospitals, were subsequently referred to tertiary medical facilities, reevaluated HR-HPV genotype and categorized based on cytological and histopathological results. The risk of cytologic/histopathology abnormalities and ≧ high grade squamous intraepithelial lesion(HSIL) or Cervical Intraepithelial Neoplasia (CIN) 2 associated with individual genotypes and related multiple HPV infections are calculated. RESULTS A total of 1677 women aged between 21 and 77 were finally included in the present study. The cytology group included 1202 women and the histopathological group included 475 women with at least one HR-HPV infection of any genotype. We only observed a higher risk of low grade cytological abnormalities in women with multiple infections than those in corresponding single infections (for all population with an OR of 1.85[1.39-2.46]; p < 0.05). However, this phenomenon was not observed in histopathology abnormalities (CIN1). The risk of developing of ≥ HSIL/CIN2 in women who were infected with multiple HR-HPV also showed a similar profile to those with a single HR-HPV genotype. CONCLUSION Multiple HR-HPV infections is only associated with a higher associated risk of low grade cytological abnormalities. There is no evidence of clinical benefit to identify the possible presence of multiple HR-HPV infection frequently in a short period of time for women with HR-HPV-DNA positive.
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Affiliation(s)
- Tong Tong
- Department of Reproductive Medicine, Department of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Di Su
- Department of Reproductive Medicine, Department of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Qi Yang
- Department of Reproductive Medicine, Department of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Kun Yang
- Department of Reproductive Medicine, Department of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yuqi Liu
- Department of Reproductive Medicine, Department of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Qun Wang
- Department of Reproductive Medicine, Department of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Tian Tian
- Department of Reproductive Medicine, Department of Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin, China.
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Huang Y, Zhang D, Yin L, Zhao J, Li Z, Lu J, Zhang X, Wu C, Wu W. Modeling the Health Impact and Cost-Effectiveness of a Combined Schoolgirl HPV Vaccination and Cervical Cancer Screening Program in Guangdong Province, China. CHILDREN (BASEL, SWITZERLAND) 2024; 11:103. [PMID: 38255416 PMCID: PMC10814869 DOI: 10.3390/children11010103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
Low human papillomavirus (HPV) vaccine uptake is a key barrier to cervical cancer elimination. We aimed to evaluate the health impact and cost-effectiveness of introducing different HPV vaccines into immunization programs and scaling up the screening program in Guangdong. We used a dynamic compartmental model to estimate the impact of intervention strategies during 2023-2100. We implemented the incremental cost-effectiveness ratio (ICER) in costs per averted disability-adjusted life year (DALY) as an indicator to assess the effectiveness of the intervention. We used an age-standardized incidence of 4 cases per 100,000 women as the threshold for the elimination of cervical cancer. Compared with the status quo, scaling up cervical cancer screening coverage alone would prevent 215,000 (95% CI: 205,000 to 227,000) cervical cancer cases and 49,000 (95% CI: 48,000 to 52,000) deaths during 2023-2100. If the coverage of vaccination reached 90%, domestic two-dose 2vHPV vaccination would be more cost-effective than single-dose and two-dose 9vHPV vaccination. If Guangdong introduced domestic two-dose 2vHPV vaccination at 90% coverage for schoolgirls from 2023 and increased the screening coverage, cervical cancer would be eliminated by 2049 (95% CI 2047 to 2051). Introducing two doses of domestic 2vHPV vaccination for schoolgirls and expanding cervical cancer screening is estimated to be highly cost-effective to accelerate the elimination of cervical cancer in Guangdong.
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Affiliation(s)
- Yating Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510200, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Dantao Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lihua Yin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianguo Zhao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Zhifeng Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jing Lu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xiaoming Zhang
- The Second Division Center for Disease Control and Prevention of Xinjiang Production and Construction Corps, Tiemenguan 841007, China
| | - Chenggang Wu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Wei Wu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510200, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
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3
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Zhao M, Zhou D, Zhang M, Kang P, Cui M, Zhu L, Luo L. Characteristic of persistent human papillomavirus infection in women worldwide: a meta-analysis. PeerJ 2023; 11:e16247. [PMID: 38025679 PMCID: PMC10655709 DOI: 10.7717/peerj.16247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives We aimed to estimate the genotype distribution of persistent human papillomavirus (HPV) infection in females worldwide, and provided a scientific basis for the prevention strategies of cervical cancer (CC) and the development of HPV vaccines. Methods Both English and Chinese databases were researched from the inception to July 2023. The pooled persistent HPV infection prevalence was calculated using a random effects model. The subgroup analysis was performed to explore the heterogeneity. Publication bias was evaluated using funnel plot, Egger's and Begg's test. Results Twenty-eight studies with 27,335 participants were included. The pooled prevalence of persistent HPV infection was 29.37% (95% CI [24.05%∼35.31%]), and the genotypes with the persistent infection prevalence were HPV16 (35.01%), HPV52 (28.19%), HPV58 (27.06%), HPV18 (25.99%), HPV33 (24.37%), HPV31 (23.35%), HPV59 (21.87%), HPV39 (19.54%), HPV68 (16.61%) and HPV45 (15.05%). The prevalence of multiple and single HPV persistent infection were 48.66% and 36.71%, respectively; the prevalence of persistent HPV infection in different age groups (<30, 30∼39, 40∼49, >50) were 29.83%, 28.39%, 22.24% and 30.22%, respectively. The follow-up time was significantly associated with heterogeneity by subgroup analysis (P < 0.05), and the prevalence of persistent infection decreased with longer follow-up time. Conclusions Multiple infections were more likely to occur persistent HPV infection than single infection. In addition to HPV vaccination, we should emphasize the follow-up management for women under 30 and over 50 years old, those with high-risk HPV infection (HPV59, 39, 68) and multiple infections.
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Affiliation(s)
- Ming Zhao
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Dan Zhou
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Min Zhang
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Peipei Kang
- Shandong Mental Health Center, Shandong University, Jinan, Shandong, China
| | - Meimei Cui
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
- School of Basic Medical, Weifang Medical College, Weifang, Shandong, China
| | - Liling Zhu
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Limei Luo
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
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Tuerxun G, Abudurexiti G, Abulizi G. Prevalence, persistence, clearance and risk factors for HPV infection in rural Uyghur women in China. BMC Womens Health 2023; 23:433. [PMID: 37582764 PMCID: PMC10426228 DOI: 10.1186/s12905-023-02558-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 07/19/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND The incidence of cervical cancer in Uyghur women ranks first among those in Han and other ethnic minority groups. We aimed to understand the natural history of HPV in Uyghur women. METHODS A longitudinal cohort study on the natural history of HPV infection in rural Uyghur women in China was conducted between May 2013 and May 2014. A total of 11000 women from South Xinjiang underwent HPV screening by careHPV and liquid-based cytology. Ultimately, a total of 298 women with positive HPV and normal biopsy results or CIN1 were enrolled to participate in a study including follow-up HPV testing for two years. RESULTS The HPV infection rate in Uyghur women was 9.15%. Among the participants, the careHPV test showed that 298 women were HPV-positive, and histology showed CIN1 or normal results for these women at baseline. Among these patients, after 24 months of initial recruitment, 92 (30.87%) patients had persistent HPV infections, and 206 (69.13%) had cleared HPV infection. Univariate analysis showed that persistent HPV infection was associated with age and shower frequency (P < 0.001 and P = 0.047, respectively). CONCLUSIONS Our results suggest that women over the age of 50 years who have been infected with HR-HPV for more than 1 year should be regularly screened and monitored for HPV. In addition, education should be strengthened to improve poor health habits in these women.
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Affiliation(s)
- Gulixian Tuerxun
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China
| | - Guligeina Abudurexiti
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China
| | - Guzalinuer Abulizi
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China.
- Xinjiang Key Laboratory of Oncology, No. 789 East Suzhou Street, Xinshi District, Urumqi, 830000, China.
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Yin J, Peng S, Zhang C, Li X, Hu F, Chen W, Qiao Y. Head-to-head comparison of genotyping of human papillomavirus by real-time multiplex PCR assay using type-specific primers and SPF10-PCR-based line probe assay. J Med Virol 2023; 95:e28579. [PMID: 36786174 DOI: 10.1002/jmv.28579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
The SPF10-polymerase chain reaction (PCR)-based line probe assay (LiPA-25) with high analytical sensitivity and specificity for human papillomavirus (HPV) genotyping in clinical samples has been widely used in vaccine and epidemiologic studies. A real-time multiplex PCR assay using type-specific primers (Hybribio-23) with low workload and cost has been developed recently. The study aimed to compare the performance of LiPA-25 and Hybribio-23 in selected 1731 cervical swab and 117 tissue samples, with a focus on 20 common HPV types (14 high-risk: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68/73; 6 low-risk: 6, 11, 42, 43, 44, and 53). The level of agreement of two assays was determined using Cohen's Kappa (κ) statistics. A total of 1296 (74.9%) swab samples were identified as HPV-positive by Hybribio-23 or LiPA-25, of which 814 (62.8%) samples exhibited concordant, 358 (27.6%) showed additional or fewer types (compatible), and 124 (9.6%) were discordant. In addition, the two assays showed a perfect agreement for 20 HPV-combined detection (κ = 0.838) and 17 individual HPV types (all κ > 0.800), a good agreement for HPV31 (κ = 0.792) and 43 (κ = 0.696), and a moderate agreement for HPV42 (κ = 0.504). Hybribio-23 was significantly more sensitive for HPV58, 59, 68/73, 42, 43, and 44, and less sensitive for HPV35 and 66 than LiPA-25 (McNemar's test: all p < 0.05). For 117 HPV-positive tissue specimens, the identification of genotypes was 85.2% identical, 12.2% compatible, and only 2.6% discordant. The agreement for HPV31 (κ = 0.786), 68/73 (κ = 0.742), and HPV53 (κ = 0.742) was good, while for other types (all κ > 0.853) and 20 HPV-combined detection (κ = 0.936) was perfect (all p > 0.05). In conclusion, Hybribio-23 and LiPA-25 are comparable. Hybribio-23 could be used for the detection and genotyping of HPV in cervical samples for epidemiological and vaccine studies worldwide.
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Affiliation(s)
- Jian Yin
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siying Peng
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Changning Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,College of Life Sciences, Hebei University, Baoding, China
| | - Xinyue Li
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,College of Life Sciences, Hebei University, Baoding, China
| | - Fangfang Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Collaborative Innovation Center of Biologic Products, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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6
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Yin J, Peng S, Li X, Zhang C, Hu F, Chen W, Qiao Y. Head-to-head comparison of genotyping of human papillomavirus by GP5+/6+-PCR-based reverse dot blot hybridization assay and SPF10-PCR-based line probe assay. J Med Virol 2023; 95:e28435. [PMID: 36571268 DOI: 10.1002/jmv.28435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/10/2022] [Accepted: 12/22/2022] [Indexed: 12/27/2022]
Abstract
The SPF10-PCR-based line probe assay (LiPA-25) for human papillomavirus (HPV) genotyping with high analytical sensitivity and specificity was widely used in HPV vaccine clinical trials and epidemiologic studies. In the study, we aimed to compare a novel GP5+/6+-PCR-based reverse dot blot hybridization assay (Yaneng-23) with LiPA-25. The performance of two assays was evaluated in 1735 cervical swab and 117 tissue samples, with a focus on 19 common HPV types (14 high-risk: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68/73; 5 low-risk: 6, 11, 42, 43, and 53). A total of 1197 (69.0%) swab samples were identified as HPV-positive by two assays. Of these, 878 (73.4%) samples displayed absolute agreement (concordant), 255 (21.3%) showed additional or fewer types (compatible), and the remaining 64 (5.3%) samples were discordant. Additionally, the two assays showed an excellent strength of agreement for 19 HPV-combined detection (κ = 0.886) and 17 individual HPV types (all κ > 0.800), and displayed a good agreement for HPV39 (κ = 0.780) and 42 (κ = 0.699). Yaneng-23 was more sensitive than LiPA-25 for HPV58, 59, 68/73, 42, 43 and 53 (McNemar's test: all p < 0.05), while LiPA-25 was more sensitive for HPV31, 39, 52, and 66 than Yaneng-23 (all p < 0.05). In 113 HPV-positive tissue specimens, the identification of genotypes was 82.3% identical and 17.7% compatible. The agreement between the tests for HPV45 (κ = 0.796) and 51 (κ = 0.742) was good, and for other types (all κ > 0.843) and 19 HPV-combined detection (κ = 0.929) was perfect (all p > 0.05). In conclusion, Yaneng-23 and LiPA-25 are comparable. Yaneng-23 could be used for the detection and genotyping of HPV in cervical samples for epidemiological and vaccine studies worldwide.
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Affiliation(s)
- Jian Yin
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siying Peng
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, Xiamen University, Xiamen, China
| | - Xinyue Li
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,College of Life Sciences, Hebei University, Baoding, China
| | - Changning Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,College of Life Sciences, Hebei University, Baoding, China
| | - Fangfang Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, Xiamen University, Xiamen, China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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7
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Purut YE, Uçkan K. Could HPV Type 33 Be More Risky Than We Thought? Int J Surg Pathol 2023; 31:4-10. [PMID: 36471500 PMCID: PMC9896528 DOI: 10.1177/10668969221134692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: The distribution of human papilloma virus (HPV) genotypes varies by country and region. HPV is the most important risk factor for cervical cancer and HPV 16/18 is the most common genotype. Other high risk HPVs (hrHPVs) other than HPV 16 and 18 contribute significantly to invasive disease. In this study, we aimed to reveal the frequency of association of HPV 16, 18 and other high-risk-HPV types with CIN 2 + (CIN 2 and above) cervical lesions in patients with cervical intraepithelial neoplasia (CIN) and to support the literature especially on the management of high-risk-HPV types other than 16 and 18. Materials and Methods: This retrospective study, which was conducted on 264 patients and 202 patients after the exclusion criteria, was conducted in the gynecology oncology outpatient clinic of the tertiary care hospital between March 2020 and May 2022. HPV 16, HPV 18 and other high-risk-HPV types with negative cytology between the ages of 25-65 were compared by taking a biopsy accompanied by colposcopy performed by the same gynecologist. As a result of colposcopy, CIN2 + patients who underwent excisional procedure were distributed according to HPV type. During this procedure, the patients who were positive for more than one HPV type were considered positive for the group with all subtypes (For example, if the patient was type 31 and 33 positive, they were included in both the 31 and 33 positive groups). The genotype distribution in the high-risk-HPV group was examined. Results: Colposcopy results showed HPV 16 positivity in 43.3%, HPV 33 positivity in 30% and HPV 18 positivity in 10% of the patients with CIN2 + and above lesions. It was observed that the incidence of CIN2 + lesions in the patients with HPV 33 positive was higher than the incidence of a lower-grade lesion (such as CIN1, chronic cervicitis) (p < 0.05). While HPV 33 (r = 0.290, p < 0.000) results were positively correlated with CIN2 + and above lesions, there was a negative correlation with HPV 45 (r = - 0.172, p < 0.015) results (p < 0.05). It was observed that HPV 33 and HPV 45 positivity was a statistically significant variable in predicting the probability of CIN2 + lesions in colposcopy results. It was determined that a HPV 33 positive patient increased the probability of having a CIN2 + lesion by 4.999 times (p < 0.000). Conclusion: In the literature, the role of high-risk -HPV types other than HPV 16 and HPV 18 with negative cytology in the women at risk of cervical preinvasive lesions has still not been fully determined. According to the results of the stuy, especially in women infected with high-risk -HPV types other than HPV 16/18, the relationship between HPV 33 type and CIN 2 + lesions was found to be high, and it was seen that colposcopic biopsy should be performed immediately instead of follow-up after 1 year.
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Affiliation(s)
- Yunus Emre Purut
- SBU Van
Research and Training Hospital,
Gynecology-Oncology clinic, Van, Turkey
| | - Kazım Uçkan
- Department of Gynecology and Obstetrics, faculty of medicine,
Van Yüzüncü
Yıl University, Van, Turkey,Kazım Uçkan, Department of Gynecology and
Obstetrics, faculty of medicine, Van Yüzüncü Yıl University Van- Turkey.
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8
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Yin J, Cheng S, Liu D, Tian Y, Hu F, Zhang Z, Zhu T, Su Z, Liu Y, Wang S, Liu Y, Peng S, Li L, Xu S, Zhang C, Qiao Y, Chen W. Head-to-head comparison of 7 high-sensitive human papillomavirus nucleic acid detection technologies with the SPF10 LiPA-25 system. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:148-154. [PMID: 39036447 PMCID: PMC11256530 DOI: 10.1016/j.jncc.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/02/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
Background The SPF10 LiPA-25 system for human papillomavirus (HPV) detection with high analytical performance is widely used in HPV vaccine clinical trials. To develop and evaluate more valent HPV vaccines, other comparable methods with simpler operations are needed. Methods The performance of the LiPA-25 against that of other 7 assays, including 4 systems based on reverse hybridization (Bohui-24, Yaneng-23, Tellgen-27, and Hybribio-16) and 3 real-time polymerase chain reaction (PCR) assays (Hybribio-23, Bioperfectus-21, and Sansure-26), was evaluated in selected 1726 cervical swab and 56 biopsy samples. A total of 15 HPV genotypes (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 66) were considered for comparison for each HPV type. Results Among the swab samples, compared to LiPA-25, compatible genotypes were observed in 94.1% of samples for Hybribio-23, 92.8% for Yaneng-23, 92.6% for Bioperfectus-21, 92.4% for Hybribio-16, 91.3% for Sansure-26, 89.7% for Bohui-24, and 88.0% for Tellgen-27. The highest overall agreement of the 15 HPV genotypes combined was noted for Hybribio-23 (κ = 0.879, McNemar's test: P = 0.136), followed closely by Hybribio-16 (κ = 0.877, P< 0.001), Yaneng-23 (κ = 0.871, P < 0.001), Bioperfectus-21 (κ = 0.848, P < 0.001), Bohui-24 (κ = 0.847, P < 0.001), Tellgen-27 (κ = 0.831, P < 0.001), and Sansure-26 (κ = 0.826, P < 0.001). Additionally, these systems were also highly consistent with LiPA-25 for biopsy specimens (all, κ > 0.897). Conclusions The levels of agreement for the detection of 15 HPV types between other 7 assays and LiPA-25 were all good, and Hybribio-23 was most comparable to LiPA-25. The testing operation of HPV genotyping should also be considered for vaccine and epidemiological studies.
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Affiliation(s)
- Jian Yin
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuqian Cheng
- Division II of In Vitro Diagnostics for Infectious Diseases, National Institutes for Food and Drug Control, Beijing, China
- National Vaccine and Serum Institute (NVSI), Beijing, China
| | - Daokuan Liu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yabin Tian
- Division II of In Vitro Diagnostics for Infectious Diseases, National Institutes for Food and Drug Control, Beijing, China
| | - Fangfang Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Zhigao Zhang
- Division II of In Vitro Diagnostics for Infectious Diseases, National Institutes for Food and Drug Control, Beijing, China
- Institute of Antibody Engineering, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Tiancen Zhu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Su
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yujing Liu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumeng Wang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiwei Liu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- College of Life Sciences, Hebei University, Baoding, China
| | - Siying Peng
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Linlin Li
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sihong Xu
- Division II of In Vitro Diagnostics for Infectious Diseases, National Institutes for Food and Drug Control, Beijing, China
| | - Chuntao Zhang
- Division II of In Vitro Diagnostics for Infectious Diseases, National Institutes for Food and Drug Control, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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9
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Ikesu R, Taguchi A, Hara K, Kawana K, Tsuruga T, Tomio J, Osuga Y. Prognosis of high-risk human papillomavirus-related cervical lesions: A hidden Markov model analysis of a single-center cohort in Japan. Cancer Med 2021; 11:664-675. [PMID: 34921517 PMCID: PMC8817087 DOI: 10.1002/cam4.4470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/14/2021] [Accepted: 11/16/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction Previous studies have shown that individuals with human papillomavirus (HPV)‐related cervical lesions have different prognoses according to the HPV genotype. However, these studies failed to account for possible diagnostic misclassification. In this retrospective cohort study, we aimed to clarify the natural course of cervical lesions according to HPV genotype to account for any diagnostic misclassification. Materials and Methods Our cohort included 729 patients classified as having cervical intraepithelial neoplasia (CIN). HPV was genotyped in all patients, who were followed up or treated for cervical lesions at the University of Tokyo Hospital from October 1, 2008 to March 31, 2015. Hidden Markov models were applied to estimate the diagnostic misclassification probabilities of the current diagnostic practice (histology and cytology) and the transitions between true states. We then simulated two‐year transition probabilities between true cervical states according to HPV genotype. Results Compared with lesions in patients with other HPV genotypes, lesions in HPV 16‐positive patients were estimated to be more likely to increase in severity (i.e., CIN3/cancer); over 2 years, 17.7% (95% confidence interval [CI], 9.3%–29.3%) and 27.8% (95% CI, 16.6%–43.5%) of those with HPV 16 progressed to CIN3/cancer from the true states of CIN1 and CIN2, respectively, whereas 55%–70% of CIN1/2 patients infected with HPV 52/58 remained in the CIN1/2 category. Misclassification was estimated to occur at a rate of 3%–38% in the current diagnostic practice. Conclusion This study contributes robust evidence to current literature on cervical lesion prognosis according to HPV genotype and quantifies the diagnostic misclassification of true cervical lesions.
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Affiliation(s)
- Ryo Ikesu
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ayumi Taguchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Konan Hara
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Economics, University of Arizona, Tucson, Arizona, USA.,Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - Kei Kawana
- Department of Obstetrics and Gynecology, School of Medicine, Nihon University, Itabashi-ku, Tokyo, Japan
| | - Tetsushi Tsuruga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Jun Tomio
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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10
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HPV Type-Specific Prevalence a Decade after the Implementation of the Vaccination Program: Results from a Pilot Study. Vaccines (Basel) 2021; 9:vaccines9040336. [PMID: 33916132 PMCID: PMC8066234 DOI: 10.3390/vaccines9040336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 12/04/2022] Open
Abstract
Human papillomavirus infection is a cause of the development of invasive cervical cancer. Three types of vaccine are currently available to prevent precancerous/cancerous lesions due to persistent infection, which is supported mainly by 7 different high-risk genotypes. The aim of this pilot study was to acquire preliminary data on type-specific prevalence 10 years after the implementation of the HPV vaccination program in Italy, in order to subsequently plan appropriate observational studies in the Italian population. First-voided urine samples were collected from 393 consenting subjects, both females and males, aged 18–40 years, and HPV DNA was detected by PCR amplification of a 450 bp L1 fragment. All amplified products were genotyped by means of the Restriction Fragment Length Polymorphism (RFLP) method. The female population was divided into three cohorts (“vaccine-eligible”, “pre-screening” and “screening” cohorts) according to the preventive intervention scheduled by age; males were included in the same three cohorts according to their year of birth. The overall prevalence of HPV infection was 19%, being higher in females than in males (22.1% vs. 13.6%, p = 0.03729). In the female population, 10 years after the start of the national immunization program, we observed a reduction in the prevalence of vaccine types and the number of circulating genotypes, especially in the “vaccine-eligible” cohort. The frequency of HPV vaccine types increased with age, particularly in males in the “pre-screening” and “screening” cohorts. Our study highlights the importance of monitoring HPV infection in both genders, to validate the effect of the HPV vaccination program.
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11
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Yamaguchi M, Sekine M, Hanley SJB, Kudo R, Hara M, Adachi S, Ueda Y, Miyagi E, Enomoto T. Risk factors for HPV infection and high-grade cervical disease in sexually active Japanese women. Sci Rep 2021; 11:2898. [PMID: 33536516 PMCID: PMC7858628 DOI: 10.1038/s41598-021-82354-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 01/05/2021] [Indexed: 11/09/2022] Open
Abstract
In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears. Although vaccine opponents claim modifying sexual behavior can prevent cervical cancer, no comprehensive data exist on sexual behavior and the risk of high-grade cervical disease in a Japanese population. This study investigates sexual behavior and the risk of HPV infection and cervical disease in 3968 women aged 20–41 yrs undergoing cervical screening between April 2014 and March 2016. Mean age at first intercourse was 18.4 yrs ± 2.8 and 32% of women reported ≥ 6 lifetime sexual partners. In regression analyses, number of partners was a significant risk factor for HPV infection. However, for high-grade disease (CIN2+), when HPV genotype was adjusted for, number of partners was not statistically significant. The greatest risk factor was an HPV16/18 infection (adjusted odds ratio 113.7, 95% CI: 40.8–316.9). In conclusion, we found that having an HPV16/18 infection and not sexual behavior was the most significant risk factor for high grade cervical disease in young Japanese women. These infections can be prevented by a highly effective vaccine and we recommend that the Japanese government resume proactive recommendations for the HPV vaccine immediately.
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Affiliation(s)
- Manako Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan.
| | - Sharon J B Hanley
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Risa Kudo
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Sosuke Adachi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
| | - Yutaka Ueda
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
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12
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Wei F, Guo M, Huang S, Li M, Cui X, Su Y, Wu X, Ma X, Zheng Y, Huang Y, Wang L, Pan L, Wu T, Zhang J, Xia N. Sex Differences in the Incidence and Clearance of Anogenital Human Papillomavirus Infection in Liuzhou, China: An Observational Cohort Study. Clin Infect Dis 2021; 70:82-89. [PMID: 30852604 DOI: 10.1093/cid/ciz168] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 03/05/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) causes anogenital warts and cancers in men and women. However, little is known about sex differences regarding the natural history of anogenital HPV infection. METHODS Starting in May 2014, an observational cohort study including 2309 men and 2378 women aged 18-55 years was conducted in Liuzhou, China. Samples from anogenital sites were tested for HPV genotypes by multicolor real-time polymerase chain reaction and melting curve analysis biannually for ~1 year. RESULTS The incidence of oncogenic HPV infection was similar in men and women (10.3 and 11.5/1000 person-months; P = .275), whereas the incidence of HPV-6/11 infection was higher in men than in women (2.0 vs 1.1; P = .018). The incidence of both oncogenic HPV and HPV-6/11 infections was significantly higher in women in the 18- to 25-year age group than in the older age groups (P = .006 and .011, respectively), whereas it did not vary by age among men (P = .552 and .425, respectively). Additionally, men were more likely than women to clear oncogenic infections (101.5 vs 58.6/1000 person-months; P < .001), but no significant difference was found in the clearance of HPV-6/11 by sex (111.7 vs 84.8; P = .266). The median time to clearance of oncogenic type and type 6/11 infections was not age dependent for either sex (all P > .05). CONCLUSIONS The natural history of oncogenic and nononcogenic HPV infection differs by sex, which implies that sex-specific vaccination strategies should be considered for oncogenic and nononcogenic HPV. CLINICAL TRIALS REGISTRATION NCT02188004.
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Affiliation(s)
- Feixue Wei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Meng Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Shoujie Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Mingqiang Li
- Liuzhou Center for Disease Control and Prevention, China
| | - Xuelian Cui
- Liuzhou Center for Disease Control and Prevention, China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Xin Wu
- Liuzhou Center for Disease Control and Prevention, China
| | - Xinjing Ma
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Ya Zheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Yue Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Lin Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Lili Pan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
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13
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Li M, Liu T, Luo G, Sun X, Hu G, Lu Y, H Xu R, Zou H, Luo X. Incidence, persistence and clearance of cervical human papillomavirus among women in Guangdong, China 2007-2018: A retrospective cohort study. J Infect Public Health 2020; 14:42-49. [PMID: 33341483 DOI: 10.1016/j.jiph.2020.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous studies showed the incidence, persistence and clearance of cervical human papillomavirus (HPV) among women varies from regions. There is no study on dynamic changes of HPV infection among women in Guangdong. METHODS It is a retrospective cohort study that included gynecological outpatients aged ≥15 years and retested for HPV within 24 months in Guangdong Women and Children Hospital to estimate HPV incidence, persistence and clearance. Outcomes were estimated through the proportion of HPV incidence, persistence and clearance in HPV-negative or HPV-positive women. Moreover, we examined HPV incidence, persistence and clearance among women who retested in four calendar periods: 0-6, 6-12, 12-18, 18-24 months after the first test. RESULTS 33,328 gynecological outpatients were included in our study. Incidence rates of any HPV, high-risk (HR) HPV and low-risk (LR) HPV were 10.58%, 8.68% and 4.83%. The most common incident HR HPV were HPV52 (2.69%), HPV16 (1.23%) and HPV58 (1.23%). Persistence rates of any HPV, HR HPV and LR HPV were 47.55%, 42.77% and 33.88%. HPV52 (42.33%), HPV58 (40.74%) and HPV68 (32.36%) were commonly found persistent types. And clearance rates of any HPV, HR HPV and LR HPV were 52.44%, 57.23% and 66.12%.The lowest clearance rates were observed for HPV52 (57.67%), HPV68 (67.64%) and HPV39 (68.56%). HPV incidence and persistence were higher among women aged 15-19 years and ≥55 years. HPV incidence and persistence were found higher among women who retested within 6 months than others in other periods. CONCLUSIONS HPV52, 58, 68, and 39 were the more likely to cause incident and persistent infection, and less likely to be cleared among women in Guangdong. HPV incidence and persistent infection were higher among women aged both younger and older women compared to middle aged women. HPV retesting period may impact the detection of HPV incidence, persistence and clearance.
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Affiliation(s)
- Meijuan Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Tingyan Liu
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Ganfeng Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Xiaoli Sun
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Guiying Hu
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Ying Lu
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Richie H Xu
- School of Public Health, University of Minnesota, MN, USA
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China; School of Public Health, Shanghai Jiao Tong University, Shanghai, PR China.
| | - Xiping Luo
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China.
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14
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Liu J, Shi Y, Wang L, Wang J, Fan D, Han S, Wei L. Epidemiology and persistence of cervical human papillomavirus infection among outpatient women in Heilongjiang province: A retrospective cohort study. J Med Virol 2020; 92:3784-3792. [PMID: 32297986 DOI: 10.1002/jmv.25899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/29/2020] [Accepted: 04/14/2020] [Indexed: 11/09/2022]
Abstract
As persistent carcinogenic human papillomavirus (HPV) infection is a prominent driver of cervical cancer, it is essential to explore HPV persistence and its associated factors for cancer screening and prevention. A retrospective cohort study was performed in outpatient women between March 2010 and 2019 in Heilongjiang, northeast China. HPV genotyping was performed by polymerase chain reaction-membrane hybridization. An unconditional logistic regression model was used to analyze the association of factors with persistence. The overall prevalence of HPV at baseline was 27.1%, with a downward trend from 2010 to 2019 (P < .0001). The most commonly observed high- and low-risk HPVs were HPV16 (N = 1094, 5.9%) and HPV11 (N = 596, 3.2%), respectively. The probabilities of 6-month persistence were high for women infected with HPV16 (P = .0001), HPV58 (P = .018), and HPV53 (P = .014), as well as for women with multiple infections (P = .009), and those who were 51 to 60 years old (P = .004) or more than 60 years old (P = .007). The probabilities of 12-month persistence were high for women infected with HPV53 (P = .017) and 51- to 60-year-old women (P = .044). HPV16 is the dominant HPV type in Heilongjiang. An age in the range of 51 to 60 years and infection with HPV53 is associated with HPV infection persistence in the Heilongjiang population.
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Affiliation(s)
- Jiaxin Liu
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Yafeng Shi
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lishuang Wang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiao Wang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Dongxue Fan
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Shiyu Han
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lanlan Wei
- Department of Microbiology, Harbin Medical University, Harbin, China
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15
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Liquid-based cervical cytology and microbiological analyses in women using cooper intrauterine device and levonorgestrel-releasing intrauterine system. Eur J Obstet Gynecol Reprod Biol 2020; 255:20-24. [PMID: 33065517 DOI: 10.1016/j.ejogrb.2020.09.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess the influence of the copper IUD and LNG-IUS on liquid-based cytology results (cellular atypia, reactive alterations, and microbiology). STUDY DESIGN This cross-sectional study was performed between January 2012 and December 2017 in the Northeast of Brazil. Three study groups, the LNG-IUS group (n = 1179), copper IUD group (n = 519), and a control group of women not using contraception (n = 14,616) were compared. To facilitate this analysis, the LNG-IUS and IUD groups were further divided into less and more than two years of use. RESULTS The mean age of the LNG-IUS and IUD groups was around 36 years and the control group was about 35 years (p = ns). The meantime between dispositive placement and examination was 19 ± 16 months for the LNG-IUS and 17 ± 15 months for the IUD. The frequency of epithelial atypia revealed upon cytological analysis did not differ between the groups. However, inflammatory infiltrates were significantly more frequent in the LNG-IUS and IUD (OR IUD = 1.32; OR LNG-IUS = 1.79) groups relative to control. Candida and cytolysis were more frequent in the LNG-IUS group (OR = 4.73 and 2.41, respectively) compared to both other groups. Bacterial vaginosis andActinomyces sp occurred more frequently in the IUD group (OR = 1.39 and 3352.55, respectively) compared to both other groups. Bacterial vaginosis was more common when using an IUD for more than two years than for less than two years (OR = 2.55). The Actinomyces morphotype was also observed at greater frequency after two years of IUD use than before (OR = 5.35). CONCLUSIONS The LNG-IUS and copper IUD do not affect the incidence of cellular atypia but do interfere with the microbiota over time. Specifically, the copper IUD is associated with bacterial vaginosis andActinomyces sp infection while the LNG-IUS is associated with candidiasis and cytolysis.
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16
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Jongen VW, van Santen DK, Alberts CJ, Schim van der Loeff MF. Estimating incidence rates of grouped HPV types: A systematic review and comparison of the impact of different epidemiological assumptions. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2019; 8:100187. [PMID: 31600572 PMCID: PMC6804437 DOI: 10.1016/j.pvr.2019.100187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Some studies on human papillomavirus (HPV) provide not only type-specific incidence rates (IR), but also IRs of HPV groupings (e.g. the nonavalent grouping). We made an inventory of the different approaches used to calculate such IRs and assessed their impact on the estimated IRs of HPV groupings. METHODS We performed a systematic review assessing all approaches used in literature to estimate IRs. Subsequently we applied these approaches to data of a Dutch cohort study on HPV in men who have sex with men (H2M). IRs were estimated for six different HPV groupings. RESULTS The systematic review yielded six different approaches (A-F) for estimating the IRs, varying in exclusion criteria at baseline, and the definitions of an incident event and person-time. Applying these approaches to the H2M dataset (n = 749), we found differences in the number of participants at risk, number of incidents events, person-time, and IR. For example, for the nonavalent grouping, depending on the approach chosen, the IR varied between 3.09 and 6.54 per 100 person-months. CONCLUSION In published studies different epidemiological assumptions are used to estimate IRs of grouped HPV types, leading to widely differing estimates of IRs. IRs between different studies may therefore not be comparable.
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Affiliation(s)
- Vita W Jongen
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Daniëla K van Santen
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Catharina J Alberts
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; International Agency for Research on Cancer, Lyon, France
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC, Univ of Amsterdam, Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam, Netherlands.
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17
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Wheeler BS, Rositch AF, Poole C, Taylor SM, Smith JS. Patterns of incident genital human papillomavirus infection in women: A literature review and meta-analysis. Int J STD AIDS 2019; 30:1246-1256. [PMID: 31640474 DOI: 10.1177/0956462418824441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human papillomavirus (HPV) infection acquisition is a necessary step in the development of cervical cancer. No study has systematically quantified the rate of newly acquired HPV infections from the published literature and determined its relationship with age. We performed a systematic review and meta-analysis to describe incident HPV infections in women. Medline® and Thomson Reuters Web of Science via PubMed® databases were searched. A total of 46 of 5136 studies met inclusion criteria and contributed results. We conducted a meta-regression analysis of 13 studies, which reported incidence rate estimates on over 13 high-risk HPV types, to provide pooled stratum-specific incidence rates and rate ratios for key population and study characteristics among 8488 women. Studies with mean age < 30 years had relatively higher HPV incidence rates compared to studies with mean age ≥30 years: relative risk = 3.12; 95% CI: 1.41–6.93. HPV-16 was most frequently detected, followed by HPV-18: relative risk = 0.47; 95% CI: 0.33–0.67, and by HPV-58: relative risk = 0.45; 95% CI: 0.27–0.74. Younger age is a key predictor of genital HPV incidence in women. These data on the relative distribution of incident HPV infections will provide a baseline comparison for monitoring of changes in HPV incidence following the implementation of population-level HPV vaccination.
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Affiliation(s)
- Bradford S Wheeler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,SALineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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18
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Rebolj M, Brentnall AR, Mathews C, Denton K, Holbrook M, Levine T, Sargent A, Smith J, Tidy J, Tyler X, Kitchener H. 16/18 genotyping in triage of persistent human papillomavirus infections with negative cytology in the English cervical screening pilot. Br J Cancer 2019; 121:455-463. [PMID: 31409912 PMCID: PMC6738108 DOI: 10.1038/s41416-019-0547-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In the English pilot of primary cervical screening with high-risk human papillomavirus (HR-HPV), we exploited natural viral clearance over 24 months to minimise unnecessary referral of HR-HPV+ women with negative cytology. Three laboratories were permitted to use 16/18 genotyping to select women for referral at 12-month recall. We estimated the clinical impact of this early genotyping referral. METHODS The observed numbers of women referred to colposcopy and with detected high-grade cervical intraepithelial neoplasia (CIN2+), and of women who did not attend early recall in the three laboratories were compared with those estimated to represent a situation without an early genotyping referral. The 95% confidence intervals (CI) for the differences between the protocols were calculated by using a parametric bootstrap. RESULTS Amongst 127,238 screened women, 16,097 (13%) had HR-HPV infections. The genotyping protocol required 5.9% (95% CI: 4.4-7.7) additional colposcopies and led to a detection of 1.2% additional CIN2+ (95% CI: 0.6-2.0), while 2.3% (95% CI: 2.1-2.5) fewer HR-HPV+/cytology- women did not attend the early recall compared with the non-genotyping protocol. CONCLUSIONS In a screening programme with high quality of triage cytology and high adherence to early recall,16/18 genotyping of persistent HPV infections does not substantially increase CIN2+ detection.
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Affiliation(s)
- Matejka Rebolj
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Adam R Brentnall
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Christopher Mathews
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Karin Denton
- Severn Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Miles Holbrook
- Clinical Virology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Tanya Levine
- Department of Cellular Pathology, Northwick Park Hospital, London, UK
| | - Alexandra Sargent
- Clinical Virology, Manchester University NHS Foundation Trust, Manchester, UK
| | - John Smith
- Cytology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - John Tidy
- Department of Gynaecological Oncology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Xenia Tyler
- Department of Cellular Pathology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Henry Kitchener
- Institute of Cancer Sciences, University of Manchester, St. Mary's Hospital, Manchester, UK
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The Use of Copper as an Antimicrobial Agent in Health Care, Including Obstetrics and Gynecology. Clin Microbiol Rev 2019; 32:32/4/e00125-18. [PMID: 31413046 DOI: 10.1128/cmr.00125-18] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Health care-associated infections (HAIs) are a global problem associated with significant morbidity and mortality. Controlling the spread of antimicrobial-resistant bacteria is a major public health challenge, and antimicrobial resistance has become one of the most important global problems in current times. The antimicrobial effect of copper has been known for centuries, and ongoing research is being conducted on the use of copper-coated hard and soft surfaces for reduction of microbial contamination and, subsequently, reduction of HAIs. This review provides an overview of the historical and current evidence of the antimicrobial and wound-healing properties of copper and explores its possible utility in obstetrics and gynecology.
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20
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Qendri V, Schurink-Van 't Klooster TM, Bogaards JA, Berkhof J. Ten years of HPV vaccination in the Netherlands: current evidence and future challenges in HPV-related disease prevention. Expert Rev Vaccines 2018; 17:1093-1104. [PMID: 30417704 DOI: 10.1080/14760584.2018.1547196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Girls-only vaccination against human papillomavirus (HPV) type 16 and 18 was implemented in the Netherlands in 2009. Despite the evidence of the efficacy against precancerous lesions, cross-protection induced by the vaccine and a greater potential for cancer prevention than cervical cancer only, vaccine coverage in the girls-only program has remained below target levels. AREAS COVERED In this paper, we review the literature from the Netherlands on the effectiveness and cost-effectiveness of HPV vaccination since vaccine introduction, give an account of the coverage, safety and effectiveness of HPV vaccination as has been reported in the Dutch surveillance program and discuss challenges of the current HPV vaccination program. EXPERT COMMENTARY Girls-only HPV vaccination may confer a substantial health gain in HPV-related disease prevention. However, vaccine coverage declined remarkably recently possibly related to safety concerns, limiting the benefits from girls' vaccination and increasing the potential additional benefit of sex-neutral HPV vaccination. Considering the emergence of novel vaccination and screening options and the change from cytology- to HPV-based screening in 2017, further research is required to inform decisions on the optimization of an integrated vaccination and screening program.
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Affiliation(s)
- V Qendri
- a Department of Epidemiology and Biostatistics , Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam , Netherlands
| | - T M Schurink-Van 't Klooster
- b Center for Infectious Disease Control , National Institute for Public Health and the Environment , Bilthoven , Netherlands
| | - J A Bogaards
- a Department of Epidemiology and Biostatistics , Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam , Netherlands.,b Center for Infectious Disease Control , National Institute for Public Health and the Environment , Bilthoven , Netherlands
| | - J Berkhof
- a Department of Epidemiology and Biostatistics , Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam , Netherlands
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21
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Ebisch RMF, Ketelaars PJW, van der Sanden WMH, Schmeink CE, Lenselink CH, Siebers AG, Massuger LFAG, Melchers WJG, Bekkers RLM. Screening for persistent high-risk HPV infections may be a valuable screening method for young women; A retrospective cohort study. PLoS One 2018; 13:e0206219. [PMID: 30356297 PMCID: PMC6200272 DOI: 10.1371/journal.pone.0206219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/09/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction Screening of young women is often discouraged because of the high risk of unnecessary diagnostics or overtreatment. Multiple countries therefore use cytology instead of high risk human papillomavirus (hrHPV)-testing as screening method for young women because of the limited specificity of hrHPV-testing. The objective of this study was to investigate how hrHPV screening before the age of 30, can be used to reduce the future prevalence of high-grade cervical lesions in young women. Methods We retrospectively analyzed follow-up data from a cohort study on HPV prevalence in unscreened Dutch women aged 18–29 years. Women performed multiple self-collected cervico-vaginal samples for HPV detection and genotyping. At least one valid cervical pathology result was obtained from 1,018 women. Women were categorized as hrHPV negative, cleared- or persistent hrHPV infection. Anonymized follow-up data for each group was obtained. Composite outcome measures were defined as; normal, low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). The association between prior hrHPV status and cytology and histology outcome was analyzed. Results After exclusion, a pathology result was registered for 962 women. The prevalence of HSIL was 19.3% in women with a persistent HPV infection at a younger age. This is significantly higher (p<0,001) compared with the HSIL prevalence of 1.5% in HPV-negative women, and 3.1% (n = 8) in women who cleared the hrHPV infection in the past. Conclusion Women with a persistent hrHPV infection in their 20s, show an increased prevalence of HSIL lesions in their early 30s. Screening for persistent hrHPV infections, instead of cytology screening before the age of 30, can be used to reduce the future prevalence of cervical cancer in young women.
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Affiliation(s)
- Renée M. F. Ebisch
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
- * E-mail:
| | - Pleun J. W. Ketelaars
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
| | | | - Channa E. Schmeink
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
| | | | - Albert G. Siebers
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
| | - Leon F. A. G. Massuger
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
| | - Willem J. G. Melchers
- Department of Medical Microbiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Ruud L. M. Bekkers
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands
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Association of cervical microbial community with persistence, clearance and negativity of Human Papillomavirus in Korean women: a longitudinal study. Sci Rep 2018; 8:15479. [PMID: 30341386 PMCID: PMC6195586 DOI: 10.1038/s41598-018-33750-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022] Open
Abstract
The present study aimed to identify the cervical microbes that are associated with HPV negativity, HPV clearance and HPV persistence and to assess the microbes’ longitudinal associations as related to HPV infection dynamics among Korean women. We enrolled 41 women with 107 samples, and classified them according to the HPV infection dynamics: HPV negativity (21 samples, 10 subjects), HPV clearance (42 samples, 15 subjects), and HPV persistence (44 samples, 16 subjects). Cervical swabs were collected at the baseline and six-month-interval follow-up visits. HPV positivity was determined by HPV DNA HC2 assay, and the microbiome was analyzed using 16SrRNA pyrosequencing, linear discriminant analysis effect size and multivariate logistic analysis. In the multivariate logistic analysis results, Lactobacillus crispatus (multivariate OR (mOR) = 8.25, 95% CI 2.13~32.0) was predominant in the HPV-negative group. We observed that Eubacterium eligens (mOR = 11.5, 95% CI 1.31~101.4), Gardnerella vaginalis (mOR = 17.0, 95% CI 2.18–131.8), and Ureaplasma urealyticum (mOR = 7.42, 95% CI 1.3–42.46) had the strongest associations with HPV clearance, and Lactobacillus johnsonii (mOR = 16.4, 95% CI 1.77–152.2) with HPV persistence. Overall, greater diversity was observed in HPV-persistence than in HPV-negative women. Our findings suggest that the presence and prevalence of a specific cervical microbiome are factors involved in HPV dynamics.
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23
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Zhang Q, Zhao M, Cao D, Wei X, Wang L, Li Y, Yang T, Zhao J, Pei M, Jia H, Cao S, Quan S, Yang X. Assessment of the effectiveness of HPV16/18 infection referred for colposcopy in cervical cancer screening in Northwest of China. J Med Virol 2017; 90:165-171. [PMID: 28710863 PMCID: PMC5725729 DOI: 10.1002/jmv.24902] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 07/07/2017] [Indexed: 11/28/2022]
Abstract
To evaluate the effectiveness of Human papillomavirus16/18 infection referral to colposcopy in cervical cancer screening for women aged 25 years and older in Chinese northwest region Shaan'xi province. A total of 2224 women were diagnosed with primary high‐risk HPV infection by HPV‐DNA genotyping technology during August 2014 to August 2015. A total of 1916 cases referred for colposcopy with histological evidence were enrolled, including 1124 women with HPV16/18 genotype and 792 with other High‐risk human papillomavirus genotypes. A total of 1916 women aged 25 years and older with HR‐HPV positive were referred to colposcopy. The distribution of HPV16, HPV18, and other HR‐HPVs infection were 49.22%, 9.45%, and 41.33%, respectively. 71.56% had normal cervical histology, 7.05% had Cervical Intraepithelial Neoplasia1, 8.82% had CIN2, 7.25% had CIN3, and 5.32% had cervical cancer. The percentage of positivity of HPV16 and HPV18 was highly associated with the relative risk of cervical lesion. The sensitivity and specificity of HPV16/18 for detection of CIN2+ (CIN3+) was 82.68% (92.12%) and 47.87% (46.15%), respectively. The positive predictive value and negative predictive value of HPV16/18 for detection of CIN2+ (CIN3+) was 30.16% (19.75%) and 91.03% (97.60%), respectively. HPV16 and HVP18 are the most common genotypes in high grade cervical lesions in Shaan'xi province. Meanwhile, these two types play predominant roles in the progression of high grade cervical lesion. Primary HPV16/18 detection has high sensitivity and negative predictive value in cervical cancer screening and the strategy for women with HPV16 and HPV18 infection referral to colposcopy is efficient and feasible in northwestern region of China.
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Affiliation(s)
- Qian Zhang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Department of Gynecology and Obstetrics, The Northwest Women and Children Hospital, Xi'an, Shaanxi, China
| | - Minyi Zhao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Di Cao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xing Wei
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Li Wang
- Center of Maternal and Child Health Care, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yang Li
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ting Yang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Juan Zhao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Meili Pei
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hongran Jia
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Department of Gynecology and Obstetrics, The Northwest Women and Children Hospital, Xi'an, Shaanxi, China
| | - Siyu Cao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shimin Quan
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaofeng Yang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Ingabire C, Lim MK, Won YJ, Oh JK. Human Papillomavirus Genotype-Specific Persistence and Potential Risk Factors among Korean Women: Results from a 2-Year Follow-up Study. Cancer Res Treat 2017; 50:813-822. [PMID: 28814070 PMCID: PMC6056951 DOI: 10.4143/crt.2017.340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/08/2017] [Indexed: 01/17/2023] Open
Abstract
Purpose High-risk human papillomavirus (HPV) infection progression should be considered a critical factor for preventing cervical cancer, although most infections are transient and rarely persist. This study aimed to examine the specific types of HPV infections, their change patterns, and the potential risk factors among Korean women. Materials and Methods We included 4,588 women who visited hospitals in Busan and Suwon for cervical cancer screening, and 1,224 of thesewomen attended a 2-yearfollow-up. Infection statuswas evaluated using HPV DNA testing (Hybrid Capture 2) and genotyping testing (Linear Array). Data regarding the potential risk factors for HPV infection were collected by trained nurses using structured questionnaires. Results Among the 1,224 women (mean age, 47 years), 105 women (8.6%) were HPV-positive at baseline. HPV infections had been cleared among 92 women (87.6%) within 2 years. Only 13 infections (12.4%) were remained, and the 10 cases of them are high-risk HPV types including genotype 33, 45, 16, 35, and 52. Among women who were negative at baseline, the HPV incidence was 4.8%. The HPV incidence was marginally associated with having multiple sexual partners (odds ratio, 2.0; 95% confidence interval, 1.0 to 3.9), although it was not significantly associated with HPV persistence. Conclusion Most HPV infections (88%) among Korean women were cleared within 2 years, with only a small number of persistent infections. The persistent HPV genotypes were different in our study, compared to those from previous studies. Having multiple sexual partners was associated with acquiring a HPV infection, but not with persistence.
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Affiliation(s)
- Cecile Ingabire
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Cancer Risk Appraisal and Prevention Branch, Division of Cancer Prevention, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Cancer Registration and Statistics Branch, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Cancer Risk Appraisal and Prevention Branch, Division of Cancer Prevention, National Cancer Center, Goyang, Korea
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25
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Fajardo-Ramírez OR, Barboza-Cerda MC, Ortiz-López R, Rojas-Martínez A, Garza-Rodríguez ML, Sepúlveda-Flores A, González-Guerrero JF, Bernal-Silva S, Cerda-Flores RM, Calleja-Macías IE, Rodríguez-Flores S, Sandoval-Guzmán E, Plascencia-Solis T, Pérez-Reyes P, Villarreal JZ, Barrera-Saldaña HA. Prevalence and 3-year persistence of human papillomavirus serotypes in asymptomatic patients in Northern Mexico. Int J Gynaecol Obstet 2016; 136:40-46. [PMID: 28099703 DOI: 10.1002/ijgo.12009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 08/10/2016] [Accepted: 10/05/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate clinical outcomes and 3-year persistence of human papillomavirus (HPV) infections among women in Mexico. METHODS A prospective study enrolled sexually active women attending primary healthcare clinics in metropolitan Monterrey, Mexico, between June 3 and August 30, 2002. Baseline data were collected and participants underwent HPV screening. Patients with HPV infections were asked to attend a repeat screening appointment after 3 years, when the same screening data were gathered. Descriptive analyses were performed and the prevalence of cervical lesions and viral infections were examined. RESULTS In total, 1188 patients who underwent initial HPV screening were included. Cervical lesions were detected in 5 (0.4%) patients and 239 (20.1%) patients had HPV infections; 129 (54.0%) of these patients attended 3-year follow-up. Among the 357 HPV serotypes identified, the most prevalent serotypes were HPV-59, HPV-52, HPV-16, and HPV-56, detected 62 (17.4%), 38 (10.6%), 27 (7.6%), and 18 (5.0%) times, respectively. Of the 129 patients attending 3-year follow-up, 104 (80.6%) were clear from HPV infections, 13 (10.1%) patients had persistent HPV infections, and 12 (9.3%) had HPV infections with different HPV types. CONCLUSIONS The HPV prevalence was 20.1% in the present study; the most prevalent infections were HPV-59, HPV-52, HPV-16, and HPV-56. At 3-year follow-up, 25 (19.4%) patients had HPV infections.
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Affiliation(s)
- Oscar R Fajardo-Ramírez
- Tecnologico de Monterrey, Escuela Nacional de Medicina y Ciencias de la Salud, Monterrey, Mexico.,Facultad de Medicina, Departamento de Bioquimica y Medicina Molecular, Universidad Autónoma de Nuevo Leon, San Nicolás de los Garza, Mexico.,Departamento de Ciencias Basicas, Universidad de Monterrey, San Pedro Garza García, Mexico
| | - María C Barboza-Cerda
- Servicio de Anatomía Patológica y Citopatología, Hospital Universitario "José Eleuterio González", Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - Rocío Ortiz-López
- Tecnologico de Monterrey, Escuela Nacional de Medicina y Ciencias de la Salud, Monterrey, Mexico.,Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, Mexico
| | - Augusto Rojas-Martínez
- Tecnologico de Monterrey, Escuela Nacional de Medicina y Ciencias de la Salud, Monterrey, Mexico.,Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, Mexico
| | - María L Garza-Rodríguez
- Facultad de Medicina, Departamento de Bioquimica y Medicina Molecular, Universidad Autónoma de Nuevo Leon, San Nicolás de los Garza, Mexico
| | - Abel Sepúlveda-Flores
- Centro Universitario contra el Cáncer, Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - Juan F González-Guerrero
- Centro Universitario contra el Cáncer, Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - Sofía Bernal-Silva
- Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Ricardo M Cerda-Flores
- Facultad de Enfermeria, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - Itzel E Calleja-Macías
- Department of Molecular Biology and Biochemistry, University of California at Irvine, Irvine, CA, USA
| | | | | | | | | | | | - Hugo A Barrera-Saldaña
- Facultad de Medicina, Departamento de Bioquimica y Medicina Molecular, Universidad Autónoma de Nuevo Leon, San Nicolás de los Garza, Mexico
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26
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Mane A, Sahasrabuddhe VV, Nirmalkar A, Risbud AR, Sahay S, Bhosale RA, Vermund SH, Mehendale SM. Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India. J Clin Virol 2016; 88:26-32. [PMID: 28152432 DOI: 10.1016/j.jcv.2016.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 09/30/2016] [Accepted: 10/25/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Several studies in recent years have documented the genotype-specific prevalence of HPV infection and wide diversity and multiplicity of HPV genotypes among HIV-seropositive women. Yet, information on changes in HPV genotype-specific incidence and clearance rates over time, and their correlation with clinical or immunologic factors among HIV-seropositive women is scarce. OBJECTIVES We conducted a prospective study to investigate the incidence and clearance rates of cervical HPV genotypes among HIV-seropositive women in India and expand the evidence base in this area of research. STUDY DESIGN Cervical samples were collected from n=215 HIV-seropositive women in Pune, India who underwent two screening visits separated by a median of 11-months (interquartile range: 8-18 months). HPV genotypes were determined by Roche Linear Array HPV assay. Individual genotype-specific and carcinogenicity-grouping-specific HPV incidence and clearance rates were calculated and the associations between incidence/clearance and age and HIV-related metrics were explored. RESULTS Incidence and clearance rates for 'any HPV' and 'carcinogenic HPV' genotypes were 11.1 and 18.3, and 6.7 and 33.8, per 100 person-years, respectively. Incidence and clearance rates for HPV genotypes of alpha-9 species (HPV16, HPV31, HPV33, HPV35, HPV52 and HPV58) and alpha-7 species (HPV18, HPV39, HPV45, HPV59 and HPV68) were 5.8 and 2.04, and 32.1 and 53.5, per 100 person-years, respectively. Clearance of any HPV type was associated with increasing age of participants (odds ratio: 1.08, 95%CI: 1.004-1.17), although the association marginally lost its statistical significance when adjusted for CD4 counts and antiretroviral therapy status. CONCLUSIONS Genotype-specific clearance rates of HPV were higher than corresponding incidence rates. The suggestion of a positive associations of increasing age with HPV clearance points to the need for etiologic studies on age-related hormonal changes on clearance of cervical HPV infection.
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Affiliation(s)
- Arati Mane
- National AIDS Research Institute, Pune, India
| | | | | | | | - Seema Sahay
- National AIDS Research Institute, Pune, India
| | | | - Sten H Vermund
- Vanderbilt University School of Medicine, Nashville, USA
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Ramanakumar AV, Naud P, Roteli-Martins CM, de Carvalho NS, de Borba PC, Teixeira JC, Blatter M, Moscicki AB, Harper DM, Romanowski B, Tyring SK, Ramjattan B, Schuind A, Dubin G, Franco EL. Incidence and duration of type-specific human papillomavirus infection in high-risk HPV-naïve women: results from the control arm of a phase II HPV-16/18 vaccine trial. BMJ Open 2016; 6:e011371. [PMID: 27566633 PMCID: PMC5013348 DOI: 10.1136/bmjopen-2016-011371] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Persistence of human papillomaviruses (HPVs) is necessary for cervical carcinogenesis. We evaluated incidence and duration of type-specific HPV infections and the influence of age and number of sexual partners. METHODS Data were obtained from 553 women (15-25 years), who were seronegative and DNA-negative for high-risk HPV (HR-HPV) types and were enrolled in the placebo arm of a randomised trial of the HPV-16/18 vaccine (NCT00689741/NCT00120848). They were followed for 6.3 years. Cervicovaginal samples were self-collected at 3-month intervals for up to 27 months, and cervical samples were collected by clinicians at 6-month intervals until study end. Samples were tested for HPV types using a broad-spectrum PCR assay. Incidence rate ratios (RRs) and 95% CIs were used to estimate the association among age, sexual habits and HPV acquisition. RESULTS Incidence rates (95% CI) using cervical samples were 11.8 (10.4 to 13.4) and 5.6 (4.7 to 6.6) per 1000 women-months for HR-HPVs and low-risk HPVs (LR-HPVs), respectively. Equivalent rates in combined cervicovaginal and cervical samples were 17.2 (15.4 to 19.2) and 6.9 (5.9 to 8.0), respectively. 54 per cent of HR-HPV types from combined cervicovaginal and cervical samples persisted for 1 year compared with 32.3% for LR-HPV types. The risk of acquiring any HPV infection was higher among women aged <21 years (RR=1.33, 95% CI 1.1 to 1.7) and women having >1 sexual partner (RR=1.83, 95% CI 1.4 to 2.4) at baseline. CONCLUSIONS HR-HPV infections were more common and lasted longer on average than LR-HPV infections. HPV acquisition was more common in younger women with multiple sexual partners. TRIAL REGISTRATION NUMBER NCT00689741, NCT00120848; Post-results.
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Affiliation(s)
| | - Paulo Naud
- Federal University of Rio Grande do Sul—UFRGS/HCPA—Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Newton S de Carvalho
- Department of Gynecology and Obstetrics, Gynecology and Obstetrics Infectious Diseases Sector, University of Parana, Curitiba, Parana, Brazil
| | | | - Julio C Teixeira
- Department of Gynecology, Oncology Division, State University of Campinas, Campinas, Brazil
| | - Mark Blatter
- Pediatric Alliance, Pittsburgh, Pennsylvania, USA
| | | | - Diane M Harper
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | | | - Stephen K Tyring
- Departments of Microbiology/Molecular Genetics, Dermatology & Internal Medicine, The University of Texas Medical School, Houston, Texas, USA
| | - Brian Ramjattan
- First Line Medical Services Ltd., St. John's, Newfoundland and Labrador, Canada
| | - Anne Schuind
- GSK Vaccines, King of Prussia, Pennsylvania, USA
| | - Gary Dubin
- GSK Vaccines, King of Prussia, Pennsylvania, USA
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
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Meyrelles AR, Siqueira JD, Santos PPD, Hofer CB, Luiz RR, Seuánez HN, Almeida G, Soares MA, Soares EA, Machado ES. Bonafide, type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities, a longitudinal cohort study. Mem Inst Oswaldo Cruz 2016; 111:120-7. [PMID: 26872340 PMCID: PMC4750452 DOI: 10.1590/0074-02760150393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/22/2015] [Indexed: 01/21/2023] Open
Abstract
This study investigated the rate of human papillomavirus (HPV) persistence,
associated risk factors, and predictors of cytological alteration outcomes in a
cohort of human immunodeficiency virus-infected pregnant women over an 18-month
period. HPV was typed through L1 gene sequencing in cervical smears
collected during gestation and at 12 months after delivery. Outcomes were defined as
nonpersistence (clearance of the HPV in the 2nd sample), re-infection (detection of
different types of HPV in the 2 samples), and type-specific HPV persistence (the same
HPV type found in both samples). An unfavourable cytological outcome was considered
when the second exam showed progression to squamous intraepithelial lesion or high
squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence
occurred in 50% of the cases composed of type-specific persistence (30%) or
re-infection (20%). A low CD4+T-cell count at entry was a risk factor for
type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR) was almost
three times higher in the type-specific group when compared with the re-infection
group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that
bonafide (type-specific) HPV persistence is a stronger predictor for the development
of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV
DNA testing in the clinical setting.
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Affiliation(s)
- Angela Ri Meyrelles
- Instituto de Ginecologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Pâmela P Dos Santos
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Cristina B Hofer
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Ronir R Luiz
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Gutemberg Almeida
- Instituto de Ginecologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | | | - Elizabeth S Machado
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Atopic Dermatitis Is Associated With Cervical High Risk Human Papillomavirus Infection. J Low Genit Tract Dis 2016; 19:345-9. [PMID: 26360236 DOI: 10.1097/lgt.0000000000000147] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE High-risk human papillomavirus (hrHPV) infection is more likely to persist and cause cervical cancer in immunosuppressed women. Atopic dermatitis, which is known to affect cell-mediated immunity and skin barrier function, is associated with recalcitrant warts; therefore, we hypothesized that women with atopic dermatitis may be more likely to be positive for hrHPV infection and progress to high-grade cervical dysplasia. MATERIALS AND METHODS A retrospective case-control study of 1,160 women who were either positive or negative for hrHPV in their index cervical cytology. Patient age, race, history of atopic dermatitis, allergic rhinitis, smoking, body mass index, socioeconomic status, marital status, hormone contraceptive use, and 2-year clinical outcomes (follow-up hrHPV testing and cervical biopsy results) were recorded. All cases with atopic dermatitis (n = 74) were confirmed by a dermatologist. Analyses were restricted to females with documented clinical follow-up, which yielded 577 hrHPV-positive and 583 hrHPV-negative cases for comparison. Associations were examined by t test, χ test, and multivariate logistic regression. RESULTS Atopic dermatitis was more common in the hrHPV-positive cases (48/577, 8.3%) compared with HPV-negative controls (26/583, 4.5%, p = .007). Multivariate logistic regression analysis revealed an adjusted odds ratio of 3.75 (95% CI = 1.3-10.9, p = .02) after controlling for significant covariates, such as age and marital status. Smoking was not associated with hrHPV infection, persistence, or high-grade cervical dysplasia in these cases. CONCLUSIONS Atopic dermatitis is associated with cervical hrHPV infection in adult women.
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DARENG EO, MA B, FAMOOTO AO, AKAROLO-ANTHONY SN, OFFIONG RA, OLANIYAN O, DAKUM PS, WHEELER CM, FADROSH D, YANG H, GAJER P, BROTMAN RM, RAVEL J, ADEBAMOWO CA. Prevalent high-risk HPV infection and vaginal microbiota in Nigerian women. Epidemiol Infect 2016; 144:123-37. [PMID: 26062721 PMCID: PMC4659743 DOI: 10.1017/s0950268815000965] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 02/19/2015] [Accepted: 04/20/2015] [Indexed: 12/20/2022] Open
Abstract
In this study, we evaluated the association between high-risk human papillomavirus (hrHPV) and the vaginal microbiome. Participants were recruited in Nigeria between April and August 2012. Vaginal bacterial composition was characterized by deep sequencing of barcoded 16S rRNA gene fragments (V4) on Illumina MiSeq and HPV was identified using the Roche Linear Array® HPV genotyping test. We used exact logistic regression models to evaluate the association between community state types (CSTs) of vaginal microbiota and hrHPV infection, weighted UniFrac distances to compare the vaginal microbiota of individuals with prevalent hrHPV to those without prevalent hrHPV infection, and the Linear Discriminant Analysis effect size (LEfSe) algorithm to characterize bacteria associated with prevalent hrHPV infection. We observed four CSTs: CST IV-B with a low relative abundance of Lactobacillus spp. in 50% of participants; CST III (dominated by L. iners) in 39·2%; CST I (dominated by L. crispatus) in 7·9%; and CST VI (dominated by proteobacteria) in 2·9% of participants. LEfSe analysis suggested an association between prevalent hrHPV infection and a decreased abundance of Lactobacillus sp. with increased abundance of anaerobes particularly of the genera Prevotella and Leptotrichia in HIV-negative women (P < 0·05). These results are hypothesis generating and further studies are required.
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Affiliation(s)
- E. O. DARENG
- Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
- Department of Primary Care and Public Health, University of Cambridge, UK
| | - B. MA
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - A. O. FAMOOTO
- Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
| | - S. N. AKAROLO-ANTHONY
- Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - R. A. OFFIONG
- University of Abuja Teaching Hospital, Gwagwalada, Nigeria
| | | | - P. S. DAKUM
- Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
| | - C. M. WHEELER
- Department of Pathology, University of New Mexico Health Sciences Centre, Albuquerque, NM, USA
| | - D. FADROSH
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - H. YANG
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - P. GAJER
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - R. M. BROTMAN
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J. RAVEL
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - C. A. ADEBAMOWO
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Institute of Human Virology and Greenebaum Cancer Centre, University of Maryland School of Medicine, Baltimore, MD, USA
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Stensen S, Kjaer SK, Jensen SM, Frederiksen K, Junge J, Iftner T, Munk C. Factors associated with type-specific persistence of high-risk human papillomavirus infection: A population-based study. Int J Cancer 2015; 138:361-8. [DOI: 10.1002/ijc.29719] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/30/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Signe Stensen
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
| | - Susanne K. Kjaer
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
- Department of Gynaecology; Rigshospitalet, University of Copenhagen; Denmark
| | - Signe M. Jensen
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
| | - Kirsten Frederiksen
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
| | - Jette Junge
- Department of Pathology; Hvidovre Hospital; Denmark
| | - Thomas Iftner
- Medical Virology, Experimental Virology Section; University Hospital of Tübingen; Germany
| | - Christian Munk
- Virus, Lifestyle and Genes; Danish Cancer Society Research Center; Copenhagen Denmark
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Comparison of human papillomavirus infection and cervical cytology in women using copper-containing and levonorgestrel-containing intrauterine devices. Obstet Gynecol 2015; 125:1101-1105. [PMID: 25932838 DOI: 10.1097/aog.0000000000000760] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate whether there is a difference in cervical cytology and high-risk human papillomavirus (HPV) infection clearance between levonorgestrel- and copper-containing intrauterine device (IUD) users. METHODS The electronic medical record system was searched by the appropriate procedural code for IUD insertion for all patients undergoing IUD placement during the study period (January 31, 2005 to January 31, 2012). Patients who received treatment for cervical dysplasia, had their IUDs removed, or conceived during the study period were excluded. High-risk HPV and cervical cytology results immediately preceding and after IUD placement were obtained. RESULTS One hundred fifty patients had a copper-containing and 152 patients a levonorgestrel-containing IUD placed. The groups were comparable in terms of age, body mass index, duration of follow-up, and percentage of smokers. Sixty-six patients were high-risk HPV-positive before IUD insertion (30 in copper compared with 36 in the levonorgestrel IUD group, P=.4), and the groups had similar follow-up times (364.1±26.3 compared with 357.2±29.7 days, respectively, between the IUD placement and a repeat Pap test with high-risk HPV cotesting, P=.2). Of those, 21 (70%; 95% confidence interval [CI] 53.6-86.4%) cleared the infection after copper-containing IUD placement compared with 15 (42%; 95% CI 25.6-57.8%) in the levonorgestrel group (P=.04). There were only two (1.7%) new high-risk HPV infections in the copper compared with eight (6.9%) in the levonorgestrel group (P=.056). CONCLUSION Our data suggest that levonorgestrel-containing IUD could be associated with decreased high-risk HPV infection clearance and possibly increased acquisition compared with the copper-containing IUD. LEVEL OF EVIDENCE II.
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Fu TCJ, Fu Xi L, Hulbert A, Hughes JP, Feng Q, Schwartz SM, Hawes SE, Koutsky LA, Winer RL. Short-term natural history of high-risk human papillomavirus infection in mid-adult women sampled monthly. Int J Cancer 2015; 137:2432-42. [PMID: 25976733 DOI: 10.1002/ijc.29602] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/15/2015] [Accepted: 05/05/2015] [Indexed: 11/11/2022]
Abstract
Characterizing short-term HPV detection patterns and viral load may inform HPV natural history in mid-adult women. From 2011-2012, we recruited women aged 30-50 years. Women submitted monthly self-collected vaginal samples for high-risk HPV DNA testing for 6 months. Positive samples were tested for type-specific HPV DNA load by real-time PCR. HPV type-adjusted linear and Poisson regression assessed factors associated with (i) viral load at initial HPV detection and (ii) repeat type-specific HPV detection. One-hundred thirty-nine women (36% of 387 women with ≥4 samples) contributed 243 type-specific HR HPV infections during the study; 54% of infections were prevalent and 46% were incident. Incident (vs. prevalent) detection and past pregnancy were associated with lower viral load, whereas current smoking was associated with higher viral load. In multivariate analysis, current smoking was associated with a 40% (95% CI: 5-87%) increase in the proportion of samples that were repeatedly positive for the same HPV type, whereas incident (vs. prevalent) detection status and past pregnancy were each associated with a reduction in the proportion of samples repeatedly positive (55%, 95% CI: 38-67% and 26%, 95% CI: 10-39%, respectively). In a separate multivariate model, each log10 increase in viral load was associated with a 10% (95% CI: 4-16%) increase in the proportion of samples repeatedly positive. Factors associated with repeat HPV detection were similar to those observed in longer-term studies, suggesting that short-term repeat detection may relate to long-term persistence. The negative associations between incident HPV detection and both viral load and repeat detection suggest that reactivation or intermittent persistence was more common than new acquisition.
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Affiliation(s)
| | - Long Fu Xi
- Department of Pathology, University of Washington, Seattle, WA
| | | | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Qinghua Feng
- FIDALAB, Seattle, WA.,Universidad Estatal De Milagro, Milagro, Ecuador
| | - Stephen M Schwartz
- Department of Epidemiology, University of Washington, Seattle, WA.,Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Laura A Koutsky
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA
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Geraets DT, Struijk L, Kleter B, Molijn A, van Doorn LJ, Quint WGV, Colau B. The original SPF10 LiPA25 algorithm is more sensitive and suitable for epidemiologic HPV research than the SPF10 INNO-LiPA Extra. J Virol Methods 2015; 215-216:22-9. [PMID: 25698462 DOI: 10.1016/j.jviromet.2015.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Two commercial HPV tests target the same 65 bp fragment of the human papillomavirus genome (designated SPF10): the original HPV SPF10 PCR-DEIA-LiPA25 system, version 1, (LiPA25) and the INNO-LiPA HPV Genotyping Extra (INNO-LiPA). The original SPF10 LiPA25 system was designed to have high analytical sensitivity and applied in HPV vaccine and epidemiology studies worldwide. But due to apparent similarities, this test can be easily confused with INNO-LiPA, a more recent assay of which the intended use, i.e., epidemiological or clinical, is currently unclear. The aim was to compare the analytical sensitivity of SPF10 LiPA25 to that of INNO-LiPA on the level of general HPV detection and genotyping. HPV testing by both assays was performed on the same DNA isolated from cervical swab (n = 365) and biopsy (n = 42) specimens. In cervical swabs, SPF10 LiPA25 and INNO-LiPA identified 35.3% and 29.3% multiple infections, 52.6% and 51.5% single infections, and no HPV type in 12.1% and 19.2%, respectively. Genotyping results were 64.7% identical, 26.0% compatible and 9.3% discordant between both methods. SPF10 LiPA25 detected significantly more genotypes (p < 0.001). The higher analytical sensitivity of SPF10 LiPA25 was confirmed by the MPTS123 genotyping assay. HPV positivity by the general probes in SPF10 DEIA was significantly higher (87.9%) than by those on INNO-LiPA (77.0%) (kappa = 0.592, p < 0.001). In cervical biopsies, SPF10 LiPA25 and INNO-LiPA identified 21.4% and 9.5% multiple types, 76.2% and 81.0% single types, and no type in 2.4% and 9.5%, respectively. Between both tests, the identification of genotypes was 76.3% identical, 14.3% compatible and 9.5% discordant. Overall, significantly more genotypes were detected by SPF10 LiPA25 (kappa = 0.853, p = 0.022). HPV positivity was higher by the SPF10 DEIA (97.6%) than by the INNO-LiPA strip (92.9%). These results demonstrate that SPF10 LiPA25 is more suitable for HPV genotyping in epidemiologic and vaccine-related studies, due to its higher analytical sensitivity.
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Affiliation(s)
- Daan T Geraets
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands.
| | - Linda Struijk
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Bernhard Kleter
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Anco Molijn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Leen-Jan van Doorn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Brigitte Colau
- GSK Vaccines, Rue de l'Institut 89, B-1330 Rixensart, Belgium
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Geraets DT, Struijk L, Kleter B, Molijn A, van Doorn LJ, Quint WGV, Colau B. TEMPORARY REMOVAL: The original SPF 10 LiPA 25 algorithm is more sensitive and suitable for epidemiologic HPV research than the SPF 10 INNO-LiPA Extra. J Virol Methods 2014; 213C:1. [PMID: 25476446 DOI: 10.1016/j.jviromet.2014.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 10/27/2014] [Accepted: 11/11/2014] [Indexed: 11/24/2022]
Abstract
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Daan T Geraets
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands.
| | - Linda Struijk
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Bernhard Kleter
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Anco Molijn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Leen-Jan van Doorn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Brigitte Colau
- GlaxoSmithKline Vaccines, Rue de l'Institut 89, B-1330 Rixensart, Belgium
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Prevalence of human papillomavirus in young Italian women with normal cytology: how should we adapt the national vaccination policy? BMC Infect Dis 2013; 13:575. [PMID: 24313984 PMCID: PMC4029487 DOI: 10.1186/1471-2334-13-575] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 12/02/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) is the most common sexually transmitted infection. In Italy, HPV vaccination is now offered free of charge to 12-year-old females. However, some regional health authorities have extended free vaccination to other age-groups, especially to girls under 18 years of age. We conducted a multicentre epidemiological study to ascertain the prevalence of different genotypes of HPV in young Italian women with normal cytology, with the aim of evaluating the possibility of extending vaccination to older females. METHODS The study was performed in 2010. Women aged 16-26 years with normal cytology were studied. Cervical samples were analyzed to identify the presence of HPV by PCR amplification of a segment of ORF L1 (450 bp). All positive HPV-DNA samples underwent viral genotype analysis by means of a restriction fragment length polymorphism assay. RESULTS Positivity for at least one HPV genotype was found in 18.2% of the 566 women recruited: 48.1% in the 16-17 age-class, 15.4 in the 18-20 age-class, 21.9% in the 21-23 age-class, and 15.5% in the 24-26 age-class; 10.1% of women were infected by at least one high-risk HPV genotype. HPV-16 was the most prevalent genotype. Only 4 (0.7%), 4 (0.7%) and 3 (0.5%) women were infected by HPV-18, HPV-6 and HPV-11, respectively. Of the HPV-DNA-positive women, 64.1% presented only one viral genotype, while 24.3% had multiple infections. The HPV genotypes most often involved in multiple infections were high-risk. A high prevalence was noted in the first years of sexual activity (48.1% of HPV-DNA-positive women aged 16-17 years); HPV prevalence subsequently declined and stabilized.The estimate of cumulative proportions of young women free from any HPV infection at each age was evaluated; 93.3% and 97.1% of 26 year-old women proved free from HPV-16 and/or HPV-18 and from HPV-6 and/or HPV-11, respectively. CONCLUSIONS Our findings confirm the crucial importance of conducting studies on women without cytological damage, in order to optimise and up-date preventive interventions against HPV infection, and suggest that vaccinating 26-year-old females at the time of their first pap-test is to be recommend, though this issue should be further explored.
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Persistence or clearance of human papillomavirus infections in women in Ouro Preto, Brazil. BIOMED RESEARCH INTERNATIONAL 2013; 2013:578276. [PMID: 24298551 PMCID: PMC3835752 DOI: 10.1155/2013/578276] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 09/06/2013] [Indexed: 11/22/2022]
Abstract
Persistent high-risk (HR) human papillomavirus (HPV) infection is necessary for development of precursor lesions and cervical cancer. We investigate persistence and clearance of HPV infections and cofactors in unvaccinated women. Cervical samples of 569 women (18–75 years), received for routine evaluation in the Health Department of Ouro Preto, Brazil, were collected and subjected to PCR (MY09/11 or GP5+/6+ primers), followed by RFLP or sequencing. All women were interviewed to collect sociodemographic and behavioral information. Viral infection persistence or clearance was reevaluated after 24 months and was observed in 59.6% and 40.4% of women, respectively. HPVs 16, 33, 59, 66, 69, and 83 (HR) were the most persistent types whereas HPVs 31, 45, and 58 were less persistent. Clearance or persistence did not differ between groups infected by HPVs 18, 53, and 67. In low-risk (LR) types, HPV 6 infected samples were associated with clearance, while HPV 11, 61, 72, or 81 infected samples were persistent in the follow-up. No statistically significant association was detected between persistent HPV infections and sociodemographic and behavioral characteristics analyzed. To study persistence or clearance in HPV infection allows the identification of risk groups, cofactors, and strategies for prevention of cervical cancer.
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Piana A, Sotgiu G, Cocuzza C, Musumeci R, Marras V, Pischedda S, Deidda S, Muresu E, Castiglia P. High HPV-51 prevalence in invasive cervical cancers: results of a pre-immunization survey in North Sardinia, Italy. PLoS One 2013; 8:e63395. [PMID: 23717420 PMCID: PMC3661560 DOI: 10.1371/journal.pone.0063395] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 03/30/2013] [Indexed: 11/19/2022] Open
Abstract
Background Human Papilloma virus (HPV) is recognized as the etiological agent of benign and malignant ano-genital lesions. The most prevalent genotypes associated with cervical carcinoma are HPV-16 and -18 worldwide. However, recent studies have emphasized the role of other genotypes, such as HPV-51, in the pathogenesis of cervical dysplasia. The aim of the study was to estimate the burden of HPV-51 infection in invasive cervical malignant lesions in Northern Sardinia, Italy. Methods/Principal Findings An observational, retrospective, prevalence, mono-center study was carried out to evaluate the presence of HPV genotypes in tissues biopsies of cervical lesions (CIN-1, CIN-2, CIN-3 and invasive carcinoma) gathered from 1996 to 2009. Biological samples were collected from women admitted consecutively to a tertiary university hospital situated in Sassari, Italy. Molecular methods were used to identify 28 oncogenic HPV types. A total of 155 formalin-fixed and paraffin-embedded cervical tissue samples were analyzed. Approximately half of the cervical lesions were classified as invasive carcinoma. HPV-DNA was detected in 71% of the samples, with a higher frequency (100%) in those categorized as invasive neoplasia. Mono- or co-infections were demonstrated in 45.8% and 25.8% of the cervical samples, respectively. Overall, the most prevalent HPV types were -16 (49%) and -51 (19.4%), with an increased frequency of detection associated with the severity of the cervical lesions. Conclusions/Significance This survey highlights for the first time the relevant role of HPV-51 infection in the pathogenesis of invasive cervical cancer prior to the introduction of a vaccination program. Although a selection bias could have influenced the results, other recent studies have described the impact of HPV-51. This remarkable epidemiological element should be carefully evaluated, particularly in the view of opting for preventive vaccines, whose cross-protection patterns determine their efficacy in protecting against infection from HPV types that are not included in the vaccine itself.
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Affiliation(s)
- Andrea Piana
- Department of Biomedical Sciences, Hygiene and Preventive Medicine Unit, University of Sassari – AOU Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- Department of Biomedical Sciences, Hygiene and Preventive Medicine Unit, University of Sassari – AOU Sassari, Sassari, Italy
| | - Clementina Cocuzza
- Department of Surgery and Interdisciplinary Medicine, University of Milano Bicocca, Milan, Italy
| | - Rosario Musumeci
- Department of Surgery and Interdisciplinary Medicine, University of Milano Bicocca, Milan, Italy
| | - Vincenzo Marras
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Stefania Pischedda
- Department of Biomedical Sciences, Hygiene and Preventive Medicine Unit, University of Sassari – AOU Sassari, Sassari, Italy
| | - Silvia Deidda
- Department of Biomedical Sciences, Hygiene and Preventive Medicine Unit, University of Sassari – AOU Sassari, Sassari, Italy
| | - Elena Muresu
- Department of Biomedical Sciences, Hygiene and Preventive Medicine Unit, University of Sassari – AOU Sassari, Sassari, Italy
| | - Paolo Castiglia
- Department of Biomedical Sciences, Hygiene and Preventive Medicine Unit, University of Sassari – AOU Sassari, Sassari, Italy
- * E-mail:
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