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Kuguyo O, Dube Mandishora RS, Thomford NE, Makunike-Mutasa R, Nhachi CFB, Matimba A, Dandara C. High-risk HPV genotypes in Zimbabwean women with cervical cancer: Comparative analyses between HIV-negative and HIV-positive women. PLoS One 2021; 16:e0257324. [PMID: 34582476 PMCID: PMC8478215 DOI: 10.1371/journal.pone.0257324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/30/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND High-risk human papillomavirus HPV (HR-HPV) modifies cervical cancer risk in people living with HIV, yet African populations are under-represented. We aimed to compare the frequency, multiplicity and consanguinity of HR-HPVs in HIV-negative and HIV-positive Zimbabwean women. METHODS This was a cross-sectional study consisting of women with histologically confirmed cervical cancer attending Parirenyatwa Group of Hospitals in Harare, Zimbabwe. Information on HIV status was also collected for comparative analysis. Genomic DNA was extracted from 258 formalin fixed paraffin embedded tumour tissue samples, and analysed for 14 HR-HPV genotypes. Data was analysed using Graphpad Prism and STATA. RESULTS Forty-five percent of the cohort was HIV-positive, with a median age of 51 (IQR = 42-62) years. HR-HPV positivity was detected in 96% of biospecimens analysed. HPV16 (48%), was the most prevalent genotype, followed by HPV35 (26%), HPV18 (25%), HPV58 (11%) and HPV33 (10%), irrespective of HIV status. One third of the cohort harboured a single HPV infection, and HPV16 (41%), HPV18 (21%) and HPV35 (21%) were the most prevalent. HIV status did not influence the prevalence and rate of multiple HPV infections (p>0.05). We reported significant (p<0.05) consanguinity of HPV16/18 (OR = 0.3; 95% CI = 0.1-0.9), HPV16/33 (OR = 0.3; 95% CI = 0.1-1.0), HPV16/35 (OR = 3.3; 95% CI = 2.0-6.0), HPV35/51 (OR = 6.0; 95%CI = 1.8-15.0); HPV39/51 (OR = 6.4; 95% CI = 1.8-15), HPV31/52 (OR = 6.2; 95% CI = 1.8-15), HPV39/56 (OR = 11 95% CI = 8-12), HPV59/68 (OR = 8.2; 95% CI = 5.3-12.4), HPV66/68 (OR = 7; 95% CI = 2.4-13.5), independent of age and HIV status. CONCLUSION We found that HIV does not influence the frequency, multiplicity and consanguinity of HR-HPV in cervical cancer. For the first time, we report high prevalence of HPV35 among women with confirmed cervical cancer in Zimbabwe, providing additional evidence of HPV diversity in sub-Saharan Africa. The data obtained here probes the need for larger prospective studies to further elucidate HPV diversity and possibility of selective pressure on genotypes.
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Affiliation(s)
- Oppah Kuguyo
- Department of Clinical Pharmacology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
- Division of Human Genetics, Department of Pathology, Pharmacogenomics and Drug Metabolism Group, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Racheal S. Dube Mandishora
- Faculty of Health Sciences, Department of Medical Microbiology Unit, University of Zimbabwe College of Health Sciences, Harare Zimbabwe University of Zimbabwe, Medical Microbiology Unit, Harare, Zimbabwe
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Nicholas Ekow Thomford
- Division of Human Genetics, Department of Pathology, Pharmacogenomics and Drug Metabolism Group, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, PMB, Ghana
| | - Rudo Makunike-Mutasa
- Department of Pathology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Charles F. B. Nhachi
- Department of Clinical Pharmacology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Alice Matimba
- Advanced Courses and Scientific Conferences, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Collet Dandara
- Division of Human Genetics, Department of Pathology, Pharmacogenomics and Drug Metabolism Group, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
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Lekoane KMB, Kuupiel D, Mashamba-Thompson TP, Ginindza TG. The interplay of HIV and human papillomavirus-related cancers in sub-Saharan Africa: scoping review. Syst Rev 2020; 9:88. [PMID: 32321580 PMCID: PMC7178989 DOI: 10.1186/s13643-020-01354-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 04/08/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND People living with HIV (PLHIV) are at a high risk of developing HPV-related cancers. HPV-related malignancies occur frequently and/or are high among PLHIV, with cervical cancer as a designated AIDS-defining condition. We aimed to explore the evidence on the interplay of HIV and HPV-related cancers in sub-Saharan Africa (SSA). METHODS The scoping review was guided by Arksey and O'Malley's framework. We searched for literature from the following databases: PubMed; World Health Organization (WHO) Library; Science Direct; Google Scholar and EBSCOhost (Academic search complete, Health Source: Nursing/Academic Edition, CINAHL). Studies reporting on evidence HIV and HPV-related cancers interplay in SSA were eligible for inclusion in this review. The Mixed Methods Appraisal Tool (MMAT) tool was used to assess the risk of bias of the included studies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for reporting the search results. Thematic analysis used to reveal the emerging themes from the included studies. RESULTS A total of 74 potentially eligible articles were screened. Of these, nine (7 reviews, 1 transversal case controls, and 1 quantitative study) were eligible for data extraction. The studies reported about a total of 16,351 participants in different settings. The nine included studies showed evidence of cervical cancer among HIV-infected women and distribution of HPV infection and cervical abnormalities among HIV-positive individuals. In the four studies generalizing about HIV and anal cancer, only one reported about HPV. Two studies generally reported about HIV and head and neck cancers and one reported about interaction of HIV with vaginal cancer, vulvar cancer, and penile cancer, respectively. CONCLUSION HIV positivity is associated with increased prevalence of HPV infection on different anatomic sites, which will result in increased burden of HPV-related cancers among PLHIV. Furthermore, primary studies with robust study designs aimed at investigating the risk developing HPV-related cancers among PLHIV are recommended. Systematic review registration: PROSPERO CRD42017062403.
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Affiliation(s)
- Kabelo Matjie Bridget Lekoane
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Desmond Kuupiel
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa. .,Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
| | - Tivani P Mashamba-Thompson
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Themba G Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Cameron JE, Dennis DC, Herrel NR, Chapple AG, Hagensee ME. Risk of abnormal cervical cytology in HIV-infected women testing positive for both human papillomavirus and Epstein-Barr virus in genital tract specimens. Cancer Causes Control 2020; 31:365-375. [PMID: 32112173 DOI: 10.1007/s10552-020-01287-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Although infection with high-risk human papillomavirus (HPV) is a prerequisite for cervical cancer development, HPV infection is not sufficient to promote cancer in the majority of infected women. We tested the hypothesis that human herpesviruses might cooperate with HPV to promote the development of cervical dysplasia, an early indicator of cervical cancer development. METHODS This study used archived specimens from a cohort of human immunodeficiency virus (HIV)-seropositive women seeking gynecological care at the Medical Center of New Orleans, Louisiana. Viral DNA was detected by PCR amplification and risk of abnormal cervical cytology was determined in relation to virus test results. RESULTS Consensus human herpesvirus PCR with herpes speciation by restriction endonuclease digestion revealed Epstein-Barr virus (EBV) to be the most prevalent herpesvirus in cervicovaginal lavage specimens. Further analysis using an EBV-specific PCR assay and cervical swab specimens demonstrated an approximately fourfold increased risk of abnormal cervical cytology in women testing positive for cervical EBV and high-risk HPV compared to women testing positive for high-risk HPV alone. This relationship was independent of markers of advancing HIV disease. CONCLUSION Cervical shedding of EBV appears to predict a greater risk of cervical dysplasia in HIV-infected women with a high-risk HPV infection.
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Affiliation(s)
- Jennifer E Cameron
- Department of Microbiology, Immunology Parasitology, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA, 70112, USA. .,The Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
| | - D'Antoni C Dennis
- Department of Microbiology, Immunology Parasitology, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA, 70112, USA.,North Oaks Physician Group LLC, 15818 Paul Vega MD Drive, Suite 301, Hammond, LA, 70403, USA
| | - Nicholas R Herrel
- Department of Microbiology, Immunology Parasitology, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA, 70112, USA.,Cantor Colburn, LLC, 20 Church Street, 22nd Floor, Hartford, CT, 06103, USA
| | - Andrew G Chapple
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Michael E Hagensee
- Department of Medicine, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.,The Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Adebamowo SN, Olawande O, Famooto A, Dareng EO, Offiong R, Adebamowo CA. Persistent Low-Risk and High-Risk Human Papillomavirus Infections of the Uterine Cervix in HIV-Negative and HIV-Positive Women. Front Public Health 2017; 5:178. [PMID: 28785554 PMCID: PMC5519520 DOI: 10.3389/fpubh.2017.00178] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 07/03/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The prevalence, persistence, and multiplicity of human papillomavirus (HPV) infection appears different comparing HIV-positive to HIV-negative women. In this study, we examined prevalent, persistent, and multiple low- and high-risk cervical HPV infections in HIV-negative and HIV-positive women. METHODS We studied 1,020 women involved in a study of HPV infection using SPF25/LiPA10. Two study visits were scheduled, at enrollment and 6 months afterward. At each study visit, research nurses used a cervical brush to collect samples of exfoliated cervical cells from the cervical os, from all the study participants. Exact logistic regression models were used to estimate associations between HIV and HPV infections. RESULTS The mean (SD) age of the study participants was 38 (8) years, 56% were HIV-negative and 44% were HIV-positive. Among HIV-negative women at baseline, single low-risk HPV (lrHPV) infections occurred in 12%; multiple lrHPV in 2%; single high-risk human papillomavirus (hrHPV) infections in 9%, and multiple hrHPV infections in 2%. Single lrHPV infections were persistent in 6%, but there was no persistent multiple lrHPV infections. Single hrHPV infections were persistent in 4% while multiple hrHPV infections were persistent in 0.3%. Among HIV-positive women at baseline, single lrHPV infections occurred in 19%, multiple lrHPV in 6%, single hrHPV infections in 17%, and multiple hrHPV infections occurred in 12%. Single lrHPV infections were persistent in 9%, multiple lrHPV infections in 0.6%, single hrHPV infections in 13%, while multiple hrHPV were persistent in 3%. Prevalent, persistent, and multiple infections were more common in HIV-positive women, compared to HIV-negative women. In multivariate models adjusted for age, marital status, socioeconomic status, age at sexual initiation, and douching, the odds ratios comparing HIV-positive to HIV-negative women, were 2.09 (95% CI 1.47-2.97, p < 0.001) for prevalent lrHPV, 1.26 (95% CI 0.66-2.40, p 0.47) for persistent lrHPV infections, 3.38 (95% CI 2.34-4.87, p < 0.001) for prevalent hrHPV, and 4.49 (95% CI 2.26-8.91, p < 0.001) for persistent hrHPV infections. CONCLUSION HIV infection was associated with higher prevalence of lrHPV, hrHPV, and persistence hrHPV infections, but not persistent lrHPV infections.
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Affiliation(s)
- Sally N Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States.,University of Maryland Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States.,Center for Bioethics and Research, Ibadan, Nigeria
| | - Oluwatoyosi Olawande
- Office of Strategic Information and Research, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Ayotunde Famooto
- Center for Bioethics and Research, Ibadan, Nigeria.,Office of Strategic Information and Research, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Eileen O Dareng
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Richard Offiong
- Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Clement A Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States.,University of Maryland Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States.,Center for Bioethics and Research, Ibadan, Nigeria.,Institute of Human Virology, University of Maryland School of Medicine, Baltimore, United States
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Crosby RA, Hagensee ME, Fisher R, Stradtman LR, Collins T. Self-collected vaginal swabs for HPV screening: An exploratory study of rural Black Mississippi women. Prev Med Rep 2016; 7:227-231. [PMID: 28879068 PMCID: PMC5575437 DOI: 10.1016/j.pmedr.2016.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/12/2016] [Accepted: 12/17/2016] [Indexed: 01/28/2023] Open
Abstract
Objectives To determine the post-procedure acceptability of self-collecting a vaginal swab for HPV testing among a highly impoverished and geographically isolated population of medically underserved Black women residing in the Mississippi Delta. Further, to test correlates of reporting that self-collection is preferred over Pap testing. Finally, to determine the prevalence of any of 13 high-risk HPV types among this population and the correlates of testing positive. Methods Eighty-eight women were recruited from two churches located in different towns of the Mississippi Delta. After completing a survey, women were provided instructions for self-collecting a cervico-vaginal swab and completing a post-collection survey. Specimens were tested for 13 oncogenic HPV types. Due to the exploratory nature of the study, significance was defined by a 0.15 alpha-level. Results Comfort levels with self-collection were high: 78.4% indicated a preference for self-collecting a specimen compared to Pap testing. Overall, 24 women (28.7%) tested positive for one or more of the 13 HPV types. Significant associations with testing positive were found for women having sex with females (P = 0.09), those never having an abnormal Pap (P = 0.06), younger women (P = 0.10), those with greater fatalism scores (P = 0.006), and those having less trust in doctors (P = 0.001). Conclusions Black rural women from the deep-south are generally comfortable self-collecting cervico-vaginal swabs for HPV testing. Given that nearly 30% tested positive for oncogenic HPV, and that fatalism as well a lack of trust in doctors predicted prevalence, a reasonable screening alternative to Pap testing may be community-based testing for HPV using self-collected vaginal swabs. The majority reported they preferred HPV testing over having Pap tests. Overall, 28.7% tested positive for one or more of the 13 HPV types. The mean fatalism score was significantly and substantially greater for HPV + women. Comfort in self-collecting was a strong correlate of preferring HPV testing.
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Affiliation(s)
- Richard A. Crosby
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, USA
- Corresponding author at: College of Public Health, 111 Washington Ave., Lexington, KY 40506-0003, USA.College of Public Health111 Washington Ave.LexingtonKY40506-0003USA
| | - Michael E. Hagensee
- Department of Microbiology, Immunology & Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Rebecca Fisher
- Department of Microbiology, Immunology & Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Lindsay R. Stradtman
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Tom Collins
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, USA
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Community-Based Screening for Cervical Cancer: A Feasibility Study of Rural Appalachian Women. Sex Transm Dis 2016; 42:607-11. [PMID: 26462184 DOI: 10.1097/olq.0000000000000365] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To describe women's comfort levels and perceptions about their experience self-collecting cervicovaginal swabs for human papillomavirus (HPV) testing, to determine whether nurse-guided patient navigation increases the odds of women receiving a traditional Papanicolaou (Pap) test after HPV screening, and to test the hypothesis that women testing positive for oncogenic HPV would be more likely to have a subsequent Pap test than those testing negative. METHODS A total of 400 women were recruited from 8 rural Appalachian counties, in 2013 and 2014. After completing a survey, women were provided instructions for self-collecting a cervicovaginal swab. Specimens were tested for 13 oncogenic HPV types. Simultaneously, women were notified of their test results and offered initial navigation for Pap testing. Chart-verified Pap testing within the next 6 months served as the end point. RESULTS Comfort levels with self-collection were high: 89.2% indicated that they would be more likely to self-collect a specimen for testing, on a regular basis, compared with Pap testing. Thirty women (7.5%) had a follow-up Pap test. Women receiving added nurse-guided navigation efforts were significantly less likely to have a subsequent test (P = 0.01). Women testing positive for oncogenic HPV were no more likely than those testing negative to have a subsequent Pap test (P = 0.27). Data were analyzed in 2014. CONCLUSIONS Rural Appalachian women are comfortable self-collecting cervicovaginal swabs for HPV testing. Furthermore, efforts to recontact women who have received an oncogenic HPV test result and an initial navigation contact may not be useful. Finally, testing positive for oncogenic HPV may not be a motivational factor for subsequent Pap testing.
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Švajdler M, Mezencev R, Kašpírková J, Kacerovská D, Kazakov DV, Ondič O, Michal M. Human papillomavirus infection and p16 expression in the immunocompetent patients with extragenital/extraungual Bowen's disease. Diagn Pathol 2016; 11:53. [PMID: 27342647 PMCID: PMC4919835 DOI: 10.1186/s13000-016-0505-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 06/15/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The role of human papillomaviruses (HPV) in the development of squamous cell carcinoma (SCC) has been established for anogenital lesions but still remains controversial for carcinomas in other sites. The aim of this study was to determine the α-HPV and β-HPV prevalence and their association with p16 expression, sun exposure, and clinicopathological findings in patients with Bowen's disease (BD). METHODS One hundred sixty nine skin biopsy specimens from 157 immunocompetent patients with extragenital/extraungual BD were examined for HPV status and p16 expression. The presence of koilocyte-like changes, solar elastosis and papillomatosis was recorded for each specimen. RESULTS BD was diagnosed more often in potentially sun-exposed sites with prevalence 73.6 % and a remarkable predilection for the head and neck region. High risk α-HPV or β-HPV were detected in 34.7 % of lesions and β-HPV infections dominated over α-HPV. Higher prevalence of koilocyte-like changes and papillomatosis was found in HPV-positive specimens but it was not statistically significant. The expression of p16 was detected in 79.8 % of lesions and displayed no correlation with the HPV status. HPV-positivity tended to be detected more often in sun-protected sites. Dual infections by α-HPV/β-HPV genera and mixed α-HPV infections were not detected, while 37.5 % of β-HPV positive specimens were infected by two or more β-HPV genotypes. HPV 9 was significantly associated with mixed β-HPV infections. CONCLUSIONS HPV may play an etiological role at least in some SCC in situ arising in extragenital sites. Sunprotected sites may be more dependent on HPV-mediated co-carcinogenesis than sun exposed areas. The presence of the p16-expression, papillomatosis or koilocyte-like change is not a reliable marker of HPV infection in SCC in situ.
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Affiliation(s)
- Marián Švajdler
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Roman Mezencev
- />Integrated Cancer Research Center, School of Biology and Parker H. Petit Institute of Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA USA
| | - Jana Kašpírková
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Denisa Kacerovská
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Dmitry V. Kazakov
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Ondrej Ondič
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Michal Michal
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
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Ngabo F, Franceschi S, Baussano I, Umulisa MC, Snijders PJF, Uyterlinde AM, Lazzarato F, Tenet V, Gatera M, Binagwaho A, Clifford GM. Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme. BMC Infect Dis 2016; 16:225. [PMID: 27221238 PMCID: PMC4877733 DOI: 10.1186/s12879-016-1539-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 05/05/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV). METHODS To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18-69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytology and HPV testing (44 types) with GP5+/6+ PCR. RESULTS HPV prevalence was 34 %, being highest (54 %) in women ≤19 years and decreasing to 20 % at age ≥50. Prevalence of high risk (HR) HPV and cytological abnormalities was 22 and 11 % respectively (including 2 % with high-grade squamous intraepithelial lesions, HSIL) decreasing with age. Age-standardised prevalence of HR HPV was 22 % (or 19 % among HIV-negative women), and HPV16 was the most common type. Prevalence of HPV and cytological abnormalities were significantly higher in HIV-positive than HIV-negative women, and the difference increased with age. Other significant risk factors for HPV positivity in multivariate analyses were high lifetime number of sexual partners, receiving cash for sex, and being a farmer. 40 % of women with HSIL were infected with HPV16/18 and there was no significant difference between HIV-positive and HIV-negative women. CONCLUSIONS This study confirms Rwanda to be a setting of high prevalence of HPV and cervical disease that is worsened by HIV. These data will serve as a robust baseline for future evaluations of HPV vaccine programme effectiveness.
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Affiliation(s)
- Fidele Ngabo
- Ministry of Health of Rwanda, Kigali, Rwanda
- Université Libre de Bruxelles, Ecole de Santé Publique, Brussels, Belgium
| | - Silvia Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Iacopo Baussano
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | | | - Peter J F Snijders
- Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Anne M Uyterlinde
- Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Fulvio Lazzarato
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Vanessa Tenet
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | | | - Agnes Binagwaho
- Ministry of Health of Rwanda, Kigali, Rwanda
- Harvard Medical School, Boston, MA, USA
- Geisel School of Medicine, Dartmouth, Hanover, USA
| | - Gary M Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France.
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Clifford GM, Franceschi S, Keiser O, Schöni-Affolter F, Lise M, Dehler S, Levi F, Mousavi M, Bouchardy C, Wolfensberger A, Darling KE, Staehelin C, Bertisch B, Kuenzli E, Bernasconi E, Pawlita M, Egger M. Immunodeficiency and the risk of cervical intraepithelial neoplasia 2/3 and cervical cancer: A nested case-control study in the Swiss HIV cohort study. Int J Cancer 2016; 138:1732-40. [PMID: 26537763 DOI: 10.1002/ijc.29913] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/14/2015] [Accepted: 10/19/2015] [Indexed: 01/07/2023]
Abstract
HIV-infected women are at increased risk of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (ICC), but it has been difficult to disentangle the influences of heavy exposure to HPV infection, inadequate screening and immunodeficiency. A case-control study including 364 CIN2/3 and 20 ICC cases matched to 1,147 controls was nested in the Swiss HIV Cohort Study (1985-2013). CIN2/3 risk was significantly associated with low CD4+ cell counts, whether measured as nadir [odds ratio (OR) per 100-cell/μL decrease = 1.15, 95% CI: 1.08, 1.22], or at CIN2/3 diagnosis (1.10, 95% CI: 1.04, 1.16). An association was evident even for nadir CD4+ 200-349 versus ≥350 cells/μL (OR = 1.57, 95% CI: 1.09, 2.25). After adjustment for nadir CD4+, a protective effect of >2-year cART use was seen against CIN2/3 (OR versus never cART use = 0.64, 95% CI: 0.42, 0.98). Despite low study power, similar associations were seen for ICC, notably with nadir CD4+ (OR for 50 vs. >350 cells/μL= 11.10, 95% CI: 1.24, 100). HPV16-L1 antibodies were significantly associated with CIN2/3, but HPV16-E6 antibodies were nearly exclusively detected in ICC. In conclusion, worsening immunodeficiency, even at only moderately decreased CD4+ cell counts, is a significant risk factor for CIN2/3 and cervical cancer.
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Affiliation(s)
| | | | - Olivia Keiser
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Franziska Schöni-Affolter
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Swiss HIV Cohort Study, Coordination and Data Center, Lausanne, Switzerland
| | - Mauro Lise
- International Agency for Research on Cancer, Lyon, France
| | - Silvia Dehler
- Cancer Registry of the Cantons of Zurich and Zug, Zurich, Switzerland
| | - Fabio Levi
- Cancer Registry of the Cantons of Vaud and Neufchatel, Lausanne, Switzerland
| | | | | | - Aline Wolfensberger
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Katharine E Darling
- Service of Infectious Diseases, Vaud University Hospital, Lausanne, Switzerland
| | - Cornelia Staehelin
- Department of Infectious Diseases, Unit HIV/AIDS, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Barbara Bertisch
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital of St Gallen, St Gallen, Switzerland
| | - Esther Kuenzli
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | | | - Michael Pawlita
- Department of Genome Modifications and Carcinogenesis, Infection and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Rondebosch, Cape Town, South Africa
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Salazar KL, Zhou HS, Xu J, Peterson LE, Schwartz MR, Mody DR, Ge Y. Multiple Human Papilloma Virus Infections and Their Impact on the Development of High-Risk Cervical Lesions. Acta Cytol 2015; 59:391-8. [PMID: 26674365 DOI: 10.1159/000442512] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 11/13/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Individuals are often infected with multiple genotypes of human papillomavirus (HPV) simultaneously, but the role these infections play in the development of cervical disease is not well established. This study aimed to determine the association of multiple HPV infections with high-risk cervical lesions (hrCLs). STUDY DESIGN HPV genotyping was performed on 798 SurePath specimens collected between December 1, 2009, and April 30, 2011. The cases were classified as hrCL (n = 90) or non-hrCL (n = 708) based on cytology diagnoses. The association between hrCL and HPV infection patterns was analyzed. RESULTS Multiple HPV infections were frequently encountered (38.2%) in the cohort. Increased frequency of hrCLs was associated with a single high-risk HPV (hrHPV) infection. An additive or synergistic effect was not observed for hrCL in multiple HPV infections. The hrCL rates appeared to decrease in various patterns of multiple HPV infections, but the reduction was not statistically significant. CONCLUSIONS Multiple HPV infections are common with no additive or synergistic effect on the development of hrCL. Conversely, reduced hrCL rates were observed in various patterns of multiple HPV infections compared to their single-genotype infection counterparts, suggestive of possible intergenotypic competition or more effective immune response triggered by multiple infections. Further studies in larger cohorts are needed.
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11
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McDonald AC, Tergas AI, Kuhn L, Denny L, Wright TC. Distribution of Human Papillomavirus Genotypes among HIV-Positive and HIV-Negative Women in Cape Town, South Africa. Front Oncol 2014; 4:48. [PMID: 24672770 PMCID: PMC3953716 DOI: 10.3389/fonc.2014.00048] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 02/27/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE HIV-positive women are known to be at high-risk of human papillomavirus (HPV) infection and its associated cervical pathology. Here, we describe the prevalence and distribution of HPV genotypes among HIV-positive and -negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN). METHODS We report data on 1,371 HIV-positive women and 8,050 HIV-negative women, aged 17-65 years, recruited into three sequential studies in Cape Town, South Africa, conducted among women who had no history of cervical cancer screening recruited from the general population. All women were tested for HIV. Cervical samples were tested for high-risk HPV DNA (Hybrid Capture 2) with positive samples tested to determine the specific genotype (Line Blot). CIN status was determined based on colposcopy and biopsy. RESULTS The HPV prevalence was higher among HIV-positive women (52.4%) than among HIV-negative women (20.8%) overall and in all age groups. Younger women, aged 17-19 years, had the highest HPV prevalence regardless of HIV status. HIV-positive women were more likely to have CIN 2 or 3 than HIV-negative women. HPV 16, 35, and 58 were the most common high-risk HPV types with no major differences in the type distribution by HIV status. HPV 18 was more common in older HIV-positive women (40-65 years) with no or low grade disease, but less common in younger women (17-29 years) with CIN 2 or 3 compared to HIV-negative counterparts (p < 0.03). Infections with multiple high-risk HPV types were more common in HIV-positive than HIV-negative women, controlling for age and cervical disease status. CONCLUSION HIV-positive women were more likely to have high-risk HPV than HIV-negative women; but, among those with HPV, the distribution of HPV types was similar by HIV status. Screening strategies incorporating HPV genotyping and vaccination should be effective in preventing cervical cancer in both HIV-positive and -negative women living in sub-Saharan Africa.
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Affiliation(s)
- Alicia C McDonald
- Department of Population Health, Hofstra North Shore Long Island Jewish School of Medicine , Great Neck, NY , USA ; Feinstein Institute for Medical Research, North Shore Long Island Jewish Health System , Manhasset, NY , USA
| | - Ana I Tergas
- Department of Epidemiology, Mailman School of Public Health, Columbia University , New York, NY , USA ; Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University , New York, NY , USA
| | - Louise Kuhn
- Department of Epidemiology, Mailman School of Public Health, Columbia University , New York, NY , USA ; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University , New York, NY , USA
| | - Lynette Denny
- Department of Obstetrics and Gynaecology, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town , Cape Town , South Africa
| | - Thomas C Wright
- Department of Pathology, College of Physicians and Surgeons, Columbia University , New York, NY , USA
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12
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Joshi S, Babu J, Jayalakshmi D, Kulkarni V, Divate U, Muwonge R, Gheit T, Tommasino M, Sankaranarayanan R, Pillai M. Human papillomavirus infection among human immunodeficiency virus-infected women in Maharashtra, India. Vaccine 2014; 32:1079-85. [DOI: 10.1016/j.vaccine.2013.12.060] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 12/13/2013] [Accepted: 12/18/2013] [Indexed: 12/14/2022]
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13
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Querec TD, Gurbaxani BM, Unger ER. Randomization modeling to ascertain clustering patterns of human papillomavirus types detected in cervicovaginal samples in the United States. PLoS One 2013; 8:e82761. [PMID: 24367553 PMCID: PMC3867389 DOI: 10.1371/journal.pone.0082761] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 11/05/2013] [Indexed: 11/25/2022] Open
Abstract
Detection of multiple human papillomavirus (HPV) types in the genital tract is common. Associations among HPV types may impact HPV vaccination modeling and type replacement. The objectives were to determine the distribution of concurrent HPV type infections in cervicovaginal samples and examine type-specific associations. We analyzed HPV genotyping results from 32,245 cervicovaginal specimens collected from women aged 11 to 83 years in the United States from 2001 through 2011. Statistical power was enhanced by combining 6 separate studies. Expected concurrent infection frequencies from a series of permutation models, each with increasing fidelity to the real data, were compared with the observed data. Statistics were computed based on the distributional properties of the randomized data. Concurrent detection occurred more than expected with 0 or ≥3 HPV types and less than expected with 1 and 2 types. Some women bear a disproportionate burden of the HPV type prevalence. Type associations were observed that exceeded multiple hypothesis corrected significance. Multiple HPV types were detected more frequently than expected by chance and associations among particular HPV types were detected. However vaccine-targeted types were not specifically affected, supporting the expectation that current bivalent/quadrivalent HPV vaccination will not result in type replacement with other high-risk types.
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Affiliation(s)
- Troy David Querec
- Chronic Viral Diseases Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Brian Mohan Gurbaxani
- Chronic Viral Diseases Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth Robinson Unger
- Chronic Viral Diseases Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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14
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Yue Y, Yang H, Wu K, Yang L, Chen J, Huang X, Pan Y, Ruan Y, Zhao Y, Shi X, Sun Q, Li Q. Genetic variability in L1 and L2 genes of HPV-16 and HPV-58 in Southwest China. PLoS One 2013; 8:e55204. [PMID: 23372836 PMCID: PMC3555822 DOI: 10.1371/journal.pone.0055204] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 12/28/2012] [Indexed: 11/19/2022] Open
Abstract
HPV account for most of the incidence of cervical cancer. Approximately 90% of anal cancers and a smaller subset (<50%) of other cancers (oropharyngeal, penile, vaginal, vulvar) are also attributed to HPV. The L1 protein comprising HPV vaccine formulations elicits high-titre neutralizing antibodies and confers type restricted protection. The L2 protein is a promising candidate for a broadly protective HPV vaccine. In our previous study, we found the most prevalent high-risk HPV infectious serotypes were HPV-16 and HPV-58 among women of Southwest China. To explore gene polymorphisms and intratypic variations of HPV-16 and HPV-58 L1/L2 genes originating in Southwest China, HPV-16 (L1: n = 31, L2: n = 28) and HPV-58 (L1: n = 21, L2: n = 21) L1/L2 genes were sequenced and compared to others described and submitted to GenBank. Phylogenetic trees were then constructed by Neighbor-Joining and the Kimura 2-parameters methods (MEGA software), followed by an analysis of the diversity of secondary structure. Then selection pressures acting on the L1/L2 genes were estimated by PAML software. Twenty-nine single nucleotide changes were observed in HPV-16 L1 sequences with 16/29 non-synonymous mutations and 13/29 synonymous mutations (six in alpha helix and two in beta turns). Seventeen single nucleotide changes were observed in HPV-16 L2 sequences with 8/17 non-synonymous mutations (one in beta turn) and 9/17 synonymous mutations. Twenty-four single nucleotide changes were observed in HPV-58 L1 sequences with 10/24 non-synonymous mutations and 14/24 synonymous mutations (eight in alpha helix and four in beta turn). Seven single nucleotide changes were observed in HPV-58 L2 sequences with 4/7 non-synonymous mutations and 3/7 synonymous mutations. The result of selective pressure analysis showed that most of these mutations were of positive selection. This study may help understand the intrinsic geographical relatedness and biological differences of HPV-16/HPV-58 and contributes further to research on their infectivity, pathogenicity, and vaccine strategy.
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Affiliation(s)
- Yaofei Yue
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
| | - Hongying Yang
- The Third Affiliated Hospital of Kunming Medical University (Yunnan Provincial Tumor Hospital), Kunming, People's Republic of China
| | - Kun Wu
- The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Lijuan Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
| | - Junying Chen
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
| | - Xinwei Huang
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
| | - Yue Pan
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
| | - Youqing Ruan
- The Third Affiliated Hospital of Kunming Medical University (Yunnan Provincial Tumor Hospital), Kunming, People's Republic of China
| | - Yujiao Zhao
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
| | - Xinan Shi
- Southwest Guizhou Vocational and Technical College for Nationalities, Xingyi, People's Republic of China
| | - Qiangming Sun
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
- * E-mail: (QS); (QL)
| | - Qihan Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, People's Republic of China
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, People's Republic of China
- * E-mail: (QS); (QL)
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Abstract
Investigating the prevalence of high-risk human papilloma virus (HPV) genotypes in human immunodeficiency virus (HIV)-infected women is vital to generate data for formulating guidelines for prevention/screening of cervical cancer in this vulnerable group. The study was aimed to analyze the HPV genotypes in HIV-infected women. It was a prospective, hospital-based, and cross-sectional study. HIV-infected women were enrolled from the antiretroviral clinic and controls from the gynecology outpatient. The HPV genotyping array kit was used for identifying 21 HPV genotypes. Detection of HPV was confirmed by performing an HPV type-specific polymerase chain reaction. A Pap smear was collected in all women. One hundred thirty HIV-infected women and 64 controls were enrolled. All women with low CD4 counts (n=97) were receiving antiretroviral therapy. Twenty-six (20%) HIV-infected women and 12 (18.7%) women in the control group tested positive for high-risk HPV (P=1.0). HPV 16 was the most common type, detected in 42% of HPV-positive women in the HIV-infected cohort, followed by HPV 45 (15%), HPV 18/52/31/58 (11.5% each), and HPV 33 (7.6%). The corresponding figures in the control group were as follows: HPV 16 (66.6%), HPV 45/18/31 (16.6% each), and HPV 33/58/68 (8.3% each). Cervical intraepithelial neoplasia was detected in 2.3% of HIV-infected women. The prevalence of high-risk HPV in HIV-infected women (20%) was similar to the prevalence in controls (18.7%). This and the incidence of cervical intraepithelial neoplasia are lower than those in previous reports. It is plausible that administration of antiretroviral therapy contributed to the reduced prevalence. The currently available vaccine would likely be beneficial to the local HIV-infected population, as nearly half the HPV-infected women harbored genotypes 16 or 18.
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16
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Burden of Human Papillomavirus among Haitian Immigrants in Miami, Florida: Community-Based Participatory Research in Action. JOURNAL OF ONCOLOGY 2012; 2012:728397. [PMID: 22619675 PMCID: PMC3349262 DOI: 10.1155/2012/728397] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 11/30/2011] [Indexed: 11/18/2022]
Abstract
Background. Haitian immigrant women residing in Little Haiti, a large ethnic enclave in Miami-Dade County, experience the highest cervical cancer incidence rates in South Florida. While this disparity primarily reflects lack of access to screening with cervical cytology, the burden of human papillomavirus (HPV) which causes virtually all cases of cervical cancer worldwide, varies by population and may contribute to excess rate of disease. Our study examined the prevalence of oncogenic and nononcogenic HPV types and risk factors for HPV infection in Little Haiti. Methods. As part of an ongoing community-based participatory research initiative, community health workers recruited study participants between 2007 and 2008, instructed women on self-collecting cervicovaginal specimens, and collected sociodemographic and healthcare access data. Results. Of the 242 women who contributed adequate specimens, the overall prevalence of HPV was 20.7%, with oncogenic HPV infections (13.2% of women) outnumbering nononcogenic infections (7.4%). Age-specific prevalence of oncogenic HPV was highest in women 18–30 years (38.9%) although the prevalence of oncogenic HPV does not appear to be elevated relative to the general U.S. population. The high prevalence of oncogenic types in women over 60 years may indicate a substantial number of persistent infections at high risk of progression to precancer.
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17
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Camargo M, Soto-De Leon SC, Sanchez R, Perez-Prados A, Patarroyo ME, Patarroyo MA. Frequency of Human Papillomavirus Infection, Coinfection, and Association with Different Risk Factors in Colombia. Ann Epidemiol 2011; 21:204-13. [DOI: 10.1016/j.annepidem.2010.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 10/21/2010] [Accepted: 11/07/2010] [Indexed: 10/18/2022]
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18
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Musa J, Taiwo B, Goldsmith S, Sutton S, Berzins B, Murphy RL. Predictors of atypical squamous cell of undetermined significance cervical cytology with high-risk human papilloma virus genotypes. Arch Gynecol Obstet 2010; 283:343-8. [DOI: 10.1007/s00404-010-1421-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Accepted: 03/01/2010] [Indexed: 11/30/2022]
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19
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Clifford GM, Franceschi S. Cancer risk in HIV-infected persons: influence of CD4(+) count. Future Oncol 2009; 5:669-78. [PMID: 19519206 DOI: 10.2217/fon.09.28] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Persons infected with HIV are at increased risk for all cancers known or suspected to have an infectious cause, an effect believed to be primarily mediated by lowered host immunity via the depletion of CD4(+) cells. Whereas Kaposi sarcoma and non-Hodgkin lymphoma were recognised as AIDS-defining illnesses early in the HIV epidemic, the influence of declining CD4(+) count on other infection-related cancers has taken longer to establish, undoubtedly because the association is weaker and the dose-response relationship is less steep. However, following improved survival made possible by combined antiretroviral therapy, declining CD4(+) count starts showing an impact on the natural history of various carcinogenic infections and on the risk for an increasingly wide range of cancers, including Hodgkin lymphoma, cervical, anal and liver cancers.
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Affiliation(s)
- Gary M Clifford
- International Agency for Research on Cancer, Lyon Cedex 08, France.
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20
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Spinillo A, Dal Bello B, Alberizzi P, Cesari S, Gardella B, Roccio M, Silini EM. Clustering patterns of human papillomavirus genotypes in multiple infections. Virus Res 2009; 142:154-9. [DOI: 10.1016/j.virusres.2009.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 02/05/2009] [Accepted: 02/06/2009] [Indexed: 11/16/2022]
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21
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HIV, human papillomavirus, and cervical neoplasia and cancer in the era of highly active antiretroviral therapy. Eur J Cancer Prev 2009; 17:545-54. [PMID: 18941376 DOI: 10.1097/cej.0b013e3282f75ea1] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The objective of this study was to review the literature on the epidemiological association between human papillomavirus (HPV), HIV, and cervical neoplasia, and the impact of highly active antiretroviral therapy (HAART) on this association. MEDLINE was searched using the terms 'human papillomavirus', 'HPV', 'HIV', 'cervix', 'neoplasm', and 'antiretroviral' to identify articles published before December 2006. HIV-infection was strongly associated with a higher prevalence, incidence, and persistence of HPV infection and correlated with prevalence, incidence, persistence, and progression of squamous intraepithelial lesions. The association between HIV and invasive cervical carcinoma has been more difficult to establish, but is now fully recognized. HAART seems to have little, if any, beneficial effect on the natural history of intraepithelial lesions in HIV-positive women. Despite this fact, HAART, does increase the life expectancy of HIV-positive women. Therefore, it remains important to closely monitor HPV-related disease in women with HIV who are receiving HAART, particularly in regions of the world where cervical screening is not available routinely.
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New variants of human papillomavirus type 18 identified in central Brazil. Virus Genes 2008; 37:282-7. [DOI: 10.1007/s11262-008-0263-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Accepted: 07/11/2008] [Indexed: 10/21/2022]
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Fusté P, Santamaría X, Carreras R. Nuevas estrategias terapéuticas para las lesiones anogenitales relacionadas con el virus del papiloma humano en pacientes con infección por el VIH: tratamiento antirretroviral de gran actividad y vacunas anti-VPH. Med Clin (Barc) 2008; 131:30-4. [DOI: 10.1157/13123038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Monsonego J, Pollini G, Evrard MJ, Sednaoui P, Monfort L, Quinzat D, Dachez R, Syrjänen K. Linear array genotyping and hybrid capture II assay in detecting human papillomavirus genotypes in women referred for colposcopy due to abnormal Papanicolaou smear. Int J STD AIDS 2008; 19:385-92. [DOI: 10.1258/ijsa.2007.007259] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Summary: The main objective of this study was to assess the feasibility of human papillomavirus (HPV) genotyping in women referred for colposcopy due to abnormal Papanicolaou (Pap) smear. A series of 248 women referred for colposcopy due to an abnormal Pap smear were analysed with the Roche Linear Array HPV genotyping test detecting 37 most frequent HPV types, and compared with hybrid capture II (HCII) assay for oncogenic (high-risk [HR] HPV) types as well as for p16INK4a expression using immunocytochemistry. All tests were performed in cervical samples collected in PreservCyt® liquid media for liquid-based cytology (ThinPrep), and colposcopic biopsy and/or loop electro excision procedure cone biopsy was used as the gold standard. HPV16 was the single most frequent genotype (29/258; 11.7%), followed by HPV51 (4.4%), HPV66 (3.6%), HPV42, 52 and 56 (3.2% for all). Linear array genotyping test significantly predicts both abnormal colposcopy (odds ratio [OR] = 9.0; 3.12-25.93), high-grade squamous intraepithelial lesions (OR = 9.6; 1.26-74.17) and cervical intraepithelial neoplasia (CIN) 3+ (OR = 29.3; 3.95-218.06). In detecting CIN3, linear array was equivalent (97.6%) to colposcopy in sensitivity (SE), both being superior to HCII (92.7%). Concordance between linear array and HCII was moderate (Cohen's kappa κ = 0.547; 95% confidence interval [CI]: 0.435-659). Specificity (SP) and positive predictive value (PPV) of linear array were significantly improved, if only HPV16 genotype was considered. Performance in the best balance is obtained, when linear array and colposcopy are combined, giving 82.9% SE, 93.9% SP, 73.9% PPV and 96.3% negative predictive value (NPV) as predictor of CIN3+ (OR 74.5; 95% CI: 27.36-202.72). In conclusion, linear array for HR-HPV is a highly sensitive test (97.6%) with high NPV (98.9%) in detecting CIN3+ lesions. HPV16 genotyping alone significantly improves SP and PPV of this test in management of women with abnormal cytology.
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Affiliation(s)
- Joseph Monsonego
- Institut Alfred Fournier, 25 Boulevard St Jacques, 75014 Paris, France
| | - Giuseppe Pollini
- Institut Alfred Fournier, 25 Boulevard St Jacques, 75014 Paris, France
| | - Marie José Evrard
- Institut Alfred Fournier, 25 Boulevard St Jacques, 75014 Paris, France
| | - Patrice Sednaoui
- Institut Alfred Fournier, 25 Boulevard St Jacques, 75014 Paris, France
| | - Laura Monfort
- Institut Alfred Fournier, 25 Boulevard St Jacques, 75014 Paris, France
| | - Dominique Quinzat
- Institut Alfred Fournier, 25 Boulevard St Jacques, 75014 Paris, France
| | - Roger Dachez
- Institut Alfred Fournier, 25 Boulevard St Jacques, 75014 Paris, France
| | - Kari Syrjänen
- Department of Oncology and Radiotherapy, Turku University Hospital, Savitehtaankatu 1, FIN-20521 Turku, Finland
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Detection of Human Papillomavirus Genotypes Among High-Risk Women: A Comparison of Hybrid Capture and Linear Array Tests. Sex Transm Dis 2008; 35:521-7. [DOI: 10.1097/olq.0b013e318164e567] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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The prevalence of human papillomavirus (HPV) infection in paired urine and cervical smear samples of HIV-infected women. J Clin Virol 2008; 41:111-5. [PMID: 18354821 DOI: 10.1016/j.jcv.2007.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND HIV-infected women are at increased risk for cervical dysplasia. Cervical dysplasia is caused by persistent infections with certain types of human papillomavirus (HPV). Conventional testing for genital HPV infections requires cervical cytology. A non-invasive screening method by detection of HPV DNA in urine samples is preferable but is not a routine practice. OBJECTIVES To investigate the prevalence and concordance of HPV in paired urine and cervical smear samples and cytological results of Pap smears in HIV-infected women. STUDY DESIGN Paired urine and cervical smear samples were collected from 27 HIV-infected women. RESULTS The HPV prevalence in urine and cervical smear samples was 81.5% and 51.9%, respectively (p = 0.01). The concordance for HPV positivity and negativity between urine and cervical smear samples is 71%. Seven women (25.9%) had an abnormal cervical smear of Pap II or higher. In all urine samples from these cases HPV DNA was detected. CONCLUSION In the present study we show that the HPV prevalence in urine and cervical smear samples of HIV-infected women is high and HPV test results are highly concordant. Therefore, urine samples can be used as medium for HPV testing. HPV testing in urine samples is a simple, reliable, non-invasive screening method.
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27
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Comparison of AMPLICOR® and Hybrid Capture II® assays for high risk HPV detection in normal and abnormal liquid-based cytology: Use of INNO-LiPA Genotyping assay to screen the discordant results. J Clin Virol 2008; 41:104-10. [DOI: 10.1016/j.jcv.2007.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 07/18/2007] [Accepted: 09/20/2007] [Indexed: 01/08/2023]
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Goldhaber-Fiebert JD, Stout NK, Ortendahl J, Kuntz KM, Goldie SJ, Salomon JA. Modeling human papillomavirus and cervical cancer in the United States for analyses of screening and vaccination. Popul Health Metr 2007; 5:11. [PMID: 17967185 PMCID: PMC2213637 DOI: 10.1186/1478-7954-5-11] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Accepted: 10/29/2007] [Indexed: 01/19/2023] Open
Abstract
Background To provide quantitative insight into current U.S. policy choices for cervical cancer prevention, we developed a model of human papillomavirus (HPV) and cervical cancer, explicitly incorporating uncertainty about the natural history of disease. Methods We developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. Input parameter sets were sampled randomly from uniform distributions, and simulations undertaken with each set. Through systematic reviews and formal data synthesis, we established multiple epidemiologic targets for model calibration, including age-specific prevalence of HPV by type, age-specific prevalence of cervical intraepithelial neoplasia (CIN), HPV type distribution within CIN and cancer, and age-specific cancer incidence. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted outcomes and calibration targets. Using 50 randomly resampled, good-fitting parameter sets, we assessed the external consistency and face validity of the model, comparing predicted screening outcomes to independent data. To illustrate the advantage of this approach in reflecting parameter uncertainty, we used the 50 sets to project the distribution of health outcomes in U.S. women under different cervical cancer prevention strategies. Results Approximately 200 good-fitting parameter sets were identified from 1,000,000 simulated sets. Modeled screening outcomes were externally consistent with results from multiple independent data sources. Based on 50 good-fitting parameter sets, the expected reductions in lifetime risk of cancer with annual or biennial screening were 76% (range across 50 sets: 69–82%) and 69% (60–77%), respectively. The reduction from vaccination alone was 75%, although it ranged from 60% to 88%, reflecting considerable parameter uncertainty about the natural history of type-specific HPV infection. The uncertainty surrounding the model-predicted reduction in cervical cancer incidence narrowed substantially when vaccination was combined with every-5-year screening, with a mean reduction of 89% and range of 83% to 95%. Conclusion We demonstrate an approach to parameterization, calibration and performance evaluation for a U.S. cervical cancer microsimulation model intended to provide qualitative and quantitative inputs into decisions that must be taken before long-term data on vaccination outcomes become available. This approach allows for a rigorous and comprehensive description of policy-relevant uncertainty about health outcomes under alternative cancer prevention strategies. The model provides a tool that can accommodate new information, and can be modified as needed, to iteratively assess the expected benefits, costs, and cost-effectiveness of different policies in the U.S.
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Kulmala SMA, Shabalova IP, Petrovitchev N, Syrjänen KJ, Gyllensten UB, Syrjänen SM. Prevalence of the most common high-risk HPV genotypes among women in three new independent states of the former Soviet Union. J Med Virol 2007; 79:771-81. [PMID: 17457909 DOI: 10.1002/jmv.20839] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Type distribution of HPV has been studied in different geographic regions, but the data are scanty from the new independent states of the former Soviet Union. Here the HPV prevalence and distribution of the most frequent high-risk HPV types among 3,187 women at different risk for HPV and cervical intraepithelial neoplasia in Russia, Belarus, and Latvia is reported. HPV detection, type distribution and viral load analysis in DNA samples from cervical scrapes were done with real-time PCR-based assay detecting HPV types 16, 18, 31, 33, 35, 39, 45, 52, and 58. The overall HPV prevalence was 31.2%, HPV16 was the most prevalent type followed by HPV31 and HPV33 group. The overall HPV prevalences in Russia, Belarus and Latvia were 33.4%, 27.5%, and 26.2%. The type distributions were similar in these countries, except for Latvia where HPV39 was the third prevalent genotype. HPV prevalence was highest (40.8%) among women from sexually transmitted disease clinic, followed by 30.9% among gynecological outpatients and 27.2% in screening patients. HPV detection increased with cytological abnormality (P = 0.0001) and lesion grade in the biopsy (P = 0.0001), from 27% to 72% in normal samples to cancer, and from 64% to 77% in cervical intraepithelial neoplasia 1 to cancer. The normalized viral loads varied greatly between and among different HPV-types. The mean log HPV33 group copies/cell increased from negative for intraepithelial lesions to cancer (P = 0.049). Distribution of the most common high-risk HPV-types seems to be similar in these countries as reported in other major geographical regions.
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Affiliation(s)
- Satu-Maria A Kulmala
- Department of Oral Pathology, Institute of Dentistry, MediCity Research Laboratory, University of Turku, Turku, Finland
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Abstract
HPV infection of both the genital tract and oral cavity of HIV+ men and women is increased. HPV-related pathology is also increased in the HIV+ individuals, usually with further increases seen for those HIV+ individuals with lower CD4 cell counts. Fortunately, the rates of cervical cancer and anal cancer are relatively low and not related to CD4 cell count. Treatment of the HIV+ individual with HPV-related disease is challenging and requires close long-term follow-up to prevent recurrent disease. The mechanism of how HPV and HIV interact is still not known but is more likely to be linked to immune suppression rather than a direct interaction between viruses. The newly developed HPV vaccines will likely have a significant impact on HPV-related disease in immunocompetent individuals. It remains to be seen what impact these vaccine will have on the immune depressed.
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Affiliation(s)
- Jennifer E Cameron
- Tulane Health Sciences Center, Tulane Medical School, New Orleans, LA, USA
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31
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Abstract
BACKGROUND HIV-positive women have a high prevalence of human papillomavirus (HPV) infection and are infected with a broader range of HPV types than HIV-negative women. It is not known to what extent these different types are associated with high-grade squamous intraepithelial lesions (HSIL) and cancer. METHODS Meta-analysis of HPV type-specific prevalence among HIV-positive women, stratified by geographical region and by cervical cytology: normal, atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL) or HSIL. RESULTS In 20 studies, 5578 HIV-positive women were identified, largely from North America but also Africa, Asia, Europe and South/Central America. For 3230 with no cytological abnormalities, prevalence was 36.3% for any HPV and 11.9% for multiple HPV types. The six most common high-risk HPV types were 16 (4.5%), 58 (3.6%), 18 (3.1%), 52 (2.8%), 31 (2.0%) and 33 (2.0%). HPV16 was also the most common type in 2053 HIV-positive women with ASCUS/LSIL and 295 with HSIL. Those with HSIL were significantly less likely to be infected with HPV16 (odds ratio, 0.6; 95% confidence interval, 0.4-0.7) than the general female population with HSIL. In contrast, HIV-positive women with HSIL were significantly more likely to be infected with HPV types 11, 18, 33, 51, 52, 53, 58 and 61, and with multiple HPV types. CONCLUSIONS The proportion of HIV-positive women with HPV16 rose with increasing severity of cervical lesions. Nevertheless, HPV16 remained underrepresented in HIV-positive women with HSIL, who showed a higher proportion of other HPV types and multiple types compared with the general female population with HSIL.
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32
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Ortiz M, Torres M, Muñoz L, Fernández-García E, Canals J, Cabornero AI, Aguilar E, Ballesteros J, Del Amo J, García-Sáiz A. Oncogenic human papillomavirus (HPV) type distribution and HPV type 16 E6 variants in two Spanish population groups with different levels of HPV infection risk. J Clin Microbiol 2006; 44:1428-34. [PMID: 16597872 PMCID: PMC1448654 DOI: 10.1128/jcm.44.4.1428-1434.2006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study is to determine oncogenic human papillomavirus (HPV) types and HPV type 16 (HPV16) variant distribution in two Spanish population groups, commercial sex workers and imprisoned women (CSW/IPW) and the general population. A multicenter cross-sectional study of 1,889 women from five clinical settings in two Spanish cities was conducted from May to November 2004. Oncogenic HPV infection was tested by an Hybrid Capture II (HC2) test, and positive samples were genotyped by direct sequencing using three different primer sets in L1 (MY09/11 and GP5+/GP6+) and E6/E7. HPV16 variants were identified by sequencing the E6, E2, and L1 regions. Four hundred twenty-five samples were positive for the HC2 test, 31.5% from CSW/IPW and 10.7% from the general population. HPV16 was the most frequent type. Distinct profiles of oncogenic HPV type prevalence were observed across the two populations. In order of decreasing frequency, HPV types 16, 31, 58, 66, 56, and 18 were most frequent in CSW/IPW women, and types 16, 31, 52, 68, 51, and 53 were most frequent in the general population. We analyzed HPV16 intratype variants, and a large majority (78.7%) belonged to the European lineage. AA variants were detected in 16.0% of cases. African variants belonging to classes Af1 (4.0%) and Af2 (1.3%) were detected. Different HPV types and HPV16 intratype variants are involved in oncogenic HPV infections in our population. These results suggest that HPV type distribution differs in CSW/IPW women and in the general population, although further analysis is necessary.
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Affiliation(s)
- M Ortiz
- Servicio de Diagnóstico y Referencia de Retrovirus y Papilomavirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda-Madrid, Spain.
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33
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Varsani A, van der Walt E, Heath L, Rybicki EP, Williamson AL, Martin DP. Evidence of ancient papillomavirus recombination. J Gen Virol 2006; 87:2527-2531. [PMID: 16894190 DOI: 10.1099/vir.0.81917-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
An open question amongst papillomavirus taxonomists is whether recombination has featured in the evolutionary history of these viruses. Since the onset of the global AIDS epidemic, the question is somewhat less academic, because immune-compromised human immunodeficiency virus patients are often co-infected with extraordinarily diverse mixtures of human papillomavirus (HPV) types. It is expected that these conditions may facilitate the emergence of HPV recombinants, some of which might have novel pathogenic properties. Here, a range of rigorous analyses is applied to full-genome sequences of papillomaviruses to provide convincing statistical and phylogenetic evidence that evolutionarily relevant papillomavirus recombination can occur.
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Affiliation(s)
- Arvind Varsani
- Department of Molecular and Cell Biology, University of Cape Town, Observatory, Cape Town 7925, South Africa
- Electron Microscope Unit, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Eric van der Walt
- Department of Molecular and Cell Biology, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Livio Heath
- Department of Molecular and Cell Biology, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Edward P Rybicki
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town 7925, South Africa
- Department of Molecular and Cell Biology, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Anna Lise Williamson
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Darren P Martin
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town 7925, South Africa
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Cerqueira DM, de S Moraes D, Camara GNL, Amaral FA, Oyama CNR, dos Santos MQC, Martins CRF. High HPV genetic diversity in women infected with HIV-1 in Brazil. Arch Virol 2006; 152:75-83. [PMID: 16896550 DOI: 10.1007/s00705-006-0828-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Accepted: 06/29/2006] [Indexed: 10/24/2022]
Abstract
The present study on genetic diversity of human papillomaviruses in women infected by HIV in Brazil describes the frequency, the genotypes, and five new variants of HPV. One hundred fifty cervical smears of HIV-positive women were subjected to cytological examination, and the DNA samples obtained were assayed by MY09/MY11 amplification, followed by RFLP typing. The overall HPV-DNA-positive rate was 42.7%. One hundred twenty-two samples (81.3%) had benign cellular alterations or normal cytological results, and HPV DNA frequency among them was 30.3%. Otherwise, 96.4% of samples with altered cytology were positive for HPV DNA. A high diversity of genotypes was observed. HPVs-16 and 81 were the most prevalent (14.1%) and were followed by HPVs 52, 35, 62, 33, 53, 56, 66, 70, 18, 58, 6b, 11, 31, 39, 40, 61, 71, 32, 54, 59, 67, 68, 85, and 102. Five new variants of the high-risk HPVs 18, 33, 53, 59, and 66 were detected. Possible associations between the detection of HPV genotypes and the cytological classification, HIV viral load, CD4 count, and antiretroviral treatment were also examined. We observed that a high proportion of HIV-infected women are infected with HPV and may carry oncogenic genotypes, even when cytological evaluation shows normal results.
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Affiliation(s)
- D M Cerqueira
- Pós-Graduação em Biologia Molecular, Instituto de Biologia, Universidade de Brasília, Brasília, Brazil
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Ashrafi GH, Brown DR, Fife KH, Campo MS. Down-regulation of MHC class I is a property common to papillomavirus E5 proteins. Virus Res 2006; 120:208-11. [PMID: 16780984 DOI: 10.1016/j.virusres.2006.02.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2005] [Revised: 02/08/2006] [Accepted: 02/08/2006] [Indexed: 01/31/2023]
Abstract
The E5 protein family of papillomaviruses comprises small hydrophobic proteins which are associated with the cell endomembrane compartments. The functions of the E5 proteins, particularly those of HPV, are still far from clear. We have reported that the E5 proteins of BPV-1, BPV-4, HPV-16 and HPV-6 down-regulate MHC class I, potentially helping the virus evade the host immune response. Others have described MHC class I down-regulation by HPV-2 E5. We report here that another E5 protein, HPV-83 E5, likewise down-regulates MHC class I and propose that interference with expression, assembly and/or transport of MHC class I is a common property of all E5 proteins evolved by the virus to circumvent host immunosurveillance and thus establish productive infection.
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Affiliation(s)
- G H Ashrafi
- Division of Pathological Sciences, Institute of Comparative Medicine, University of Glasgow, Garscube Estate, Glasgow G61 1QH, Scotland, UK
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36
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de Oliveira ERZM, Derchain SFM, Sarian LOZ, Rabelo-Santos SH, Gontijo RC, Yoshida A, Andrade LALA, Zeferino LC. Prediction of high-grade cervical disease with human papillomavirus detection in women with glandular and squamous cytologic abnormalities. Int J Gynecol Cancer 2006; 16:1055-62. [PMID: 16803485 DOI: 10.1111/j.1525-1438.2006.00462.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The objective of this study was to assess whether human papillomavirus (HPV) detection with hybrid capture II (HC II) can help predict the presence and the nature, glandular or squamous, of histologic cervical lesions in women referred due to atypical glandular cells (AGC) or high-grade squamous intraepithelial lesion (HSIL). A total of 247 women were included. Referral Pap smears comprised AGC (51 cases), AGC plus HSIL (28 cases), adenocarcinoma in situ (10 cases), and HSIL (158 cases). All patients were tested for high-risk HPV with HC II and had a histologic assessment of their cervix. Histologic analysis showed 38 women with (15.3%) cervicitis, 194 with (75.5%) squamous lesions, and 15 with (9.2%) glandular neoplasia. The overall rate of high-risk HPV detection was 77%. Almost 70% of AGC-HPV-negative patients did not have a pathologically proven cervical neoplasia, whereas 76% of women with AGC-HPV-positive result were diagnosed with a squamous or glandular neoplasia. Most (95%) of the lesions in patients with AGC-HSIL were of squamous nature, and HPV detection did not contribute to their differentiation from glandular lesions. We conclude that in women with AGC, HPV positivity strongly correlated with the presence of glandular or squamous cervical lesion but did not help distinguishing women with squamous from those with glandular neoplasia.
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MESH Headings
- Adult
- Carcinoma in Situ/diagnosis
- Carcinoma in Situ/epidemiology
- Carcinoma in Situ/virology
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/virology
- DNA Probes, HPV
- Diagnosis, Differential
- Female
- Humans
- Mass Screening/methods
- Middle Aged
- Neoplasms, Glandular and Epithelial/diagnosis
- Neoplasms, Glandular and Epithelial/epidemiology
- Neoplasms, Glandular and Epithelial/virology
- Neoplasms, Squamous Cell/epidemiology
- Neoplasms, Squamous Cell/virology
- Papillomaviridae/isolation & purification
- Precancerous Conditions/diagnosis
- Precancerous Conditions/epidemiology
- Precancerous Conditions/virology
- Predictive Value of Tests
- Uterine Cervical Diseases/diagnosis
- Uterine Cervical Diseases/epidemiology
- Uterine Cervical Diseases/virology
- Uterine Cervical Dysplasia/diagnosis
- Uterine Cervical Dysplasia/epidemiology
- Uterine Cervical Dysplasia/virology
- Uterine Cervical Neoplasms/diagnosis
- Uterine Cervical Neoplasms/epidemiology
- Uterine Cervical Neoplasms/virology
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Affiliation(s)
- E R Z M de Oliveira
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Rua Antônio Hossri 629, Cidade Universitária, 13083-370 Campinas, São Paulo, Brazil
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37
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Chaturvedi AK, Myers L, Hammons AF, Clark RA, Dunlap K, Kissinger PJ, Hagensee ME. Prevalence and Clustering Patterns of Human Papillomavirus Genotypes in Multiple Infections. Cancer Epidemiol Biomarkers Prev 2005; 14:2439-45. [PMID: 16214929 DOI: 10.1158/1055-9965.epi-05-0465] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Prevalence of multiple human papillomavirus (HPV) infections, involvement of specific HPV phylogenetic clades in multiple infections, and clustering patterns of multiple infections at the clade level were assessed in 854 HIV (-) and 275 HIV (+) women cross-sectionally. Reverse line blot assay was used to detect 27 HPV genotypes. Involvement of specific clades in coinfections and clustering patterns were assessed using HPV clade/genotype as the unit of analyses. Expected frequencies assuming independence for all possible clade combinations in two-genotype infections were derived using a multinomial expansion and comparisons of observed and expected frequencies were done using a composite goodness-of-fit test. In all, 100 two-genotype infections were detected; 61 in HIV (-) and 39 in HIV (+) women. Clade A9 (HPV types 16, 31, 33, 35, 52, and 58) was significantly less likely to be involved in multiple infections compared with all other clades (55.2% versus 64.6%; adjusted odds ratios, 0.68; 95% confidence interval, 0.48-0.95). Observed patterns for all possible clade combinations (among HPV clades A3, A5, A6, A7, A9, and A10) in two-genotype infections did not significantly differ from those expected in the entire sample, across HIV, Pap smear, and age strata (all goodness-of-fit exact P > 0.20). These results indicate that clade A9 is less likely to be involved in multiple infections and that HPV genotypes predominantly establish multiple infections at random, with little positive/negative clustering for either phylogenetically related or unrelated types. The current method of analysis affords the opportunity to test clustering of a large number of HPV genotype/clade combinations at nominal alpha levels.
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Affiliation(s)
- Anil K Chaturvedi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
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Williamson AL, Passmore JA, Rybicki EP. Strategies for the prevention of cervical cancer by human papillomavirus vaccination. Best Pract Res Clin Obstet Gynaecol 2005; 19:531-44. [PMID: 16150392 DOI: 10.1016/j.bpobgyn.2005.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
As cervical cancer is causally associated with 14 high-risk types of human papillomavirus (HPV), a successful HPV vaccine will have a major impact on this disease. Although some persistent HPV infections progress to cervical cancer, host immunity is generally able to clear most HPV infections. Both cell-mediated and antibody responses have been implicated in influencing the susceptibility, persistence or clearance of genital HPV infection. There have been two clinical trials that show that vaccines based on virus-like particles (VLPs) made from the major capsid protein, L1, are able to type specifically protect against cervical intra-epithelial neoplasia and infection. However, there is no evidence that even a mixed VLP vaccine will protect against types not included in the vaccine, and a major challenge that remains is how to engineer protection across a broader spectrum of viruses. Strategies for production of HPV vaccines using different vaccine vectors and different production systems are also reviewed.
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Affiliation(s)
- A-L Williamson
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
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