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Calvo‐Torres J, Rejas‐Gutiérrez J, Ramírez‐Mena M, Bradbury M, Del Pino M, González‐Granados C, Procas B, Coronado PJ. Population-based norms for the human papillomavirus-quality of life (HPV-QoL) questionnaire: A cross-sectional multicenter study. Acta Obstet Gynecol Scand 2024; 103:1584-1595. [PMID: 38872262 PMCID: PMC11266628 DOI: 10.1111/aogs.14877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/26/2024] [Accepted: 05/04/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Human papillomavirus (HPV) diagnosis has a considerable emotional and psychological impact on women. To evaluate the impairment this infection leads to regarding quality of life (QoL), several scales have been suggested, such as the human-papillomavirus-quality-of-life (HPV-QoL) questionnaire. This has been validated for the Spanish population and measures the impact of HPV on health-related-quality-of-life (HR-QoL). However, normative values are yet to be developed. Thus, the objective was to describe the population-based norms of the HPV-QoL for Spanish women aged 25-65 years and to test the questionnaire's construct validity. MATERIAL AND METHODS This was a cross-sectional nationwide multicenter study. Women from outpatient clinics in Spain aged 25-65 years, with a diagnosis of past or active HPV infection were recruited. The central tendency, dispersion, and percentiles were calculated for the total score and its dimensions for each age group. Construct validity was tested by analyzing age groups and their correlations with other related scales (12-Item General Health Questionnaire [GHQ-12], Female Sexual Function Index [FSFI], and Hospital Anxiety and Depression Scale [HADS]). RESULTS A total of 1352 women were included in the study. The norms showed moderate and significant coefficients of correlation with other related scales. Significant differences between age strata groups were found according to educational level, sexual dysfunction, sexual activity, mental deterioration, and severity of anxiety and depression symptoms (p < 0.001 in all cases). The total score differed significantly between the groups (p = 0.006). Significant differences in the contagiousness, health, and sexuality dimensions (p < 0.05) were found among the groups. It was seen that HPV infection impaired women's QoL. Dimensions within all test age groups (p < 0.001 in all cases) were significantly different, with the health dimension being the highest contributor to women's QoL impairment, whereas social well-being was the main determinant of QoL. CONCLUSIONS Population-based norms for the novel HPV-QoL questionnaire showed adequate validity and could be a useful tool for assessing the impact of QoL among women with HPV in Spain.
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Affiliation(s)
- Javier Calvo‐Torres
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
| | | | - Mar Ramírez‐Mena
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
| | - Melissa Bradbury
- Unit of Gynecologic Oncology, Service of Gynecology, Gynecology Oncology Department, Hospital Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Marta Del Pino
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital ClínicUniversitat de BarcelonaBarcelonaSpain
| | | | - Beatriz Procas
- Department of Obstetrics and GynecologyHospital General Universitario San JorgeHuescaSpain
| | - Pluvio J. Coronado
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
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Cassani C, Dominoni M, Pasquali MF, Gardella B, Spinillo A. Multiple human papillomavirus infection and high-grade cervical squamous intraepithelial lesions among women with human immunodeficiency virus: a systematic review and a meta-analysis. Front Med (Lausanne) 2024; 11:1403548. [PMID: 39076762 PMCID: PMC11284066 DOI: 10.3389/fmed.2024.1403548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/27/2024] [Indexed: 07/31/2024] Open
Abstract
Background This study aimed to evaluate the prevalence of multiple high-risk (HR) human papillomavirus (HPV) infections in women with human immunodeficiency virus (HIV) compared to negative controls. This study also aimed to assess the impact of multiple HR-HPVs on the risk of high-grade squamous cervical lesions (HSILs) among women with HIV. Methods We performed a systematic search of PubMed/Medline, Scopus, Cochrane databases, and ClinicalTrials.gov from 1 January 2004 to 30 June 2023, including screenings and clinical studies evaluating the rates and role of multiple HPV infections in squamous intraepithelial lesions (SILs). Three reviewers independently screened the abstracts of the selected studies and extracted data from full-text articles. The data were subsequently tabulated and compared for consistency. The bias associated with each included study was evaluated according to the OSQE method. Results Forty-seven studies meet definitive inclusion criteria. The quality of the observations was considered low in 26 of the included studies and moderate in 21 of the included studies. In comparative screening studies, the pooled prevalence of multiple HR-HPV was 39.1% (95% CI = 33.7-44.7) among women with (n = 1734) and 21.6% (95% CI = 17.3-26.1) in those without HIV infection (n = 912) (OR = 2.33, 95% CI = 1.83-2.97, I 2 = 2.8%). The pooled ORs of HR-HPV multiple infections were similar in African (OR = 2.72, 95% CI = 1.89-3.9) and non-African countries (OR = 2.1, 95% CI = 1.46-3, p for difference = 0.96). Among women with HIV, the risk of HSIL diagnosed either by cytology or histology was higher among those with overall (OR = 2.62, 95% CI = 1.62-4.23) and HR multiple infections than those with single HPV infection (OR = 1.93, 95% CI = 1.51-2.46). Among women with HIV, the excess rates of multiple HPV infections and the excess risk of associated HSIL were consistent across studies including both HIV-naïve subjects and those on antiretroviral therapy, as well as in studies with different rates of immunocompromised women. When study quality (low vs. moderate) was used as a moderator, the results were unchanged. Conclusion Multiple HR-HPV infections are common among women living with HIV and are associated with an increased prevalence of HSIL. These associations were also confirmed in studies with high rates of antiretroviral therapy and low rates of immunocompromise.Systematic Review Registration: PROSPERO [registration number: CRD42023433022].
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Affiliation(s)
- Chiara Cassani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mattia Dominoni
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marianna Francesca Pasquali
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Arsenio Spinillo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Hernández-Aguado JJ, de La Fuente-Valero J, Ramírez Mena M, Ortega-Medina L, Vidart Aragón JA, Galán JC. Comparative pilot study about HPV test with partial genotyping in primary screening versus other strategies for cervical cancer population screening, CRYGEN 16/18 study. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:262-268. [PMID: 35963773 DOI: 10.1016/j.eimce.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 05/06/2023]
Abstract
INTRODUCTION The early detection of cervical cancer requires the implementation of molecular screening programmes for human papillomavirus (HPV). However, there are discrepancies in the optimization of screening protocols. The performance of 10 primary screening strategies based on molecular, cytological or combined techniques is now evaluated. MATERIAL AND METHODS A blind, prospective, and interventional study was designed in 1.977 35-year-old women. The molecular determination was carried out by the Cobas 4800 HPV platform. Cytological analysis were performed on the same samples without knowledge of the result of the molecular assay. All women in whom HPV-16/HPV-18 was detected or presented cytological alteration together with detection of other high-risk genotypes (HPVhr) were referred to colposcopy. RESULTS The molecular assay detected the presence of HPVhr genotypes in 12.5% of the women, while only 8.1% of the cytologies were pathological. Among the patients referred to colposcopy, in 19.5% high-grade lesions were observed, being HPV-16 present in 65.3% of them. In six of these high-grade lesions (associated with HPV-16 in all cases), cytology was reported as normal. The follow-up one year later, of women with normal cytology and HPVhr detection a HSIL/CIN2+ lesion was detected (associated to HPV-33). In the comparative study with other strategies, the protocol called CRYGEN 16/18 yielded the best balance of sensitivity and specificity with the least referral to colposcopy. CONCLUSIONS Performing molecular detection of HPVhr with partial first-line genotyping of at least HPV-16, with direct referral to colposcopy, increases the detection rate of HSIL/CIN2+ lesions.
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Affiliation(s)
| | | | - Mar Ramírez Mena
- Servicio de Ginecología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Luis Ortega-Medina
- Servicio de Anatomía Patológica, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain; CIBER Epidemiología Salud Pública (CIBERESP), Madrid, Spain.
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Selenocoxib-3, a novel anti-inflammatory therapeutic effectively resolves colitis. Mol Cell Biochem 2023; 478:621-636. [PMID: 36001205 DOI: 10.1007/s11010-022-04532-y] [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: 02/02/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022]
Abstract
Ulcerative colitis (UC) is an idiopathic, chronic and relapsing colonic inflammatory disease. Despite the involvement of diverse intricate mechanisms, COX mediated inflammatory pathway is crucial in the pathophysiology of colitis. Thus, COX inhibition is imperative for managing colitis-associated inflammation. However, the use of COX inhibitory classical non-steroidal anti-inflammatory drugs (NSAIDs) for inflammation resolution has been linked to sudden increased flare-ups. Therefore, considering the anti-inflammatory and pro-resolution effects of antioxidant and essential trace element Selenium (Se), a Seleno-derivative of Celecoxib called Selenocoxib-3 was characterized and evaluated for its favourable pharmacokinetics, safety margins and anti-inflammatory therapeutic potential in DSS-induced experimental colitis. The serum pharmacokinetic profiling [elimination rate constant (K) and clearance (Cl) and toxicity profiling suggested enhanced efficacy, therapeutic potential and lesser toxicity of Selenocoxib-3 as compared to its parent NSAID Celecoxib. In vivo studies demonstrated that Selenocoxib-3 efficiently resolves the gross morphological signs of DSS-induced colitis such as diarrhoea, bloody stools, weight loss and colon shortening. Further, intestinal damage evaluated by H & E staining and MPO activity suggested of histopathological disruptions, such as neutrophil infiltration, mucodepletion and cryptitis, by Selenocoxib-3. The expression profiles of COX-1/2 demonstrated mitigation of pro-inflammatory mediators thereby promoting anti-inflammatory efficacy of Selenocoxib-3 when compared with Celecoxib. The current study suggests translational applicability of Se-containing novel class of COX inhibitors for efficiently managing inflammatory disorders such as UC.
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Efficacy of a Coriolusversicolor-Based Vaginal Gel in Human Papillomavirus-Positive Women Older Than 40 Years: A Sub-Analysis of PALOMA Study. J Pers Med 2022; 12:jpm12101559. [PMID: 36294699 PMCID: PMC9605554 DOI: 10.3390/jpm12101559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
In the PALOMA trial, Papilocare® demonstrated efficacy in repairing low-grade cervical lesions related to human papillomavirus (HPV). This sub-analysis aimed to evaluate its efficacy in repairing these cervical lesions and clearing HPV in women aged older than 40 years. This was a multicenter, randomized, open-label, parallel-group, controlled clinical trial. Patients with low-degree HPV-dependent cervical lesions receiving 6-month treatment with the vaginal gel were compared to those with a watchful waiting approach. Among the 41 women analyzed (aged 47.7 years), 31 presented high-risk (HR) oncogenic HPV subtypes, and 14 had 16-18-31 HPV genotypes. After 6 months, normalized cytology and concordant colposcopy were achieved by a greater percentage of treated women. The difference was significant in the total population (92.3% vs. 50.0%, p = 0.007), and HR-HPV subpopulation (90.5% vs. 33.3%, p = 0.003). In the HR HPVs-16-18-31 subpopulation, the values were 75.0% and 40.0% (p = 0.293). In the total population, 61.5% of treated patients obtained HPV clearance, compared to 50.0% in the control group. Regarding the HR-HPV subpopulation, these values were 66.7% and 44.4%, respectively. Papilocare® demonstrated significant efficacy in repairing low-degree HPV-related cervical lesions and a positive trend to clear HPV in women older than 40 years old in comparison to the watchful waiting approach.
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Hernandez-Aguado JJ, Sánchez Torres DÁ, Martínez Lamela E, Aguión Gálvez G, Sanz Espinosa E, Pérez Quintanilla A, Martínez-Carrillo DA, Ramírez Mena M, Coronado Martín PJ, Zapardiel I, de la Fuente-Valero J. Quadrivalent Human Papillomavirus Vaccine Effectiveness after 12 Years in Madrid (Spain). Vaccines (Basel) 2022; 10:vaccines10030387. [PMID: 35335019 PMCID: PMC8952248 DOI: 10.3390/vaccines10030387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/17/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023] Open
Abstract
A fully government-funded human papillomavirus (HPV) vaccination program started in 2007 in Spain (only 11–14-year-old girls). The first of those vaccinated cohorts, with the quadrivalent vaccine (Gardasil), turned 25 years old in 2018, the age at which cervical cancer screening begins in Spain. The current study could provide the first evidence about the effectiveness of the quadrivalent vaccine against HPV in Spain and the influence of age of vaccination. The present ambispective cohort study, which was conducted on 790 women aged 25 and 26 years old, compares the rate of HPV prevalence and cytologic anomaly according to the vaccination status. The overall infection rate was 40.09% (vaccinated group) vs. 40.6% (non-vaccinated group). There was a significant reduction in the prevalence of HPV 6 (0% vs. 1.3%) and 16 (2.4% vs. 6.1%), and in the prevalence of cytological abnormalities linked to HPV16: Atypical Squamous Cells of Undetermined Significance (ASCUS) (2.04% vs. 14%), Low-grade Squamous Intraepithelial Lesions (LSIL) (2.94% vs. 18.7%) and High-grade Squamous Intraepithelial Lesion (HSIL) (0% vs. 40%), in the vaccinated group vs. the non-vaccinated group. Only one case of HPV11 and two cases of HPV18 were detected. The vaccine effectively reduces the prevalence of vaccine genotypes and cytological anomalies linked to these genotypes.
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Affiliation(s)
- Juan J. Hernandez-Aguado
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
- Correspondence:
| | - Damián Ángel Sánchez Torres
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
| | - Esther Martínez Lamela
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
| | - Gema Aguión Gálvez
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
| | - Eva Sanz Espinosa
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
| | - Almudena Pérez Quintanilla
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
| | - Daniela A. Martínez-Carrillo
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
| | - Mar Ramírez Mena
- Gynecology Oncology Unit, Institute of Women’s Health, San Carlos Clinical Hospital (IdISSC), Complutense University, 28040 Madrid, Spain; (M.R.M.); (P.J.C.M.)
| | - Pluvio J. Coronado Martín
- Gynecology Oncology Unit, Institute of Women’s Health, San Carlos Clinical Hospital (IdISSC), Complutense University, 28040 Madrid, Spain; (M.R.M.); (P.J.C.M.)
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital-IdiPAZ, 28046 Madrid, Spain;
| | - Jesús de la Fuente-Valero
- Gynecology Department, Infanta Leonor University Hospital, 28031 Madrid, Spain; (D.Á.S.T.); (E.M.L.); (G.A.G.); (E.S.E.); (A.P.Q.); (D.A.M.-C.); (J.d.l.F.-V.)
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Hernández-Aguado JJ, de La Fuente-Valero J, Ramírez Mena M, Ortega-Medina L, Vidart Aragón JA, Galán JC. Comparative pilot study about HPV test with partial genotyping in primary screening versus other strategies for cervical cancer population screening, CRYGEN 16/18 study. Enferm Infecc Microbiol Clin 2021; 41:S0213-005X(21)00231-7. [PMID: 34404547 DOI: 10.1016/j.eimc.2021.07.010] [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: 04/07/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The early detection of cervical cancer requires the implementation of molecular screening programs for human papillomavirus (HPV). However, there are discrepancies in the optimization of screening protocols. The performance of 10 primary screening strategies based on molecular, cytological or combined techniques is now evaluated. MATERIAL AND METHODS A blind, prospective, and interventional study was designed in 1977 35-year-old women. The molecular determination was carried out by the Cobas 4800 HPV platform. Cytological analysis was performed on the same samples without knowledge of the result of the molecular assay. All women in whom HPV-16/HPV-18 was detected or presented cytological alteration together with detection of other high-risk genotypes (HPVhr) were referred to colposcopy. RESULTS The molecular assay detected the presence of HPVhr genotypes in 12.5% of the women, while only 8.1% of the cytologies were pathological. Among the patients referred to colposcopy, in 19.5% high-grade lesions were observed, being HPV-16 present in 65.3% of them. In six of these high-grade lesions (associated with HPV-16 in all cases), cytology was reported as normal. The follow-up one year later, of women with normal cytology and HPVhr detection a HSIL/CIN2+ lesion was detected (associated to HPV-33). In the comparative study with other strategies, the protocol called CRYGEN 16/18 yielded the best balance of sensitivity and specificity with the least referral to colposcopy. CONCLUSIONS Performing molecular detection of HPVhr with partial first-line genotyping of at least HPV-16, with direct referral to colposcopy, increases the detection rate of HSIL/CIN2+ lesions.
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Affiliation(s)
| | | | - Mar Ramírez Mena
- Servicio de Ginecología, Hospital Universitario Clínico San Carlos, Madrid, España
| | - Luis Ortega-Medina
- Servicio de Anatomía Patológica, Hospital Universitario Clínico San Carlos, Madrid, España
| | | | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, España; CIBER Epidemiología Salud Pública (CIBERESP), Madrid, España.
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On the Elimination of Infections Related to Oncogenic Human Papillomavirus: An Approach Using a Computational Network Model. Viruses 2021; 13:v13050906. [PMID: 34068358 PMCID: PMC8153310 DOI: 10.3390/v13050906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/02/2021] [Accepted: 05/12/2021] [Indexed: 12/27/2022] Open
Abstract
Cervical cancer is the fourth most common malignancy in women worldwide, although it is preventable with prophylactic HPV vaccination. HPV transmission-dynamic models can predict the potential for the global elimination of cervical cancer. The random network model is a new approach that allows individuals to be followed, and to implement a given vaccination policy according to their clinical records. We developed an HPV transmission-dynamic model on a lifetime sexual partners network based on individual contacts, also accounting for the sexual behavior of men who have sex with men (MSM). We analyzed the decline in the prevalence of HPV infection in a scenario of 75% and 90% coverage for both sexes. An important herd immunity effect for men and women was observed in the heterosexual network, even with 75% coverage. However, HPV infections are persistent in the MSM population, with sustained circulation of the virus among unvaccinated individuals. Coverage around 75% of both sexes would be necessary to eliminate HPV-related conditions in women within five decades. Nevertheless, the variation in the decline in infection in the long term between a vaccination coverage of 75% and 90% is relatively small, suggesting that reaching coverage of around 70-75% in the heterosexual network may be enough to confer high protection. Nevertheless, HPV elimination may be achieved if men's coverage is strictly controlled. This accurate representation of HPV transmission demonstrates the need to maintain high HPV vaccination coverage, especially in men, for whom the cost-effectiveness of vaccination is questioned.
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Ibáñez R, Mareque M, Granados R, Andía D, García-Rojo M, Quílez JC, Oyagüez I. Comparative cost analysis of cervical cancer screening programme based on molecular detection of HPV in Spain. BMC WOMENS HEALTH 2021; 21:178. [PMID: 33902553 PMCID: PMC8074415 DOI: 10.1186/s12905-021-01310-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/15/2021] [Indexed: 12/24/2022]
Abstract
Background HPV cervical cancer screening (CCS) must use validated HPV tests based on the molecular detection of either viral mRNA (Aptima HPV Assay—AHPV) or DNA. AHPV has demonstrated the same cross-sectional and longitudinal sensitivity for the detection of HSIL/CIN2+ lesions but with greater specificity than HPV-DNA tests. The study aimed to estimate the total costs of a CCS with a primary HPV test based on the detection of mRNA compared to DNA in women aged 35–65 years for the National Health System. Methods A decision-tree-based model to estimate the cost of the CCS until the first colposcopy was designed based on Spanish CCS guidelines. The total cost (€, 2019) for CCS with AHPV or DNA tests (HC2 and Cobas) was calculated, including HPV test, liquid-based cytology (LBC) and colposcopy, for a population of 7,263,529 women aged 35–65 years (assuming 70% coverage). Clinical inputs derived from a literature review were validated by a multidisciplinary expert panel. Data from head-to-head studies between different HPV tests were selected. Results The use of AHPV showed reduction of 290,541 (− 35%) and 355,913 (− 40%) LBC compared to HC2 or Cobas, respectively. Furthermore, AHPV avoided 151,699 (− 47%) colposcopies versus HC2 and 151,165 (− 47%) versus Cobas. The total cost of CCS was € 282,747,877 with AHPV, € 322,587,588 with HC2 and € 324,614,490 with Cobas. Therefore, AHPV savings € − 39,839,711 versus HC2 and € − 41,866,613 versus Cobas. Conclusions Assuming that 70% of women from 35 to 65 years attend the CCS programme, the cost of screening up to the first colposcopy using AHPV would provide cost savings of up to € 41.9 million versus DNA tests in Spain. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01310-8.
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Affiliation(s)
- R Ibáñez
- Institut Català d'Oncologia (ICO), Cancer Epidemiology Research Program, Barcelona, Spain
| | - M Mareque
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain.
| | - R Granados
- Pathology Department. Hospital, Universitario de Getafe, Madrid, Spain
| | - D Andía
- Gynecology and Obstetrics. Hospital Universitario Basurto, Bilbao, Spain
| | - M García-Rojo
- Pathology Department, Hospital, Universitario Puerta del Mar, Cádiz, Spain
| | - J C Quílez
- Gynecology and Obstetrics. Hospital Universitario Basurto, Bilbao, Spain
| | - I Oyagüez
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
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Serrano L, López AC, González SP, Palacios S, Dexeus D, Centeno-Mediavilla C, Coronado P, de la Fuente J, López JA, Vanrell C, Cortés J. Efficacy of a Coriolus versicolor-Based Vaginal Gel in Women With Human Papillomavirus-Dependent Cervical Lesions: The PALOMA Study. J Low Genit Tract Dis 2021; 25:130-136. [PMID: 33746195 PMCID: PMC7984756 DOI: 10.1097/lgt.0000000000000596] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the efficacy of Papilocare, a Coriolus versicolor-based vaginal gel, in repairing human papillomavirus (HPV)-related low-grade cervical lesions. METHODS The study is a multicenter, open-label, randomized, parallel-group, watchful waiting approach-controlled trial involving 91 HPV-positive women with low-grade Pap smear alterations and consistent colposcopy. RESULTS The percentage of patients with normal Pap smear and concordant colposcopy 3 and 6 months after receiving treatment (78.0% and 84.9%) was significantly higher than without treatment (54.8% and 64.5%), especially in high-risk HPV patients (79.5% and 87.8% vs 52.0% and 56.0%). At 6-month visit, overall HPV clearance was achieved by a greater number of patients receiving treatment (59.6%) compared with those without treatment (41.9%), especially high-risk HPV ones (62.5% vs 40.0%). The cervical re-epithelization score was significantly higher with treatment (mean = 4.5) than without (mean = 4.1). Compared with baseline, perceived stress decreased in the treatment group (from 21.1 to 19.0) and increased in the control group (from 17.7 to 20.7). A total of 7 possible or probable treatment-related adverse events were reported, most of them (n = 6) being mild or moderate in severity. CONCLUSIONS Treatment with Papilocare has demonstrated a better clinical benefit than the conventional watchful waiting approach in clinical practice for total and high-risk HPV patients in terms of its efficacy to treat HPV-related cervical lesions and to clear all HPV strains after a single 6-month period. It has demonstrated an adequate safety and tolerability and confers additional benefits such as higher re-epithelization, stress reduction, and high treatment adherence.
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Impact of a Gender-Neutral HPV Vaccination Program in Men Who Have Sex with Men (MSM). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030963. [PMID: 33499347 PMCID: PMC7908442 DOI: 10.3390/ijerph18030963] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 12/23/2022]
Abstract
A major challenge in human papillomavirus (HPV) vaccine programs is the universal gender-neutral recommendation, as well as estimation of its long-term effect. The objective of this study is to predict the added benefit of male vaccination, especially in men who have sex with men (MSM), and to analyze the impact of the program on society. We propose a mathematical model of the HPV infection based on a network paradigm. Data from Spain allowed constructing the sexual network. HPV force of infection was taken from literature. Different scenarios using variable vaccine coverage in both males and females were studied. Strong herd immunity is shown in the heterosexual population, with an important decrease of HPV 6/11 infections both in men and in unvaccinated women with an only-women vaccination at 14 years of age. No impact of this program occurred in the infection incidence in MSM. This group would only benefit from a vaccination program that includes males. However, the impact at short term would be lower than in heterosexual men. The protection of MSM can only be achieved by direct vaccination of males. This may have important consequences for public health.
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Andujar M, Roura E, Torres A, Vega B, Pavcovich M, Sanchez MA, Lubrano A, Trujillo JL, Almeida L, Santana M, Hurtado R, Arencibia O, Benito V, Medina N, Carballo S, Camacho MDC, Ruiz Del Pozo A, Quesada A, Salido E, de Sanjosé S, Bruni L. Prevalence and genotype distribution of cervical human papilomavirus infection in the pre-vaccination era: a population-based study in the Canary Islands. BMJ Open 2020; 10:e037402. [PMID: 32973061 PMCID: PMC7517562 DOI: 10.1136/bmjopen-2020-037402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE National Spanish studies show that prevalence of cervical human papillomavirus (HPV) infection in the female population is increasingly frequent, with an overall estimate of 14% in women aged 18-65 years. The objective of this study is to know the prevalence and distribution of HPV types in the female population of the Canary Islands prior to the introduction of HPV vaccines and to investigate the associated clinical and sociodemographic factors. METHODS Based on the Primary Health Care database, a sample of adult women (aged 18-65 years) of Gran Canaria (GC) and Tenerife (TF) stratified into nine age groups was carried out between 2002 and 2007. Women were contacted by postal letter and telephone call and were visited in their primary care centre. A clinical-epidemiological survey was completed and cervical samples were taken for cytological study and HPV detection. HPV prevalence and its 95% CI were estimated, and multivariate analyses were performed using logistic regression to identify factors associated with the infection. RESULTS 6010 women participated in the study, 3847 from GC and 2163 from TF. The overall prevalence of HPV infection was 13.6% (CI 12.8%-14.5%) and 11.1% (CI 10.3%-11.9%) for high-risk types. The most frequent HPV type was 16 followed by types 51, 53, 31, 42 and 59. HPV types included in the nonavalent vaccine were detected in 54.1% of infected women. Factors associated with an increased risk of infection were: young ages (18-29 years), the number of sexual partners throughout life, not being married, being a smoker, and having had previous cervical lesions or genital warts. CONCLUSIONS It is confirmed that prevalence of HPV infection in the female population of the Canary Islands is high, but similar to that of Spain, HPV 16 being the most frequent genotype. The determinants of infection are consistent with those of other populations.
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Affiliation(s)
- Miguel Andujar
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Esther Roura
- Unit of Infections and Cancer-Information and Interventions (UNIC-I&I)-Cancer Epidemiology Research Program (CERP)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Alejandra Torres
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Begoña Vega
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Marta Pavcovich
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Miguel Angel Sanchez
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Amina Lubrano
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Jose Luis Trujillo
- Department of Obstetrics and Gynecology, Hospital Universitario de Canarias, La Laguna, Spain
| | - Lucia Almeida
- Department of Obstetrics and Gynecology, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Milagros Santana
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Rosaura Hurtado
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Octavio Arencibia
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Virginia Benito
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Norberto Medina
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Sonia Carballo
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Maria Del Carmen Camacho
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Arancha Ruiz Del Pozo
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Alfoso Quesada
- Department of Obstetrics and Gynecology, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Eduardo Salido
- Department of Pathology, Hospital Universitario de Canarias, La Laguna, Spain
| | - Silvia de Sanjosé
- Reproductive Health Global Programme, PATH, Seattle, Washington, USA
- Cancer Epidemiology Research Program (CERP)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Laia Bruni
- Unit of Infections and Cancer-Information and Interventions (UNIC-I&I)-Cancer Epidemiology Research Program (CERP)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
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Epidemiology of human papillomavirus-related oropharyngeal cancer in a classically low-burden region of southern Europe. Sci Rep 2020; 10:13219. [PMID: 32764593 PMCID: PMC7411067 DOI: 10.1038/s41598-020-70118-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/21/2020] [Indexed: 01/22/2023] Open
Abstract
The incidence of human papillomavirus (HPV)-related oropharyngeal cancer is increasing in some regions. Nevertheless, the epidemiology of this disease has not been extensively investigated in southern Europe. We conducted a retrospective cohort study of patients diagnosed with primary oropharyngeal cancer from 1991 to 2016. Cancer tissues underwent histopathological evaluation, DNA quality control, HPV-DNA detection and p16INK4a immunohistochemistry. Data were collected from medical records. Factors associated with HPV positivity and time trends were evaluated with multivariable Bayesian models. The adjusted prevalence of HPV-related cases in 864 patients with a valid HPV-DNA result was 9.7%, with HPV-DNA/p16INK4a double positivity being considered. HPV-related oropharyngeal cancer was likely to occur in non-smokers and non-drinkers, to be located in the tonsil or diagnosed at advanced stages. Time-trend analysis showed an increasing risk of HPV-related oropharyngeal cancer in the most recent periods (5-year period increase of 30%). This increase was highest and with a clear increasing trend only in the most recent years (2012–2016). The prevalence of HPV-related oropharyngeal cancer started to sharply increase in the most recent years in our setting, as occurred two decades ago in areas where most oropharyngeal cancer cases are currently HPV-related. Our results provide a comprehensive assessment of the epidemiological landscape of HPV-related oropharyngeal cancer in a region of southern Europe.
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Martín-Merino E, Llorente-García A, Castillo Cano B, Montero Corominas D, Huerta-Álvarez C. The Longitudinal Incidence of Human Papillomavirus Vaccination in Spanish Primary Care in the First 10 Years After Approval. Pharmaceut Med 2019; 33:519-530. [DOI: 10.1007/s40290-019-00309-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Calibration of an agent-based simulation model to the data of women infected by Human Papillomavirus with uncertainty. Appl Soft Comput 2019. [DOI: 10.1016/j.asoc.2019.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Bergengren L, Lillsunde-Larsson G, Helenius G, Karlsson MG. HPV-based screening for cervical cancer among women 55-59 years of age. PLoS One 2019; 14:e0217108. [PMID: 31199811 PMCID: PMC6568382 DOI: 10.1371/journal.pone.0217108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/03/2019] [Indexed: 11/19/2022] Open
Abstract
AIM Many cervical cancers occurs among women over 65 and prevalence of HPV genotypes in this age cohort is sparingly studied. One aim of this study was to study the prevalence and distribution of HPV genotypes in women 55-59 years, with normal cytology when exiting the screening program. Secondly, HPV clearance as well as the value of HPV genotyping and/or liquid based cytology as triage tests for identifying histological dysplasia among women with persistent HPV was studied. METHODS Women that exited the screening program with normal cytology, between the years 2012-2014, in Örebro County, Sweden, were invited to this study. A total of 2946 samples were analyzed with a broad-spectrum assay to detect both hrHPV and lrHPV in order to investigate the distribution of genotypes. In the consent group, women with a positive hrHPV test were offered a follow-up test and a cone biopsy for histological confirmation, and a follow up sample 6 months post cone. RESULTS The overall prevalence of hrHPV was 7.4% and 59% of them remained hrHPV positive in a follow-up test after 12 months. A total of 99 women had a cone biopsy done, where 19% showed histological dysplasia. HPV 53 was the most common genotype, and among women with histology confirmed LSIL or HSIL, HPV 31 was most common. A positive hrHPV result showed a PPV of 25% for LSIL+ and 12.5%for HSIL+. Using detection of HPV 16/18 genotypes as a triage test for hrHPV positive tests, indicated FNR for histological LSIL+ and HSIL+ of 94% and 87.5% respectively, whilst triage based on cervical cytology had a FNR of 69% for LSIL+ and 37.5% for HSIL+. CONCLUSION The most common hrHPV genotypes among women 55-59 years of age were non HPV16/18 genotypes, and in this population, these genotypes represented most of the histological verified HSIL lesions. This result does not support the proposition of a HPV 16/18 triaging test after a positive hrHPV test as a marker of histological HSIL+ cervical lesions in women over 55 years of age. Similarly, cytological triage after a positive hrHPV showed no additional benefit in this population. Specific triaging tests should be validated to follow post-menopausal women with a positive hrHPV test.
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Affiliation(s)
- Lovisa Bergengren
- Dept of Women’s Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- * E-mail:
| | - Gabriella Lillsunde-Larsson
- Dept. of Laboratory Medicine, Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Gisela Helenius
- Dept of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mats G. Karlsson
- Dept of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Martín-Merino E, Llorente-García A, Montero Corominas D, Huerta-Álvarez C. RETRACTED ARTICLE: The Longitudinal Incidence of Human Papillomavirus Vaccination in Spanish Primary Care in the First 6 Years After Approval. Pharmaceut Med 2019; 33:135-144. [PMID: 31933248 DOI: 10.1007/s40290-019-00268-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Spain, girls and women are vaccinated against human papillomavirus (HPV) in the primary care setting, according to a national vaccination program. Vaccination is voluntary and the cost is covered by the public health system. OBJECTIVES The aim of the study was to estimate the incidence and patterns of HPV vaccination amongst girls in Spain. METHODS A cohort study was performed using the information recorded in the Spanish Primary Care Database for Pharmacoepidemiological Research (BIFAP) from 7.4 million patients from eight Spanish regions, between 2001 and 2013 (56% of the regional population). Data available in BIFAP include patient age, sex, lifestyle factors, clinical events, specialist referrals, prescriptions, and vaccinations as recorded by the primary care physician (PCP) or administering nurse. The study cohort comprised all girls aged 11-18 years registered in BIFAP between 1 January 2007 and 31 December 2013 who had at least 1 year of clinical record information with their PCP (inclusion criteria). The date the inclusion criteria were met was designated as the start date of the study cohort contribution. In order to estimate the incidence of HPV vaccination, girls forming the study cohort were followed from start date until there was a recorded HPV vaccination, they reached 19 years of age or died, the end of available information, or 31 December 2013. The person-time of all patients forming the study cohort was taken into account in the incidence estimations. The cumulative incidence (CuIn) of vaccination by birth cohort, year and region was estimated using life-tables (proportion of vaccination by intervals in which the denominator is the initial population corrected for losses). RESULTS Out of 273,098 girls forming the study population, 81,461 were vaccinated during 2007-2013. Age ranged from 12 to 14 years at first dose in 86.0% of vaccinated girls; 54.1% received a quadrivalent vaccine, 21.9% a bivalent vaccine, and 24.0% an unknown type. Out of the vaccinated population, 87.9% received three doses, 8.2% two and 3.9% one dose, at a maximum of 7 years of follow-up. By calendar year and region, the CuIn reached 70.0-95.8% for birth cohorts between 1993 and 1999, 28.6-99.0% for births cohorts between 1990 and 1992, and exceptionally, 70.6-99.8% for births cohorts between 2000 and 2002 in three regions. CONCLUSIONS According to BIFAP primary care data, a high incidence of vaccination among girls aged 13-15 years was observed. Vaccination among younger and older girls was less common although they reached high incidence in those regions that included girls aged 11-18 years in mass programs. Most vaccination patterns adjusted to a three-dose regimen, as recommended.
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Affiliation(s)
- Elisa Martín-Merino
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Calle Campezo nº 1, Edificio 8, 28022, Madrid, Spain.
| | - Ana Llorente-García
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Calle Campezo nº 1, Edificio 8, 28022, Madrid, Spain
| | - Dolores Montero Corominas
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Calle Campezo nº 1, Edificio 8, 28022, Madrid, Spain
| | - Consuelo Huerta-Álvarez
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Calle Campezo nº 1, Edificio 8, 28022, Madrid, Spain
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Martínez-Gómez X, Curran A, Campins M, Alemany L, Rodrigo-Pendás JÁ, Borruel N, Castellsagué X, Díaz-de-Heredia C, Moraga-Llop FA, Del Pino M, Torné A. Multidisciplinary, evidence-based consensus guidelines for human papillomavirus (HPV) vaccination in high-risk populations, Spain, 2016. Euro Surveill 2019; 24:1700857. [PMID: 30782268 PMCID: PMC6381660 DOI: 10.2807/1560-7917.es.2019.24.7.1700857] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 10/15/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Although human papillomavirus (HPV) routine vaccination programmes have been implemented around the world and recommendations have been expanded to include other high-risk individuals, current recommendations often differ between countries in Europe, as well as worldwide. AIM To find and summarise the best available evidence of HPV vaccination in high-risk patients aiding clinicians and public health workers in the day-to-day vaccine decisions relating to HPV in Spain. METHODS We conducted a systematic review of the immunogenicity, safety and efficacy/effectiveness of HPV vaccination in high-risk populations between January 2006 and June 2016. HPV vaccination recommendations were established with levels of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS A strong recommendation about HPV vaccination was made in the following groups: HIV infected patients aged 9-26 years; men who have sex with men aged 9-26 years; women with precancerous cervical lesions; patients with congenital bone marrow failure syndrome; women who have received a solid organ transplant or hematopoietic stem cell transplantation aged 9-26 years; and patients diagnosed with recurrent respiratory papillomatosis. CONCLUSIONS Data concerning non-routine HPV vaccination in populations with a high risk of HPV infection and associated lesions were scarce. We have developed a document to evaluate and establish evidence-based guidelines on HPV vaccination in high-risk populations in Spain, based on best available scientific evidence.
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Affiliation(s)
- Xavier Martínez-Gómez
- Servei de Medicina Preventiva i Epidemiologia, Hospital Universitari Vall d'Hebron - Universitat Autònoma de Barcelona, Barcelona, España
| | - Adrian Curran
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron - Universitat Autònoma de Barcelona, Barcelona, España
| | - Magda Campins
- Servei de Medicina Preventiva i Epidemiologia, Hospital Universitari Vall d'Hebron - Universitat Autònoma de Barcelona, Barcelona, España
| | - Laia Alemany
- Programa de Recerca en Epidemiologia del Càncer, Institut Català d'Oncologia - IDIBELL CIBER Epidemiología y Salud Pública, Barcelona, España
| | - José Ángel Rodrigo-Pendás
- Servei de Medicina Preventiva i Epidemiologia, Hospital Universitari Vall d'Hebron - Universitat Autònoma de Barcelona, Barcelona, España
| | - Natalia Borruel
- Unitat d'Atenció Crohn-Colitis, Servei d'Aparell Digestiu; Hospital Universitari Vall d'Hebron - Universitat Autònoma de Barcelona, Barcelona, España
| | - Xavier Castellsagué
- Programa de Recerca en Epidemiologia del Càncer, Institut Català d'Oncologia - IDIBELL CIBER Epidemiología y Salud Pública, Barcelona, España
| | - Cristina Díaz-de-Heredia
- Servei d'Oncologia i Hematologia Pediàtrica, Hospital Universitari Vall d'Hebron - Universitat Autònoma de Barcelona, Barcelona, España
| | | | - Marta Del Pino
- Unidad de Ginecología Oncológica, Instituto Clínico de Ginecología y Obstetricia y Neonatología (ICGON), Hospital Clínic de Barcelona, Barcelona, España
- Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Facultad de Medicina, Universidad de Barcelona, Barcelona, España
| | - Aureli Torné
- Unidad de Ginecología Oncológica, Instituto Clínico de Ginecología y Obstetricia y Neonatología (ICGON), Hospital Clínic de Barcelona, Barcelona, España
- Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Facultad de Medicina, Universidad de Barcelona, Barcelona, España
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Cobo-Cuenca AI, Rodríguez-Borrego MA, Hidalgo-Lópezosa P, Rodríguez-Muñoz PM, Martins M, Carmona-Torres JM. Prevalence and determinants in cytology testing for cervical cancer screening in Spain (2006-14). Eur J Public Health 2018; 28:410-415. [PMID: 29444273 DOI: 10.1093/eurpub/cky015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Cervical cancer has decreased in developed countries thanks to cytology screening programmes. The aims of this study were To analyse the frequency and evolution of performing cytology tests and to determine the variables that influence their use. Methods Cross-sectional study of non-institutionalized women who participated in the national health survey (2006, 2011/12) and the European Health Survey in Spain (2009, 2014). Study variables: cytology-testing, time since last cytology-test, reason for performing the test, age, nationality, marital status, social status, education level and place of residence. Results The study evaluated 53 628 women in Spain over 15 years old, with a mean age of 52.68 (SD ± 19.12). About 94.1% were Spanish, 49.2% were married and 77.2% lived with a partner. In 2014, 72% had a cytology test, a number that increased significantly. Women aged 25-65 were 5.13 times more likely to undergo a cytology test than those aged 15-24 years old (odds ratio (OR): 5.13; P < 0.001); women with university educations were 9.23 times more likely to undergo a cytology test than those without university educations (P > 0.001); those of social classes I and II (high) were 1.2 more likely to undergo a cytology test than those of low social class (P = 0.026); and Spanish women were 1.74 times more likely to undergo a cytology test than foreigners living in Spain (P < 0.001). Conclusion Frequency of cytology testing has increased in the last few years. Screening for cervical cancer is associated with higher social status, education level, age, and not being foreign.
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Affiliation(s)
- Ana I Cobo-Cuenca
- E.U. de Enfermería y Fisioterapia de Toledo, Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Universidad de Castilla la Mancha, Spain.,Instituto Maimónides de Investigación Biomédica de Córdoba, Spain
| | - María-Aurora Rodríguez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba, Spain.,Facultad de Medicina y Enfermería, Departamento de Enfermería, Universidad de Córdoba, Spain.,Hospital Universitario Reina Sofía de Córdoba, Spain
| | - Pedro Hidalgo-Lópezosa
- Instituto Maimónides de Investigación Biomédica de Córdoba, Spain.,Facultad de Medicina y Enfermería, Departamento de Enfermería, Universidad de Córdoba, Spain.,Hospital Universitario Reina Sofía de Córdoba, Spain
| | - Pedro M Rodríguez-Muñoz
- Instituto Maimónides de Investigación Biomédica de Córdoba, Spain.,Facultad de Medicina y Enfermería, Departamento de Enfermería, Universidad de Córdoba, Spain.,Hospital Universitario Reina Sofía de Córdoba, Spain
| | | | - Juan M Carmona-Torres
- E.U. de Enfermería y Fisioterapia de Toledo, Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Universidad de Castilla la Mancha, Spain.,Instituto Maimónides de Investigación Biomédica de Córdoba, Spain
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21
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López N, Gil-de-Miguel Á, Pascual-García R, Gil-Prieto R. Reduction in the burden of hospital admissions due to cervical disease from 2003-2014 in Spain. Hum Vaccin Immunother 2018; 14:917-923. [PMID: 29206085 PMCID: PMC5893208 DOI: 10.1080/21645515.2017.1412897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/07/2017] [Accepted: 11/28/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cervix uteri cancer is the 4th most common cancer among women worldwide and the second most frequent cancer in women under 45 years old in Spain. We aimed to describe the burden of hospital admissions by malignant neoplasia (MN) and in situ carcinoma (ISC) of the cervix in Spain from 2003 to 2014, a 12-year period that included the first years after introduction of an HPV vaccination program. METHODS This epidemiological study reviewed data from the Ministry of Health National Surveillance System, which includes more than 98% of Spanish hospitals. Hospitalization rate, mortality rate, and case fatality rates were calculated per year and age group. RESULTS We found 74,933 hospitalizations due to MN and ISC of the cervix. The average age at hospitalization increased significantly during the study period. The average length of hospital stay decreased significantly (p<0.001), while hospitalization costs increased. The mean hospitalization rate was 27.532 cases per 100,000 women (95% CI: 27.335-27.729). This rate decreased significantly during the study period. The mean mortality rate was 1.418 deaths per 100,000 women (95% CI: 1.373-1.463) and the mean case-fatality rate was 5.150% (95% CI: 4.992-5.308). CONCLUSION Our study showed a substantial decrease in the hospitalization burden due to cervical disease. This decrease could be attributable to different causes including cervical cancer prevention measures, and changes in disease management. Further research is needed to confirm the cause. This information could contribute to further evaluations of the impact and cost effectiveness analysis of HPV vaccination in Spain.
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Affiliation(s)
- Noelia López
- PhD Candidate, Epidemiology and Public Health Program, University Rey Juan Carlos, Madrid, Spain
| | - Ángel Gil-de-Miguel
- Department of Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain
| | - Raquel Pascual-García
- Department of Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain
| | - Ruth Gil-Prieto
- Department of Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain
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López N, Gil-de-Miguel Á, Pascual-García R, Ramón Y Cajal JM, Gil-Prieto R. Hospitalization burden associated with malignant neoplasia and in situ carcinoma in vulva and vagina during a 5-year period (2009-2013) in Spain: An epidemiological study. PAPILLOMAVIRUS RESEARCH 2018; 5:80-86. [PMID: 29458181 PMCID: PMC5886908 DOI: 10.1016/j.pvr.2018.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/20/2018] [Accepted: 02/11/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Vulvar and vaginal cancers are considered rare cancers in women. Human Papillomavirus is responsible for 30-76% of them. The aim of this study was to describe the burden of hospital admissions by malignant neoplasia (MN) and in situ carcinoma (ISC) of vulva and vagina from 2009 to 2013, in Spain METHODS: This observational, descriptive study used discharge information obtained from the national surveillance system for hospital data, Conjunto Mínimo Básico de Datos, CMBD, provided by the Ministry of Health. RESULTS From 2009-2013, we found 9,896 hospitalizations coded as MN or ISC of vulva and vagina. Mean age of hospitalization was 69.94 ± 15.16 years; average length of hospital stay (ALOS) was 10.02 ± 12.40 days, and mean hospitalization costs were 5,140.31 ± 3,220.61 euros. Mean hospitalization rate was 9.874 per 100,000 women aged >14 years old (95% CI: 9.689-10.058); mean mortality rate was 0.932 per 100,000 women aged >14 years old (95% CI: 0.872-0.991) and mean case fatality rate was 9.438% (95% CI: 8.862-10.014). CONCLUSION MN and ISC of vulva and vagina are responsible for a considerable hospitalization burden. Information about these hospitalizations could be useful for cost effectiveness analysis and monitoring of HPV vaccination effectiveness.
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Affiliation(s)
- Noelia López
- PhD Candidate in Epidemiology and Public Health Program. University Rey Juan Carlos, Madrid, Spain.
| | - Ángel Gil-de-Miguel
- Area of Preventive Medicine and Public Health. University Rey Juan Carlos, Madrid, Spain
| | - Raquel Pascual-García
- Area of Preventive Medicine and Public Health. University Rey Juan Carlos, Madrid, Spain
| | | | - Ruth Gil-Prieto
- Area of Preventive Medicine and Public Health. University Rey Juan Carlos, Madrid, Spain
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23
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Present and future of cervical cancer prevention in Spain: a cost-effectiveness analysis. Eur J Cancer Prev 2018; 25:430-9. [PMID: 26375246 DOI: 10.1097/cej.0000000000000202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human papillomavirus (HPV) vaccination within a nonorganized setting creates a poor cost-effectiveness scenario. However, framed within an organized screening including primary HPV DNA testing with lengthening intervals may provide the best health value for invested money. To compare the effectiveness and cost-effectiveness of different cervical cancer (CC) prevention strategies, including current status and new proposed screening practices, to inform health decision-makers in Spain, a Markov model was developed to simulate the natural history of HPV and CC. Outcomes included cases averted, life expectancy, reduction in the lifetime risk of CC, life years saved, quality-adjusted life years (QALYs), net health benefits, lifetime costs, and incremental cost-effectiveness ratios. The willingness-to-pay threshold is defined at 20 000&OV0556;/QALY. Both costs and health outcomes were discounted at an annual rate of 3%. A strategy of 5-year organized HPV testing has similar effectiveness, but higher efficiency than 3-year cytology. Screening alone and vaccination combined with cytology are dominated by vaccination followed by 5-year HPV testing with cytology triage (12 214&OV0556;/QALY). The optimal age for both ending screening and switching age from cytology to HPV testing in older women is 5 years later for unvaccinated than for vaccinated women. Net health benefits decrease faster with diminishing vaccination coverage than screening coverage. Primary HPV DNA testing is more effective and cost-effective than current cytological screening. Vaccination uptake improvements and a gradual change toward an organized screening practice are critical components for achieving higher effectiveness and efficiency in the prevention of CC in Spain.
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Paz-Zulueta M, Álvarez-Paredes L, Rodríguez Díaz JC, Parás-Bravo P, Andrada Becerra ME, Rodríguez Ingelmo JM, Ruiz García MM, Portilla J, Santibañez M. Prevalence of high-risk HPV genotypes, categorised by their quadrivalent and nine-valent HPV vaccination coverage, and the genotype association with high-grade lesions. BMC Cancer 2018; 18:112. [PMID: 29382323 PMCID: PMC5791190 DOI: 10.1186/s12885-018-4033-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 01/23/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The new nine-valent vaccine against human papillomavirus (HPV) includes the four HPV genotypes (6, 11, 16, and 18) that are targeted by the older quadrivalent HPV vaccine, plus five additional oncogenic types (31, 33, 45, 52, and 58) remain significantly associated with high grade lesions. We aimed to determine the prevalence of high-risk HPV genotypes in unvaccinated subjects and the association of these genotypes with the incidence of high-grade lesions. We also assessed which, if either, of these two HPV vaccines could have prevented these cases. METHODS This cross-sectional study, conducted from 4 January 2010 to 30 December 2011, was composed of 595 women attending the Hospital General Universitario de Elche (Spain) gynaecology department who were positively screened for opportunistic cervical cancer by pap smears and HPV detection during a routine gynaecological health check. The pap smear results were classified using the Bethesda system. HPV genotyping was performed with the Linear Array HPV genotyping test, and viruses were classified by the International Agency for Research on Cancer assessment of HPV carcinogenicity. Odds ratios (ORs) with their 95% confidence intervals (95% CI) were estimated by logistic regression, adjusting for age and immigrant status. The prevented fraction among those exposed (PFe-adjusted) was determined as a measure of impact. RESULTS At least one of the additional five high-risk HPV genotypes present in the nine-valent HPV vaccine was detected in 20.5% of subjects. After excluding women with genotype 16 and/or 18 co-infection, high-risk genotypes (31, 33, 45, 52, and 58) were associated with a higher risk of intraepithelial lesion or malignancy: adjusted OR = 3.51 (95% CI, 1.29-9.56), PFe-adjusted = 0.72 (95% CI, 0.22-0.90). Genotypes that are still non-vaccine-targeted were detected in 17.98% of the women, but these were not significantly associated with high-grade lesions. CONCLUSION The greater protection of the nine-valent HPV vaccine is likely to have a positive impact because, in the absence of genotype 16 or 18 infection, these five genotypes on their own remained significantly associated with high-grade lesions.
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Affiliation(s)
- María Paz-Zulueta
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P.: 39008, Cantabria, Spain
| | - Ledicia Álvarez-Paredes
- Department of Microbiology and Parasitology, University Hospital of Burgos, C/ Islas Baleares, 3 - C.P.: 09006, Burgos, Spain
| | - Juan Carlos Rodríguez Díaz
- Department of Microbiology, University General Hospital of Alicante. Pintor Baeza, 11- C.P.: 03010, Alicante, Spain
| | - Paula Parás-Bravo
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P.: 39008, Cantabria, Spain
| | - Ma. Encarnación Andrada Becerra
- Department of Pathological Anatomy, University General Hospital of Elche. Camí de l’Almazara, 11 – C.P.: 03203, Alicante, Spain
| | - José María Rodríguez Ingelmo
- Department of Gynecology, University General Hospital of Elche. Camí de l’Almazara, 11 – C.P.: 03203, Alicante, Spain
| | - María Montserrat Ruiz García
- Department of Microbiology, University General Hospital of Elche. Camí de l’Almazara, 11 – C.P.: 03203, Alicante, Spain
| | - Joaquín Portilla
- Department of Infectious Diseases, University Hospital of Alicante. Pintor Baeza, 11- C.P.: 03010, Alicante, Spain
| | - Miguel Santibañez
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P.: 39008, Cantabria, Spain
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25
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Is incidence of multiple HPV genotypes rising in genital infections? J Infect Public Health 2017; 10:730-733. [DOI: 10.1016/j.jiph.2016.10.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/17/2016] [Accepted: 10/01/2016] [Indexed: 11/18/2022] Open
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26
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Díez-Domingo J, Sánchez-Alonso V, Villanueva RJ, Acedo L, Moraño JA, Villanueva-Oller J. Random Network Models to Predict the Long-Term Impact of HPV Vaccination on Genital Warts. Viruses 2017; 9:E300. [PMID: 29035332 PMCID: PMC5691651 DOI: 10.3390/v9100300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/11/2017] [Accepted: 10/13/2017] [Indexed: 12/27/2022] Open
Abstract
The Human papillomaviruses (HPV) vaccine induces a herd immunity effect in genital warts when a large number of the population is vaccinated. This aspect should be taken into account when devising new vaccine strategies, like vaccination at older ages or male vaccination. Therefore, it is important to develop mathematical models with good predictive capacities. We devised a sexual contact network that was calibrated to simulate the Spanish epidemiology of different HPV genotypes. Through this model, we simulated the scenario that occurred in Australia in 2007, where 12-13 year-old girls were vaccinated with a three-dose schedule of a vaccine containing genotypes 6 and 11, which protect against genital warts, and also a catch-up program in women up to 26 years of age. Vaccine coverage were 73 % in girls with three doses and with coverage rates decreasing with age until 52 % for 20-26 year-olds. A fast 59 % reduction in the genital warts diagnoses occurred in the model in the first years after the start of the program, similar to what was described in the literature.
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Affiliation(s)
| | - Víctor Sánchez-Alonso
- Instituto Universitario de Matemática Multidisciplinar, 8G building, 2nd Floor, Camino de Vera, Universitat Politècnica de Valéncia, 46022 Valencia, Spain.
| | - Rafael-J Villanueva
- Instituto Universitario de Matemática Multidisciplinar, 8G building, 2nd Floor, Camino de Vera, Universitat Politècnica de Valéncia, 46022 Valencia, Spain.
| | - Luis Acedo
- Instituto Universitario de Matemática Multidisciplinar, 8G building, 2nd Floor, Camino de Vera, Universitat Politècnica de Valéncia, 46022 Valencia, Spain.
| | - José-Antonio Moraño
- Instituto Universitario de Matemática Multidisciplinar, 8G building, 2nd Floor, Camino de Vera, Universitat Politècnica de Valéncia, 46022 Valencia, Spain.
| | - Javier Villanueva-Oller
- Departamento de Ciencias de la Computación, Arquitectura de Computadores, Lenguajes y Sistemas Informáticos, Estadística e Investigación Operativa, Universidad Rey Juan Carlos, Móstoles, 28933 Madrid, Spain.
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27
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Fernández-Feito A, Antón-Fernández R, Paz-Zulueta M. [Sexual risk behaviours and PAP testing in university women vaccinated against human papillomavirus]. Aten Primaria 2017; 50:291-298. [PMID: 28867156 PMCID: PMC6836978 DOI: 10.1016/j.aprim.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/05/2017] [Accepted: 05/14/2017] [Indexed: 11/24/2022] Open
Abstract
Objetivo Estimar la asociación entre la vacunación frente al virus papiloma humano (VPH) y las conductas sexuales de riesgo, así como la participación en el Programa de Detección Precoz de Cáncer de Cuello Uterino (PDPCCU). Diseño Estudio descriptivo transversal. Emplazamiento Facultad de Medicina y Ciencias de la Salud, Facultad de Derecho y Facultad de Economía y Empresa (Universidad de Oviedo). Participantes Estudiantes universitarias. Mediciones principales Se recogió información sobre métodos anticonceptivos, conducta sexual, conocimientos sobre VPH y participación en el PDPCCU. Se estimaron proporciones y odds ratio (OR) con sus correspondientes intervalos de confianza al 95% (IC 95%). Resultados El 67,7% de la muestra estaban vacunadas frente al VPH. Un total de 216 mujeres (65,3%) eran sexualmente activas. El 67,6% utilizaba un método de barrera en la relación actual, siendo menos frecuente entre las mujeres no vacunadas (54,9% frente al 75,4% en estudiantes vacunadas) (p = 0,002). El riesgo de mantener al menos una conducta sexual de riesgo era mayor entre las mujeres no vacunadas: OR 2,29 (IC 95%: 1,29-4,07). La probabilidad de realizar una citología dentro del PDPCCU fue mayor entre las mujeres no vacunadas: OR 2,18 (IC 95%: 1,07-4,47). Conclusiones La prevalencia de conductas sexuales de riesgo en mujeres no vacunadas es elevada y se relaciona con la no utilización de métodos de barrera. La vacunación frente al VPH puede influir en la conducta sexual y en la participación en PDPCCU. Se debería reforzar la información que reciben los jóvenes sobre anticoncepción, enfermedades de transmisión sexual y prevención del cáncer.
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Affiliation(s)
- Ana Fernández-Feito
- Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España.
| | | | - María Paz-Zulueta
- Departamento de Enfermería, Escuela Universitaria de Enfermería, Universidad de Cantabria, Santander, España
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28
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Vergara N, Espinoza G, Balanda M, Quiero A, Hidalgo W, San Martín H, Ramírez A, Ramírez E. Prevalence of Human Papillomavirus infection among Chilean women from 2012 to 2016. J Med Virol 2017; 89:1646-1653. [PMID: 28294358 DOI: 10.1002/jmv.24805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/24/2017] [Indexed: 02/02/2023]
Abstract
Here, we evaluated the prevalence of Human Papillomavirus (HPV) in two groups of Chilean women. The first group consisted of 3235 women aged 18-64 years attended in six primary care centers of Santiago. The second group consisted of 456 women 18-85 aged who consulted the Gynaecology Department of the Reference Hospital of Santiago. Samples were collected from October 2012 to February 2016. Cervical swabs were analyzed both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. Results showed a prevalence of 12.0% HPV positive, 10.3% high-risk (HR) HPV types positive, 3.9% low-risk (LR) HPV types positive, and 1.0% Pap positive in group 1. The most frequent types were 16, 66, and 59, with a prevalence of 3.0%, 1.6%, and 1.5%, respectively. The prevalence were 71.9% HPV positive, 67.3% HR-HPV types positive, 13.6% LR-HPV types positive, and 62.5% Pap positive in group 2. The most frequent types were 16, 31, and 58, with prevalence of 33.6%, 10.5%, and 7.0%, respectively. Among infected women with HPV: 7.6% were infected with HPV16 or HPV18, 3.0% with HPV31, HPV33 or HPV45, and 6.7% with any other HR-HPV. These findings show great difference in HPV prevalence and types between primary care and reference center, and provide useful epidemiological information to assess the impact of HPV vaccination in the future.
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Affiliation(s)
- Nicolás Vergara
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Gloria Espinoza
- Dirección de Atención Primaria, Servicio de Salud Metropolitano Central, Santiago, Chile
| | - Monserrat Balanda
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Andrea Quiero
- Dirección de Atención Primaria, Servicio de Salud Metropolitano Central, Santiago, Chile
| | - Wilma Hidalgo
- Dirección de Salud, Municipalidad de Huechuraba, Santiago, Chile
| | - Héctor San Martín
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | | | - Eugenio Ramírez
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile.,Programa de Virología, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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29
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Sabeena S, Bhat PV, Kamath V, Bhat SK, Nair S, n R, Chandrabharani K, Arunkumar G. Community-Based Prevalence of Genital Human Papilloma Virus (HPV) Infection: a Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2017; 18:145-154. [PMID: 28240509 PMCID: PMC5563091 DOI: 10.22034/apjcp.2017.18.1.145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction: Cervical cancer probably represents the best-studied human cancer caused by a viral infection and the causal association of this preventable cancer with human papilloma virus (HPV) is well established. Worldwide there is a scarcity of data regarding HPV prevalence with vast differences existing among populations. Objective: The aim of this meta-analysis was to determine the community-based HPV prevalence estimates among asymptomatic women from urban and rural set ups and in participants of cancer screening clinics. Study design: Systematic review and meta-analysis. Methods: PubMed-Medline, CINAHL, Scopus, and Google scholar were systematically searched for studies providing prevalence data for HPV infection among asymptomatic women between 1986 and 2016. Results: The final analysis included 32 studies comprising a population of 224,320 asymptomatic women. The overall pooled HPV prevalence was 11% (95% confidence interval (CI), 9%-12%). The pooled HPV prevalence of 11% (95% CI, 9%-11%) was observed among women attending cervical cancer screening clinics. The pooled HPV prevalences were 10% (95% CI 8%-12%) and 11% (95% CI 4%-18%) from urban and rural areas respectively, indicating higher infection rates among the rural women with the least access to cancer screening and cancer care. Conclusion: The prevalence rates in this systematic quantitative review provide a reliable estimate of the burden of HPV infection among asymptomatic women from developed as well as developing nations. Rural women and women attending cervical cancer screening programmes feature higher genital HPV prevalences compared to their urban counterparts.
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30
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Moreno-Pérez D, Álvarez García FJ, Arístegui Fernández J, Cilleruelo Ortega MJ, Corretger Rauet JM, García Sánchez N, Hernández Merino A, Hernández-Sampelayo Matos T, Merino Moína M, Ortigosa Del Castillo L, Ruiz-Contreras J. [Immunisation schedule of the Spanish Association of Paediatrics: 2015 recommendations]. An Pediatr (Barc) 2016; 82:44.e1-44.e12. [PMID: 25554656 DOI: 10.1016/j.anpedi.2014.10.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 10/23/2014] [Indexed: 11/28/2022] Open
Abstract
The Advisory Committee on Vaccines of the Spanish Association of Paediatrics updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on the safety, effectiveness and efficiency of current vaccines, including levels of recommendation. In our opinion, this is the optimal vaccination calendar for all children resident in Spain. Regarding the vaccines included in the official unified immunization schedule, the Committee emphasizes the administration of the first dose of hepatitis B either at birth or at 2 months of life; the recommendation of the first dose of MMR and varicella vaccine at the age of 12 months, with the second dose at the age of 2-3 years; DTaP or Tdap vaccine at the age of 6 years, followed by another Tdap booster dose at 11-12 years old; Tdap strategies for pregnant women and household contacts of the newborn, and immunization against human papillomavirus in girls aged 11-12 years old with a 2 dose scheme (0, 6 months). The Committee reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule, the same as it is being conducted in Western European countries. The recently authorised meningococcal B vaccine, currently blocked in Spain, exhibits the profile of a universal vaccine. The Committe insists on the need of having the vaccine available in communitary pharmacies. It has also proposed the free availability of varicella vaccines. Their efectiveness and safety have been confirmed when they are administred from the second year of life. Vaccination against rotavirus is recommended in all infants. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A.
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31
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Fontecha N, Basaras M, Hernáez S, Andía D, Cisterna R. Assessment of human papillomavirus E6/E7 oncogene expression as cervical disease biomarker. BMC Cancer 2016; 16:852. [PMID: 27816058 PMCID: PMC5097850 DOI: 10.1186/s12885-016-2885-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 10/25/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The aims of this study were to detect HPV E6/E7 mRNA expression in women with high-risk genotypes (HPV-16, -18, -31, -33 and -45) analysing its relationship with tissue pathology and 2) 2-year follow-up of E6/E7 mRNA tested group. METHODS Our samples were genotyped and classified by pathologists according to Bethesda system. After RNA extraction, E6/E7 oncogene mRNA detection was performed by NucliSens® EasyQ® HPV v1 Test (bioMérieux). RESULTS The results of the present study showed that E6/E7 mRNA positivity rate was 68.29 % in women tested once and 69.56 % in women tested twice. According to tissue pathology, all samples with high-grade lesions were positive for mRNA. Among women with low-grade lesions varied over the years from 89.28 to 84 % in women tested once and from 77.77 to 70 % in tested twice. Among women without lesion, positivity rate maintained in women tested once (from 50 to 41.38 %) and decreased in tested twice, from 63.63 to 44.44 %. Regarding lesion evolution, mRNA positivity was higher in women with lesion progression (53.13 %) and in women with positive results in two tested samples (83.33 %). CONCLUSION HPV E6/E7 mRNA detection may be an effective screening test and biomarker for cervical cancer in women infected with these five genotypes. Nonetheless, further studies are needed to standardize as routine triage test.
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Affiliation(s)
- Nerea Fontecha
- Department of Immunology, Microbiology and Parasitology, Medicine and Odontology Faculty, University of Basque Country (UPV/EHU), Sarriena auzoa, 48940, Leioa-Bizkaia, Spain
| | - Miren Basaras
- Department of Immunology, Microbiology and Parasitology, Medicine and Odontology Faculty, University of Basque Country (UPV/EHU), Sarriena auzoa, 48940, Leioa-Bizkaia, Spain.
| | - Silvia Hernáez
- Clinical Microbiology and Infection Control Department, Basurto University Hospital, Bilbao, 48013, Spain
| | - Daniel Andía
- Department of Obstetrics and Gynaecology, Basurto University Hospital, Bilbao, 48013, Spain
| | - Ramón Cisterna
- Department of Immunology, Microbiology and Parasitology, Medicine and Odontology Faculty, University of Basque Country (UPV/EHU), Sarriena auzoa, 48940, Leioa-Bizkaia, Spain.,Clinical Microbiology and Infection Control Department, Basurto University Hospital, Bilbao, 48013, Spain
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32
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Prevalence of human papillomavirus infection among women presenting for cervical cancer screening in Chile, 2014-2015. Med Microbiol Immunol 2016; 205:585-594. [PMID: 27539577 DOI: 10.1007/s00430-016-0473-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/18/2016] [Indexed: 12/18/2022]
Abstract
Cervical cancer is the fourth most common malignancy in women worldwide. In Chile, cervical cancer is the second leading cause of death among women of reproductive age, causing more than 600 deaths annually. This study was carried out to determine the burden and confirm the predominant human papillomavirus (HPV) genotypes among women presenting for cervical cancer screening in public health services in Chile. Women aged 18-64 years residing in the north and central areas covered by six primary care centers of Santiago, Chile, were invited to participate from March 2014 to August 2015. Cervical swabs were examined both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. A total of 1738 women were included in this study: 11.1 % were HPV positive, 9.7 % were high-risk types positive, 3.2 % were low-risk types positive, 1.4 % were Pap positive and 0.9 % were positive by both tests. The four most predominant genotypes were 16, 66, 51 and 59, with prevalence of 2.8, 1.4, 1.2 and 1.2 %, respectively. Multiple HPV infections were detected among 3.8 % participants. Age-specific prevalence of HPV showed a peak in HPV infection at younger ages (≤30 years), declining to a plateau in middle age. Among women with normal cytology, the 9.4 % were HPV positive, while 58.3 % of women with abnormal cytology were HPV positive. These findings show new epidemiological data confirming HPV 16 and 66 as the most predominant genotypes in Chile. These data are important for design successful strategies for prevention of cervical cancer in Chile.
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Ortiz AP, Romaguera J, Pérez CM, González D, Muñoz C, González L, Marrero E, Tortolero-Luna G, Suárez E, Palefsky J. Prevalence, genotyping, and correlates of anogenital HPV infection in a population-based sample of women in Puerto Rico. ACTA ACUST UNITED AC 2016; 2:89-96. [PMID: 29074191 PMCID: PMC5886867 DOI: 10.1016/j.pvr.2016.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/29/2016] [Accepted: 04/08/2016] [Indexed: 11/28/2022]
Abstract
Background Oncogenic HPV infection is associated to anogenital cancer. We estimate the prevalence and correlates of anogenital HPV infection among a population-based sample of women aged 16–64 years living in the metropolitan area of Puerto Rico. Methods 564 women completed face-to-face and computer assisted interviews and self-collected anal and cervical specimens. HPV DNA testing used MY09/MY11 consensus HPV L1 primers and beta-globin as an internal control for sample amplification. Positive specimens were typed by dot-blot hybridization. Results Weighted prevalence of cervical, anal, and cervical/anal co-infection was 29.4%, 38.6%, and 17.1%, respectively. The commonest oncogenic HPV types detected in the cervix and anus were: 68 (8% vs. 7%) and 16 (5.5% vs. 5.1%), correspondingly. Having ≥3 lifetime sexual partners (OR: 2.3; 95% CI: 1.5–3.5) and last year anal intercourse (OR: 1.6; 95% CI: 1.1–2.5) increased the odds of anogenital HPV infection. Cervical infection was independently associated to anal infection (OR: 3.0; 95% CI: 2.0–4.6). Conclusions Similar to others, our results confirm the burden of anogenital HPV infection in women and its relationship with sexual behavior. As vaccination increases, future studies should monitor changing trends in HPV infection in this population, and the relationship between anal and cervical HPV-related disease.
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Affiliation(s)
- A P Ortiz
- Cancer Control and Population Sciences Program, Comprehensive Cancer Center, University of Puerto Rico, United States; Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, United States.
| | - J Romaguera
- Department of OBGYN, School of Medicine, Medical Sciences Campus, University of Puerto Rico, United States
| | - C M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, United States
| | - D González
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, United States
| | - C Muñoz
- Cancer Control and Population Sciences Program, Comprehensive Cancer Center, University of Puerto Rico, United States
| | - L González
- Puerto Rico Clinical and Translational Research Consortium, Medical Sciences Campus, University of Puerto Rico, United States
| | - E Marrero
- Cancer Control and Population Sciences Program, Comprehensive Cancer Center, University of Puerto Rico, United States
| | - G Tortolero-Luna
- Cancer Control and Population Sciences Program, Comprehensive Cancer Center, University of Puerto Rico, United States; Department of OBGYN, School of Medicine, Medical Sciences Campus, University of Puerto Rico, United States
| | - E Suárez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, United States
| | - J Palefsky
- University of California, San Francisco (UCSF), United States
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Félix A, Alemany L, Tous S, de Sanjosé S, Bosch FX. HPV distribution in cervical cancer in Portugal. A retrospective study from 1928 to 2005. PAPILLOMAVIRUS RESEARCH 2016; 2:41-45. [PMID: 29074184 PMCID: PMC5886866 DOI: 10.1016/j.pvr.2016.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/11/2016] [Accepted: 02/22/2016] [Indexed: 12/05/2022]
Abstract
Objectives To determine human papillomavirus (HPV) types in invasive cervical cancer in Portugal. Methods Cases diagnosed at the Instituto Português de Oncologia de Lisboa de Francisco Gentil from the year 1928 to 2005 were selected for HPV DNA detection and genotyping using SPF10/DEIA/LiPA25 system. Results Of the 1214 samples that were considered appropriate for HPV detection, 714 (58.8%; 95% CI: 56.0–61.6%) were positive for HPV DNA. This detection rate varied being lower in the first 3 decades (31.3%; 50.1%; 46.5%) and higher in the last decades (77.4–95.1%). This difference was due probably to the fixative used in the first three decades. The five most common types identified among HPV positive cases were HPV16 (58.2%), HPV18 (9.2%), HPV33 (6.2%), HPV45 (4.7%) and HPV31 (4.4%). Multiple infections were detected in 2.8% of the cases. HPV16 and 18 accounted for 67.4% of infections. There were no statistically significant changes of these types over the studied period. An increase at patient׳s age at diagnosis was observed in the last decades (p<0.001). Conclusion HPV16 and 18 accounts for almost 70% of cervical cancers in all 9 decades studied and support data that effective vaccination against these 2 types will reduce the cervical burden in Portuguese women. Wide snapshot of HPV genotype profile of invasive carcinomas of the cervix in a European country. Characterization of HPV by LiPA25 assay of 882 cases of invasive carcinomas of the cervix diagnosed before 1949. Maintenance of HPV types associated with invasive carcinomas of the cervix along the XX century.
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Affiliation(s)
- Ana Félix
- Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa, Francisco Gentil, 1099-023 Lisboa, Portugal; Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Cedoc, Campo Mártires da Pátria 130; 1169-056 Lisboa, Portugal.
| | - Laia Alemany
- IDIBELL, Institut Català d'Oncologia-Catalan Institute of Oncology, Av. Granvia de l'Hospitalet 199-203 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública, Av. de la Granvia de l׳Hospitalet, 199-203, 08908 L׳Hospitalet de Llobregat, Barcelona, Spain.
| | - Sara Tous
- IDIBELL, Institut Català d'Oncologia-Catalan Institute of Oncology, Av. Granvia de l'Hospitalet 199-203 08908 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Silvia de Sanjosé
- IDIBELL, Institut Català d'Oncologia-Catalan Institute of Oncology, Av. Granvia de l'Hospitalet 199-203 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública, Av. de la Granvia de l׳Hospitalet, 199-203, 08908 L׳Hospitalet de Llobregat, Barcelona, Spain.
| | - F Xavier Bosch
- IDIBELL, Institut Català d'Oncologia-Catalan Institute of Oncology, Av. Granvia de l'Hospitalet 199-203 08908 L'Hospitalet de Llobregat, Barcelona, Spain.
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Carlos S, Osorio A, Calatrava M, Lopez-Del Burgo C, Ruiz-Canela M, de Irala J. Project YOURLIFE (What Young People Think and Feel about Relationships, Love, Sexuality, and Related Risk Behavior): Cross-sectional and Longitudinal Protocol. Front Public Health 2016; 4:28. [PMID: 26942175 PMCID: PMC4761899 DOI: 10.3389/fpubh.2016.00028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/08/2016] [Indexed: 01/01/2023] Open
Abstract
Introduction Sexually transmitted infections and unplanned pregnancies affect adolescent sexual health and are serious public health concerns. They result from sexual intercourse in adolescence, which is usually associated with multiple partners, unprotected sex, and condom misuse. This behavior is related to socio-ecological factors that influence lifestyles. The YOURLIFE project aims to find out what young people think and feel about relationships, love, and sexuality, and to assess the associations between these thoughts and attitudes, adolescents’ social factors, and sexual health. Materials and equipment An international school-based study with a cross-sectional and optional subsequent longitudinal design. Three online questionnaires designed for adolescents aged 13/14, 15/16, and 17/18, respectively, will be used. A matching coding system will allow longitudinal follow-up when adolescents reply to follow-up surveys. Questionnaires will include questions related to sociodemographic data; information/communication technologies; leisure time; parental supervision; influences of parents/friends; information sources; messages perceived; and sexuality-related knowledge, attitudes, and opinions. The second and third questionnaires for participants aged 15/16 and 17/18 will also contain variables concerning sexual behavior. Schools will be able to use their results to tailor educational approaches targeting the needs of their students. Multivariate analyses will be performed using the larger international dataset. Expected impact of the study on public health The YOURLIFE project will collect comprehensive information about the socio-ecological determinants of the sexual risk-taking of schooled adolescents worldwide. Effective preventive programs could be subsequently designed and tailored to the specific determinants of adolescents from different schools and settings, and also, when analyzed globally, to public health professionals.
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Affiliation(s)
- Silvia Carlos
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, Pamplona, Spain; Education of Affectivity and Human Sexuality, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Alfonso Osorio
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, Pamplona, Spain; Education of Affectivity and Human Sexuality, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain; School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - María Calatrava
- Education of Affectivity and Human Sexuality, Institute for Culture and Society (ICS), University of Navarra , Pamplona , Spain
| | - Cristina Lopez-Del Burgo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, Pamplona, Spain; Education of Affectivity and Human Sexuality, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, Pamplona, Spain
| | - Jokin de Irala
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, Pamplona, Spain; Education of Affectivity and Human Sexuality, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
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Pérez MRO, Violeta VB, Del Campo AV, Ruiz C, Castaño SY, Conde LPP, López JSJ. Cross-sectional study about primary health care professionals views on the inclusion of the vaccine against human papillomavirus in the vaccine schedules. Infect Agent Cancer 2015; 10:41. [PMID: 26576200 PMCID: PMC4645478 DOI: 10.1186/s13027-015-0034-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the inclusion of the HPV vaccine has been registered in Spain since 2007, vaccination rates are lower than expected. The patients wish to be vaccinated is heavily influenced by information they have received from many source. The Knowledge of primary health care professionals affects the information provided to patients and is fundamental in the decision making. The aim of this study is to assess the opinions of primary health care professionals on the vaccine against HPV and their knowledge about HPV infection and its links to with gynecological and oropharyngeal cancer. METHODS Cross-sectional study. A 19-item survey was drawn up. It included questions on basic aspects of HPV infection and marketed vaccines, personal opinion about the inclusion in the immunization schedules and their level of prescription and recommendation to patients in their clinical practice. From October 2013 to December 2013, 607 surveys were distributed among 20 primary health centers affiliated to the University Hospital 12 de Octubre. The results were analyzed using SPSS statistical package. RESULTS One hundred sixty four successfully completed surveys were obtained for analysis. 89 % of the professionals knew about the relationship between HPV infection and cervical cancer, 57.3 % did not know any of the serotypes against which vaccines are targeted; 40.4 % believed that there is insufficient data to support the commercialization of the vaccines. Of these, 65.7 % argue that there is no data of its long-term effectiveness, 13.4 % that there is no data as to its side effects, 13.4 % believed that the cost effectiveness is not worthwhile. CONCLUSIONS There is a strong controversy among health professionals regarding the marketing and inclusion of HPV vaccine in immunization schedules. However, the knowledge of the primary care health professionals on key aspects of infection and vaccine protection are insufficient. The training of professionals in vaccination, cervical pathology and HPV infection should be improved to provide objective information on the use as this vaccine for patients.
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Affiliation(s)
- M Reyes Oliver Pérez
- Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain
| | - Victoria Bravo Violeta
- Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain
| | - Ana Vazquez Del Campo
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Cristina Ruiz
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Sonia Yáñez Castaño
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Laura P Pérez Conde
- Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain
| | - Jesús S Jiménez López
- Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain
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Micalessi MI, Boulet GA, Bogers J. A real-time PCR approach based on SPF10 primers and the INNO-LiPA HPV genotyping extra assay for the detection and typing of human papillomavirus. Methods Mol Biol 2015; 1249:27-35. [PMID: 25348295 DOI: 10.1007/978-1-4939-2013-6_2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A highly sensitive SPF10 real-time PCR was developed to achieve simultaneous amplification and detection of the human papillomavirus (HPV) target. That way, LiPA analysis of the HPV-negative samples can be avoided, reducing workload and cost. Here, we describe in detail a SYBR Green I-based real-time PCR assay based on SPF10 primers using the LightCycler(®) 480 system to generate and detect HPV amplicons, which are compatible with the LiPA assay.
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Affiliation(s)
- M Isabel Micalessi
- Applied Molecular Biology Research (AMBIOR) group, Laboratory of Cell Biology and Histology, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp (Campus Groenenborger), Groenenborgerlaan 171, B-2020, Antwerp, Belgium,
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Fontecha N, Basaras M, Arrese E, Hernáez S, Andía D, Cisterna R. Human Papillomavirus 16 Variants May Be Identified by E6 Gene Analysis. Intervirology 2015; 58:143-8. [DOI: 10.1159/000381745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 03/18/2015] [Indexed: 11/19/2022] Open
Abstract
Aims: The aims of the study were (1) to characterize the genetic variability of human papillomavirus (HPV) genotype 16 in the E6 region when this genotype is present in multiple infection samples, (2) to assess the prevalence of variants in our region and (3) to analyze the relationship between variants, patients' ages and pathology. Methods: The Clinical Microbiology and Infection Control Department analyzed samples which were positive for genotype 16 and other genotypes from 2007 to 2013. Variants were assigned to European, Euro-German, Asian, Asian-American or African lineage by sequence analysis. The relationship among variants, age and different types of lesion was studied. Results: In HPV-16 sequence analysis, the European variant was detected in 85.10% of samples, the Asian-American in 7.80%, the African in 4.25% and the Euro-German in 2.83% of specimens. Sequence genetic variability showed 16 nucleotide substitutions. Moreover, non-European variants were mainly found in old women and in isolates from high-grade squamous intraepithelial lesions since European variants were mainly detected in negative cytologies. Conclusion: Multiple infections may take effect on nucleotide substitution and the appearance of recombinant samples. Single gene analysis makes it impossible to detect recombination which has a great influence on drug response and vaccine strategies. Thus, E6 gene analysis would be enough to identify HPV-16 intratypic variants but not to confirm the results.
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Morales Martínez Á, Blanco Rodríguez L, Morales Martínez C, Tejuca Somoano S. [Cervical cancer screening: Is active recruitment worth the effort?]. Aten Primaria 2015; 47:653-8. [PMID: 25824868 PMCID: PMC6983784 DOI: 10.1016/j.aprim.2014.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 11/16/2014] [Accepted: 12/04/2014] [Indexed: 12/01/2022] Open
Abstract
Objetivos Conocer el porcentaje de mujeres que han realizado una citología en los últimos 5 años y el ámbito de realización. Detectar alteraciones citológicas precursoras de cáncer de cérvix en mujeres sin cribado o con cribados inadecuados y conocer la prevalencia de determinaciones de VPH positivas. Diseño Estudio descriptivo transversal. Emplazamiento Centro de Salud de Natahoyo, Gijón. Participantes Mujeres de 40 a 50 años residentes en la zona básica y adscritas al centro de salud. Métodos Recogida de información en bases de datos, telefónicamente y por encuestas en domicilios. Captación activa, en atención primaria, de mujeres sin cribado o con cribado inadecuado para realizar citología y determinación de VPH. Resultados De las 1.420 mujeres de 40 a 50 años 1.236 (87%) habían realizado una citología en los últimos 5 años y 184 (13%) nunca habían hecho una citología o llevaban más de 5 años sin hacerla. De las 184 mujeres sin cribado o con cribados inadecuados 108 (el 58,7%) accedieron a realizar citología y determinación de VPH. En las citologías realizadas no se diagnosticó ninguna displasia de alto grado. El 8,3% de las determinaciones de VPH fueron positivas. Conclusiones En nuestra población existe una alta cobertura del cribado oportunista de cáncer de cérvix. La captación activa de mujeres que se encontraban fuera del programa de cribado no resultó rentable.
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Affiliation(s)
| | | | | | - Sonia Tejuca Somoano
- Servicio de Ginecología y Obstetricia, Hospital Fundación de Jove, Gijón, España
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Moreno-Pérez D, Álvarez García F, Arístegui Fernández J, Cilleruelo Ortega M, Corretger Rauet J, García Sánchez N, Hernández Merino A, Hernández-Sampelayo Matos T, Merino Moína M, Ortigosa del Castillo L, Ruiz-Contreras J. Immunisation schedule of the Spanish Association of Paediatrics: 2015 Recommendations. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.anpede.2014.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Freire MP, Pires D, Forjaz R, Sato S, Cotrim I, Stiepcich M, Scarpellini B, Truzzi JC. Genital prevalence of HPV types and co-infection in men. Int Braz J Urol 2014; 40:67-71. [PMID: 24642151 DOI: 10.1590/s1677-5538.ibju.2014.01.10] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 09/17/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION HPV infection is a highly prevalent sexually transmitted disease and there is evidence of the relationship of HPV infection and the development of genital warts, penile intraepitelial neoplasia, invasive penile carcinoma and cervical cancer. However, there is sparse data regarding the prevalence of HPV types and co-infection of different HPV types among men. OBJECTIVES To assess the prevalence of HPV subtypes infections and rates of co-infection among men. MATERIALS AND METHODS 366 men were evaluated from March to October 2010. Men were referred to our institution for HPV diagnostic evaluation based on the following criteria: 1. presence of a genital wart; 2. presence of an atypical genital lesion; 3. absence of symptoms and a partner with a HPV diagnosis; 4. absence of symptoms and a desire to undergo a full STD diagnostic evaluation. Genital samples were collected from the urethra, penile shaft, scrotum and anus with Digene® collection and preservation kit and submitted to HPV genotype microarray detection (Papillocheck®). All men were tested for the low-risk HPV types 6-11-40-42-43-44 and for the high-risk HPV types 16-18-31-33-35-39-45-51-52-53-56-58-59-66-68-70-73-82. RESULTS Of the 366 men, 11 were tested inconclusive and were excluded from the analysis. 256 men (72.1% of the men from the cohort referred to our institution) tested positive with genotype micro-array detection and 99 tested negative. The most preva¬lent HPV-subtypes in the studied population were 6, 42, 51 and 16. Co-infection was found in 153 men. Of those, 70 (19.7%) had a co-infection by 2 types, 37 (10.4%) by 3 types; 33 men (9.2%) by 4 types; 8 men (2.2%) by 5 types; 1 man (0.3%) by 6 types; 1 man (0.3%) by 7 types; 2 men (0.6%) by 8 types and 1 man (0.3%) by 9 types. CONCLUSION The most frequent HPV types were 6, 16, 42 and 51. Co-infection was found in 59% of our patients. This information is vital to drive future public health policies including massive public vaccination campaign.
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Affiliation(s)
- Marcos P Freire
- Division of Urology, Fleury Group; Anhembi Morumbi Medical School and Federal University of Sao Paulo, SP, Brazil
| | - Daniel Pires
- Anhembi Morumbi Medical School, Sao Paulo, SP, Brazil
| | | | - Sérgio Sato
- Anhembi Morumbi Medical School, Sao Paulo, SP, Brazil
| | - Ismael Cotrim
- Division of Urology, Fleury Group and Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - José C Truzzi
- Division of Urology, Fleury Group, Sao Paulo and Federal University of Sao Paulo, Sao Paulo, SP, Brazil
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Paesi S, Correa L, Tregnago MC, Mandelli J, Roesch-Ely M. Human papillomavirus among women with atypical squamous cells of undetermined significance in southern Brazil. Int J Gynaecol Obstet 2014; 128:23-6. [PMID: 25257569 DOI: 10.1016/j.ijgo.2014.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 06/30/2014] [Accepted: 08/29/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the prevalence of atypical squamous cells of undetermined significance (ASCUS) and human papillomavirus (HPV) genotypes in a population in southern Brazil. METHODS In a retrospective cross-sectional study, the prevalence of ASCUS was determined among women aged 20-60 years who were referred to a private medical center in Caxias do Sul by a gynecologist for assessment of a cervical condition between January 1, 2010, and September 30, 2011. Histologic and cytologic samples were tested for HPV, and polymerase chain reaction (PCR) was used to genotype any HPV DNA identified. RESULTS Among the 250 included women, 25 (10.0%) had ASCUS. HPV DNA was found in 15 (60.0%) women with ASCUS and 115 (51.1%) of the 225 without ASCUS. Viral typing showed that 7 (46.7%) HPV-positive women with ASCUS had multiple infections with up to five different genotypes. Both low- and high-risk HPV genotypes were found in ASCUS samples; the most prevalent genotypes were HPV6/HPV11 (affecting 10 [66.7%] women), HPV51 (6 [40.0%]), and HPV16 (6 [40.0%]). CONCLUSION ASCUS is not an indication of HPV infection. HPV screening and genotyping would benefit women with ASCUS, because treatment can be planned according to risk of carcinogenesis.
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Affiliation(s)
- Suelen Paesi
- Molecular Diagnostics Laboratory, Biotechnology Institute, Universidade de Caxias do Sul, Caxias do Sul, Brazil.
| | - Leonardo Correa
- Molecular Diagnostics Laboratory, Biotechnology Institute, Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | | | - Jovana Mandelli
- Molecular Diagnostics Laboratory, Biotechnology Institute, Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | - Mariana Roesch-Ely
- Laboratory of Genomics, Proteomics and DNA Repair, Biotechnology Institute, Universidade de Caxias do Sul, Caxias do Sul, Brazil
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Trigo-Daporta M, García-Campello M, Pérez-Ríos M, Santiago-Pérez MI, Fernandez-Rodriguez E, Guinarte G, Troncoso A, Pardavila R, Malvar A. High-risk human papillomavirus in Galicia, Spain: prevalence and evaluation of the sample representativeness. ACTA ACUST UNITED AC 2014; 46:737-44. [PMID: 25189272 DOI: 10.3109/00365548.2014.930966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The prevalence of high-risk genotypes of the human papillomavirus (HR-HPV) in Galicia remained unknown before the introduction of the HPV vaccine. The objective of this study was to estimate this prevalence in non-vaccinated women when vaccination against HR-HPV started. Sample representativeness was also evaluated. METHODS Female volunteers aged 16-64 years, residents in Galicia, Spain, completed a questionnaire and provided biological samples for a virological study and for cytology. The sample was weighted; prevalence rates were estimated and are shown with 95% confidence intervals. RESULTS Virological results were available for 1703 women. HR-HPV prevalence was 10.1%, decreasing notably at ages above 30 years. HPV-16 was the most frequent genotype and 3.6% of women were infected by more than one genotype. No adjustment was necessary to generalize the results of the study. CONCLUSIONS In Galicia in 2009 there would be 96 400 women aged 16-64 years infected with HR-HPV. It is possible to estimate HR-HPV prevalence in a population starting from a volunteer sample.
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Navarro-Illana P, Aznar J, Díez-Domingo J. Ethical considerations of universal vaccination against human papilloma virus. BMC Med Ethics 2014; 15:29. [PMID: 24708813 PMCID: PMC3996512 DOI: 10.1186/1472-6939-15-29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 03/05/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND From an epidemiological perspective, the practice of universal vaccination of girls and young women in order to prevent human papilloma virus (HPV) infection and potential development of cervical cancer is widely accepted even though it may lead to the neglect of other preventive strategies against cervical cancer. DISCUSSION It is argued that removing the deterrent effect--the fear of developing cancer--could encourage teenage sex. This paper reflects on the ethical legitimacy of the universal vaccination of girls and young women against HPV infection, especially regarding safety issues, the need to vaccinate people who have opted to abstain from sex, the presumption of early onset of sexual relations, the commercial interests of the companies that manufacture the vaccine, and the recommendation of universal vaccination in males. SUMMARY Based on the aforementioned information, we believe that the universal vaccination against HPV in young women is acceptable from an ethical point of view, given the medical advantages it presents.
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Affiliation(s)
- Pedro Navarro-Illana
- Facultad de Enfermería, Universidad Católica de Valencia “San Vicente Mártir”, Valencia, Spain
| | - Justo Aznar
- Instituto de Ciencias de la Vida, Universidad Católica de Valencia “San Vicente Martir”, Valencia, Spain
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Alsbeih G. HPV Infection in Cervical and Other Cancers in Saudi Arabia: Implication for Prevention and Vaccination. Front Oncol 2014; 4:65. [PMID: 24744990 PMCID: PMC3978341 DOI: 10.3389/fonc.2014.00065] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/17/2014] [Indexed: 01/13/2023] Open
Abstract
Human papillomavirus (HPV) is closely associated with cervical cancer that the incidence of this tumor is regarded as a surrogate marker for HPV infection in countries lacking epidemiological studies. HPV is also implicated in subsets of anogenital and oropharyngeal cancers. Although cervical cancer is the third most common cancer in women worldwide, its reported incidence is low in Saudi Arabia, ranking number 12 between all cancers in females and accounts only for 2.4% of all new cases, despite the lack of national screening programs. However, the limited available studies from Saudi Arabia indicate that HPV prevalence and genotypes' distribution in invasive cervical cancer show similar pattern as in the world. Cytology screening (Pap smear) and HPV vaccinations are the two preventive measures against cervical cancer. The two available vaccines are effective against the two most common HPV genotypes (HPV-16 and -18). Since 92% of cervical tumors in the Kingdom are infected with HPV of which 78% are HPV-16 and -18 genotypes, vaccination is expected to protect against more than two-third of cervical cancers in Saudi Arabia. Nevertheless, due to its low incidence (2.1/100,000 women), a proper cost-effectiveness analysis is required to justify the implementation of a costly vaccine bearing in mind that HPV could potentially be associated with about 3% of all cancers. However, further studies are needed to ascertain the real prevalence of HPV at the population level at large, its association with various types of cancers, and also the impact of local tradition and emerging behavioral trends that could affect HPV transmission and consequently the effectiveness of applying national vaccination program.
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Affiliation(s)
- Ghazi Alsbeih
- Research Centre, King Faisal Specialist Hospital and Research Centre , Riyadh , Saudi Arabia
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Beca F, Pinheiro J, Rios E, Pontes P, Amendoeira I. Genotypes and prevalence of HPV single and multiple concurrent infections in women with HSIL. Diagn Cytopathol 2014; 42:919-23. [PMID: 24623593 DOI: 10.1002/dc.23143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/21/2014] [Accepted: 02/24/2014] [Indexed: 11/07/2022]
Abstract
The contribution of human papillomavirus (HPV) types to the carcinogenesis of cervical cancer has been established for a long time. However, the role of phylogenetically related and rare variants remains uncertain, as well as the influence of concurrent multiple HPV genotypes infection. We aimed at studying the prevalence of several HPV genotypes infecting women with single versus concurrent multiple HPV genotypes infection with a HSIL diagnosis in a cervical cytology. We conducted a cross-sectional study using Thin-Prep(®) liquid-based cervical cytology specimens with the diagnosis of high-grade squamous intraepithelial lesion (HSIL), in which HPV genotype was sequentially tested. Genotypes were determined with a PapilloCheck(®) system, a DNA-Chip for the type-specific identification of 18 high-risk and six low-risk types of HPV. Of the total study population, 176 cases had a diagnosis of HSIL and positive HPV genotyping result, being HPV16 the most prevalent genotype (48.86%; 95%CI: 41.58-56.19) followed by HPV31 (14.20%; 95%CI: 9.75-20.18). Concurrent multiple HPV genotypes were detected in 36.93% (95%CI: 30.15-44.27) of the patients. The prevalence of the 10 most common HPV genotypes detected varied significantly according to the presence of single vs. concurrent multiple HPV genotypes (P = 0.022). Moreover, women with concurrent multiple HPV genotypes were on average 3.53 (95%CI: 0.43-6.64) years younger than women with single genotype infection. Our results suggest that women with multiple genotype HPV infection differ in terms of age and distribution of the most prevalent HPV genotypes. Additionally, we provide further evidence of the predominance of HPV16 in HSIL lesions of the uterine cervix.
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Affiliation(s)
- Francisco Beca
- IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal; Department of Pathology and Oncology, Faculty of Medicine, University of Porto, Portugal; Department of Pathology, Centro Hospitalar de São João, Porto, Portugal
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Moreno-Pérez D, Álvarez García F, Arístegui Fernández J, Cilleruelo Ortega M, Corretger Rauet J, García Sánchez N, Hernández Merino A, Hernández-Sampelayo Matos T, Merino Moína M, Ortigosa del Castillo L, Ruiz-Contreras J. Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2014. An Pediatr (Barc) 2014; 80:55.e1-55.e37. [DOI: 10.1016/j.anpedi.2013.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 10/01/2013] [Indexed: 01/29/2023] Open
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Pérez-Castro S, Lorenzo-Mahía Y, Iñarrea Fernández A, Lamas-González MJ, Sarán-Díez MT, Rubio-Alarcón J, Reboredo-Reboredo MC, Mosteiro-Lobato S, López-Miragaya I, Torres-Piñón J, Melón-García S. Cervical intraepithelial neoplasia grade 2 or worse in Galicia, Spain: HPV 16 prevalence and vaccination impact. Enferm Infecc Microbiol Clin 2013; 32:479-85. [PMID: 24274937 DOI: 10.1016/j.eimc.2013.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 08/28/2013] [Accepted: 09/18/2013] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The etiology of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) can influence the efficacy of Public Health preventive strategies. This study aimed to determine the high-risk papillomavirus (HR-HPV) prevalence in CIN2+ cases in unvaccinated women in Galicia (Spain), the expected impact of bivalent vaccination, and the distribution of HPV 16 in squamous lesions. MATERIAL AND METHODS Ninety-four histologically confirmed cases of CIN2+ (2009-2010) were retrospectively studied: 23 CIN2, 58 CIN3- squamous carcinoma in situ (CIN3-CIS), 5 adenocarcinoma in situ (AIS), and 8 invasive squamous cervical cancer (SCC). Linear Array HPV Genotyping Test (Roche Diagnostics, Mannheim, Germany) was performed on the cervical specimens. Bivalent vaccination impact was calculated, based on regional vaccination coverage data, local HR-HPV prevalence, and reported efficacy (direct and cross-protection) of the vaccine. RESULTS HR-HPV prevalence was 96.8%. The most frequent genotypes were HPV 16 (48.8-58.2%) and HPV 31 (9.3%-12.1%), considering single infections or single-multiple infections, respectively (hierarchical attribution). In squamous lesions, HPV 16 prevalence in women younger than 45 years of age increased in severe lesions (CIN3-CIS/SCC, OR 4.2), and was higher than in older women (OR 5.5). The vaccine could reduce the cumulative incidence of CIN2+ by 50.6% (direct protection), or by 62.7% (direct and cross-protection). CONCLUSION HPV vaccination could have a great impact in women younger than 45 years of age due to the high prevalence of HPV 16 in their lesions.
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Affiliation(s)
- Sonia Pérez-Castro
- Department of Microbiology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
| | | | | | | | | | | | | | | | | | - Julio Torres-Piñón
- Department of Microbiology, University Hospital of Vigo, Vigo, Pontevedra, Spain
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Herraez-Hernandez E, Alvarez-Perez M, Navarro-Bustos G, Esquivias J, Alonso S, Aneiros-Fernandez J, Lacruz-Pelea C, Sanchez-Aguera M, Santamaria JS, de Antonio JC, Rodriguez-Peralto JL. HPV Direct Flow CHIP: A new human papillomavirus genotyping method based on direct PCR from crude-cell extracts. J Virol Methods 2013; 193:9-17. [DOI: 10.1016/j.jviromet.2013.04.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 03/26/2013] [Accepted: 04/29/2013] [Indexed: 11/28/2022]
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Micalessi MI, Boulet GA, Pillet S, Jacquet J, Pozzetto B, Bogers JJ, Bourlet T. Comparison of SPF10 real-time PCR and conventional PCR in combination with the INNO-LiPA HPV Genotyping Extra assay for the detection and typing of human papillomavirus in cervical samples. J Virol Methods 2013; 194:113-7. [PMID: 23978605 DOI: 10.1016/j.jviromet.2013.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 08/12/2013] [Accepted: 08/15/2013] [Indexed: 11/18/2022]
Abstract
The novel SPF10 real-time PCR assay allows the simultaneous amplification and detection of the HPV target. That way, LiPA analysis of the HPV-negative samples can be avoided, reducing workload and cost. This study aims to evaluate the performance of the SPF10 real-time PCR in combination with the LiPA assay for HPV detection and typing in cervical samples. Thirty-nine cervical samples were subjected to the SPF10 conventional PCR in combination with the LiPA assay. Subsequently, the SPF10 real-time PCR was performed to enable the comparison between the SPF10 conventional and the real-time PCR results. In case of discrepancy, the samples were subjected to the CLART HPV2 assay. As a result, 27 out of 39 samples were identified as HPV-positive by the SPF10 real-time PCR and were genotyped further by the LiPA assay. Twenty samples (74.1%) showed an absolute agreement between the conventional and real-time SPF10 PCR (concordant), three (11.1%) displayed additional or fewer types (compatible), two (7.4%) did not show any similarity between both assays (discordant) and the remaining two (7.4%) were LiPA-negative. The two assays showed an excellent strength of agreement for individual (κ=0.932) and multiple genotype detection (κ=0.834). In conclusion, the two SPF10 PCR methods are comparable. Therefore, the SPF10 real-time PCR with subsequent LiPA could be used for the detection and genotyping of HPV in cervical samples.
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Affiliation(s)
- M I Micalessi
- Applied Molecular Biology Research (AMBIOR) Group, Laboratory of Cell Biology and Histology, University of Antwerp, Groenenborgerlaan 171, B2020 Antwerp, Belgium; Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium.
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