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Zhao M, Zhou D, Zhang M, Kang P, Cui M, Zhu L, Luo L. Characteristic of persistent human papillomavirus infection in women worldwide: a meta-analysis. PeerJ 2023; 11:e16247. [PMID: 38025679 PMCID: PMC10655709 DOI: 10.7717/peerj.16247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives We aimed to estimate the genotype distribution of persistent human papillomavirus (HPV) infection in females worldwide, and provided a scientific basis for the prevention strategies of cervical cancer (CC) and the development of HPV vaccines. Methods Both English and Chinese databases were researched from the inception to July 2023. The pooled persistent HPV infection prevalence was calculated using a random effects model. The subgroup analysis was performed to explore the heterogeneity. Publication bias was evaluated using funnel plot, Egger's and Begg's test. Results Twenty-eight studies with 27,335 participants were included. The pooled prevalence of persistent HPV infection was 29.37% (95% CI [24.05%∼35.31%]), and the genotypes with the persistent infection prevalence were HPV16 (35.01%), HPV52 (28.19%), HPV58 (27.06%), HPV18 (25.99%), HPV33 (24.37%), HPV31 (23.35%), HPV59 (21.87%), HPV39 (19.54%), HPV68 (16.61%) and HPV45 (15.05%). The prevalence of multiple and single HPV persistent infection were 48.66% and 36.71%, respectively; the prevalence of persistent HPV infection in different age groups (<30, 30∼39, 40∼49, >50) were 29.83%, 28.39%, 22.24% and 30.22%, respectively. The follow-up time was significantly associated with heterogeneity by subgroup analysis (P < 0.05), and the prevalence of persistent infection decreased with longer follow-up time. Conclusions Multiple infections were more likely to occur persistent HPV infection than single infection. In addition to HPV vaccination, we should emphasize the follow-up management for women under 30 and over 50 years old, those with high-risk HPV infection (HPV59, 39, 68) and multiple infections.
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Affiliation(s)
- Ming Zhao
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Dan Zhou
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Min Zhang
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Peipei Kang
- Shandong Mental Health Center, Shandong University, Jinan, Shandong, China
| | - Meimei Cui
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
- School of Basic Medical, Weifang Medical College, Weifang, Shandong, China
| | - Liling Zhu
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Limei Luo
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
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2
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Roman C, Andrade D, Hernández Y, Salazar ZK, Espinosa L, Campoverde E, Guallaizaca L, Merchán M, Sarmiento M, Brenner J. Biological, demographic, and health factors associated with HPV infection in Ecuadorian women. Front Public Health 2023; 11:1158270. [PMID: 37397749 PMCID: PMC10311495 DOI: 10.3389/fpubh.2023.1158270] [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: 02/06/2023] [Accepted: 05/11/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives The study aims to identify the correlation between human papillomavirus (HPV) infection and sociodemographic and sexual reproductive health factors in Ecuadorian women from March to August 2019. Methods 120 women were randomly selected from two gynecological clinics to complete a questionnaire and provide a biospecimen. PCR-Hybridization was used to genotype 37 HPV serotypes in samples obtained by endo-cervical brushing for liquid-based cytology. Sociodemographic and sexual health data were collected through a validated questionnaire during a medical consultation. Mathematical modeling of HPV infection was done using bivariate logistic regression. Results 65.0% of the women sampled had an HPV infection; 74.3% of these women had co-infections with other HPV genotypes. Out of the women who were HPV positive, 75.6% were diagnosed with high-risk genotypes from HPV strains 18, 35, 52, and 66. Parity, immunosuppression, and use of oral contraception/intrauterine devices (IUDs) were identified as associated variables. The explanatory model had a sensitivity of 89.5% and a specificity of 73.8%. Conclusion The predominant strains of HPV among Ecuadorian women are diverse. The risk of HPV infection is a complex phenomenon where biological and psychosocial variables are integrated into a model. In populations with limited access to health services, low socioeconomic status, and negative sociocultural beliefs about sexually transmitted infections (STIs), surveys can be used as a pre-screening step for HPV infections. The diagnostic value of the model should be tested in multicenter studies that include women from all over the country.
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Affiliation(s)
- Carlos Roman
- Diagnostic Department, MEDsan, Inc., Saint Petersburg, FL, United States
| | - Diego Andrade
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Yenima Hernández
- Department of Mental Health, The Angels Mental Health Community, Tampa, FL, United States
| | - Zoila K. Salazar
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
- Medical Center Association for the Well-being of the Ecuadorian Family (APROFE), Cuenca, Ecuador
| | - Lizette Espinosa
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Erika Campoverde
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Lourdes Guallaizaca
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - María Merchán
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Miriam Sarmiento
- Obstetrics Department, San Juan de Dios Hospital, Cuenca, Ecuador
| | - Jonathan Brenner
- Diagnostic Department, MEDsan, Inc., Saint Petersburg, FL, United States
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Immunoinformatics-based characterization of immunogenic CD8 T-cell epitopes for a broad-spectrum cell-mediated immunity against high-risk human papillomavirus infection. Microb Pathog 2022; 165:105462. [DOI: 10.1016/j.micpath.2022.105462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
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Liu J, Shi Y, Wang L, Wang J, Fan D, Han S, Wei L. Epidemiology and persistence of cervical human papillomavirus infection among outpatient women in Heilongjiang province: A retrospective cohort study. J Med Virol 2020; 92:3784-3792. [PMID: 32297986 DOI: 10.1002/jmv.25899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/29/2020] [Accepted: 04/14/2020] [Indexed: 11/09/2022]
Abstract
As persistent carcinogenic human papillomavirus (HPV) infection is a prominent driver of cervical cancer, it is essential to explore HPV persistence and its associated factors for cancer screening and prevention. A retrospective cohort study was performed in outpatient women between March 2010 and 2019 in Heilongjiang, northeast China. HPV genotyping was performed by polymerase chain reaction-membrane hybridization. An unconditional logistic regression model was used to analyze the association of factors with persistence. The overall prevalence of HPV at baseline was 27.1%, with a downward trend from 2010 to 2019 (P < .0001). The most commonly observed high- and low-risk HPVs were HPV16 (N = 1094, 5.9%) and HPV11 (N = 596, 3.2%), respectively. The probabilities of 6-month persistence were high for women infected with HPV16 (P = .0001), HPV58 (P = .018), and HPV53 (P = .014), as well as for women with multiple infections (P = .009), and those who were 51 to 60 years old (P = .004) or more than 60 years old (P = .007). The probabilities of 12-month persistence were high for women infected with HPV53 (P = .017) and 51- to 60-year-old women (P = .044). HPV16 is the dominant HPV type in Heilongjiang. An age in the range of 51 to 60 years and infection with HPV53 is associated with HPV infection persistence in the Heilongjiang population.
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Affiliation(s)
- Jiaxin Liu
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Yafeng Shi
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lishuang Wang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiao Wang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Dongxue Fan
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Shiyu Han
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lanlan Wei
- Department of Microbiology, Harbin Medical University, Harbin, China
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Hsu LC, Tsui KH, Wei JCC, Yip HT, Hung YM, Chang R. Female Human Papillomavirus Infection Associated with Increased Risk of Infertility: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186505. [PMID: 32906724 PMCID: PMC7558487 DOI: 10.3390/ijerph17186505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 01/23/2023]
Abstract
Objective. This study investigated whether women with a history of human papillomavirus (HPV) infection have an increased risk of infertility. Material and Methods. All patients with an HPV infection (n = 11,198) in Taiwan’s National Health Insurance Research Database (2000–2012) were propensity score matched with control subjects (n = 11,198) without an HPV infection by age, sex, index year, and relevant co-morbidities. Both groups were tracked until a diagnosis of infertility was recorded. The Chi-square test was used to analyze the distribution of demographic characteristics in the HPV group and non-HPV group. A Cox proportional hazards regression was used to estimate the hazard ratios (HRs) for the development of infertility, adjusting for age, sex, and co-morbidities. The Kaplan–Meier method was used to plot the cumulative incidence curves. We also performed negative controls to test for possible unmeasured confounding. Results. The HPV cohort had a higher risk of infertility. The adjusted HR (aHR) was found to be 1.39 (95% CI = 1.19–1.63) after adjusting for demographic characteristics and relevant co-morbidities. In the age subgroup analysis, patients with an HPV infection had an increased risk of infertility compared to the non-HPV cohort in the group aged 26 to 35 years (aHR, 1.53; 95% CI = 1.24–1.88). As we used propensity score matching to treat measurable confounders and negative controls to access unmeasured confounders, the findings of the study are robust. Conclusions. Among females of reproductive age, HPV infection is a potential risk factor that predisposes individuals to subsequent infertility.
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Affiliation(s)
- Li-Chuan Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital Pingtung Branch, Pingtung 91245, Taiwan;
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan;
| | - Kuan-Hao Tsui
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan;
- Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung 90741, Taiwan
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 40402, Taiwan
| | - Hei-Tung Yip
- Management Office for Health Data, China Medical University Hospital, Taichung 404332, Taiwan;
| | - Yao-Min Hung
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- Department of Senior Citizen Service Management, Yuh-Ing Junior College of Health Care and Management, Kaohsiung 80776, Taiwan
- Correspondence: (Y.-M.H.); (R.C.)
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Department of Recreation Sports Management, Tajen University, Pingtung 90741, Taiwan
- Correspondence: (Y.-M.H.); (R.C.)
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Colpani V, Soares Falcetta F, Bacelo Bidinotto A, Kops NL, Falavigna M, Serpa Hammes L, Schwartz Benzaken A, Kalume Maranhão AG, Domingues CMAS, Wendland EM. Prevalence of human papillomavirus (HPV) in Brazil: A systematic review and meta-analysis. PLoS One 2020; 15:e0229154. [PMID: 32084177 PMCID: PMC7034815 DOI: 10.1371/journal.pone.0229154] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/30/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of genital, anal and oral HPV infection in Brazil through systematic review and meta-analysis. METHODS We searched EMBASE, LILACS, MEDLINE, Web of Science and SciELO from inception to December 2018. Original research articles that assessed the prevalence of genital (i.e., cervical, penile), anal and oral HPV infection in Brazil were selected in pairs by independent authors. No sex, age, HPV vaccination, language or date restrictions were applied. HPV prevalence was estimated and stratified according to risk factors population and by geographic area throughout the country. The study prevalence was pooled using a random effects model. Analysis was performed using R (version 3.5.2), packages meta version 4.9-4 and metaphor 2.0-0. This review is registered on PROSPERO under protocol number CRD42016032751. RESULTS We identified 3,351 references. After the screening process, 139 of them were eligible for this systematic review (57,513 total participants). Prevalence of cervical HPV was 25.41% (95% CI 22.71-28.32). Additionally, prevalence was 36.21% (95% CI 23.40, 51.33) in the penile region, 25.68% (95%CI 14.64, 41.04) in the anal region, and 11.89% (95%CI 6.26, 21.43) in the oral region. Subgroup analysis showed prevalence in each anatomic site was higher in high-risk populations. CONCLUSION The prevalence of HPV is high in the Brazilian population and varies by population risk and anatomic body site, with lower rates in the oral cavity compared to that in the cervical, penile and anal region. Studies on HPV have primarily been developed to evaluate infection and cancer in the cervical region. There is a profound lack of HPV data in many geographic regions of Brazil and for different anatomic sites.
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Affiliation(s)
- Verônica Colpani
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | - Maicon Falavigna
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Adele Schwartz Benzaken
- Tropical Medicine Foundation Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Aids Health Care Foundation, Manaus, Amazonas, Brazil
| | | | | | - Eliana Márcia Wendland
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Community Health, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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7
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Wheeler BS, Rositch AF, Poole C, Taylor SM, Smith JS. Patterns of incident genital human papillomavirus infection in women: A literature review and meta-analysis. Int J STD AIDS 2019; 30:1246-1256. [PMID: 31640474 DOI: 10.1177/0956462418824441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human papillomavirus (HPV) infection acquisition is a necessary step in the development of cervical cancer. No study has systematically quantified the rate of newly acquired HPV infections from the published literature and determined its relationship with age. We performed a systematic review and meta-analysis to describe incident HPV infections in women. Medline® and Thomson Reuters Web of Science via PubMed® databases were searched. A total of 46 of 5136 studies met inclusion criteria and contributed results. We conducted a meta-regression analysis of 13 studies, which reported incidence rate estimates on over 13 high-risk HPV types, to provide pooled stratum-specific incidence rates and rate ratios for key population and study characteristics among 8488 women. Studies with mean age < 30 years had relatively higher HPV incidence rates compared to studies with mean age ≥30 years: relative risk = 3.12; 95% CI: 1.41–6.93. HPV-16 was most frequently detected, followed by HPV-18: relative risk = 0.47; 95% CI: 0.33–0.67, and by HPV-58: relative risk = 0.45; 95% CI: 0.27–0.74. Younger age is a key predictor of genital HPV incidence in women. These data on the relative distribution of incident HPV infections will provide a baseline comparison for monitoring of changes in HPV incidence following the implementation of population-level HPV vaccination.
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Affiliation(s)
- Bradford S Wheeler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,SALineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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8
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Diversity of human papillomavirus typing among women population living in rural and remote areas of Brazilian territory. PAPILLOMAVIRUS RESEARCH 2019; 8:100186. [PMID: 31539646 PMCID: PMC6804508 DOI: 10.1016/j.pvr.2019.100186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 07/04/2019] [Accepted: 09/16/2019] [Indexed: 12/09/2022]
Abstract
Objectives Genotyping HPV from samples tested positive to careHPV™ assay in rural and remote areas of Brazilian territory. Methods A total of 5079 women were enrolled in an opportunistic screening from the Barretos Cancer Hospital, through mobile units or ambulatory unit. All careHPV™ hr-HPV positive samples were tested by a Luminex-based protocol in order to evaluate the HPV infecting types. Results Positive hr-HPV results were obtained in 10.6% (536/5068) of women. Among these cases, HPV-56 and HPV-51 were the most common types detected in 32.3% and 31.4%, respectively. HPV-53 (20.5%), HPV-18 (18.5%), HPV-58 (17.6%), HPV-52 (16.0%) and HPV-16.6%) were the other most frequent types detected. These frequencies represent prevalences of 2.35%, 2.12%, 2.02%, 1.84% and 1.80% respectively, within the population studied. Regarding low-risk HPVs, HPV-6 was detected in 12.9% of the samples. The less frequent types (<3%) were: HPV-70, HPV-11 and HPV-26. Conclusions The most frequent types detected were: HPV-56, HPV-51, HPV-53, HPV-18, HPV-58, HPV-52 and HPV-16 according to decreasing rates.
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9
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Bik EM, Bird SW, Bustamante JP, Leon LE, Nieto PA, Addae K, Alegría-Mera V, Bravo C, Bravo D, Cardenas JP, Carson GA, Caughey A, Covarrubias PC, Pérez-Donoso J, Gass G, Gupta SL, Harman K, Hongo DMB, Jiménez JC, Kraal L, Melis-Arcos F, Morales EH, Morton A, Navas CF, Nuñez H, Olivares E, Órdenes-Aenishanslins N, Ossandon FJ, Phan R, Pino R, Soto-Liebe K, Varas I, Vera-Wolf P, Walton NA, Almonacid DE, Goddard AD, Ugalde JA, Zneimer S, Richman J, Apte ZS. A novel sequencing-based vaginal health assay combining self-sampling, HPV detection and genotyping, STI detection, and vaginal microbiome analysis. PLoS One 2019; 14:e0215945. [PMID: 31042762 PMCID: PMC6493738 DOI: 10.1371/journal.pone.0215945] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 04/12/2019] [Indexed: 11/18/2022] Open
Abstract
The composition of the vaginal microbiome, including both the presence of pathogens involved in sexually transmitted infections (STI) as well as commensal microbiota, has been shown to have important associations for a woman's reproductive and general health. Currently, healthcare providers cannot offer comprehensive vaginal microbiome screening, but are limited to the detection of individual pathogens, such as high-risk human papillomavirus (hrHPV), the predominant cause of cervical cancer. There is no single test on the market that combines HPV, STI, and microbiome screening. Here, we describe a novel inclusive vaginal health assay that combines self-sampling with sequencing-based HPV detection and genotyping, vaginal microbiome analysis, and STI-associated pathogen detection. The assay includes genotyping and detection of 14 hrHPV types, 5 low-risk HPV types (lrHPV), as well as the relative abundance of 31 bacterial taxa of clinical importance, including Lactobacillus, Sneathia, Gardnerella, and 3 pathogens involved in STI, with high sensitivity, specificity, and reproducibility. For each of these taxa, reference ranges were determined in a group of 50 self-reported healthy women. The HPV sequencing portion of the test was evaluated against the digene High-Risk HPV HC2 DNA test. For hrHPV genotyping, agreement was 95.3% with a kappa of 0.804 (601 samples); after removal of samples in which the digene hrHPV probe showed cross-reactivity with lrHPV types, the sensitivity and specificity of the hrHPV genotyping assay were 94.5% and 96.6%, respectively, with a kappa of 0.841. For lrHPV genotyping, agreement was 93.9% with a kappa of 0.788 (148 samples), while sensitivity and specificity were 100% and 92.9%, respectively. This novel assay could be used to complement conventional cervical cancer screening, because its self-sampling format can expand access among women who would otherwise not participate, and because of its additional information about the composition of the vaginal microbiome and the presence of pathogens.
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Affiliation(s)
| | - Sara W. Bird
- uBiome, San Francisco, CA, United States of America
| | | | - Luis E. Leon
- uBiome, San Francisco, CA, United States of America
| | | | - Kwasi Addae
- uBiome, San Francisco, CA, United States of America
| | | | | | | | | | | | - Adam Caughey
- uBiome, San Francisco, CA, United States of America
| | | | | | - Graham Gass
- uBiome, San Francisco, CA, United States of America
| | | | - Kira Harman
- uBiome, San Francisco, CA, United States of America
| | | | | | | | | | | | | | | | - Harold Nuñez
- uBiome, San Francisco, CA, United States of America
| | | | | | | | - Richard Phan
- uBiome, San Francisco, CA, United States of America
| | - Raul Pino
- uBiome, San Francisco, CA, United States of America
| | | | | | | | | | | | | | | | | | | | - Zachary S. Apte
- uBiome, San Francisco, CA, United States of America
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, United States of America
- * E-mail:
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10
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Chabeda A, Yanez RJR, Lamprecht R, Meyers AE, Rybicki EP, Hitzeroth II. Therapeutic vaccines for high-risk HPV-associated diseases. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2018; 5:46-58. [PMID: 29277575 PMCID: PMC5887015 DOI: 10.1016/j.pvr.2017.12.006] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 12/13/2017] [Accepted: 12/17/2017] [Indexed: 12/16/2022]
Abstract
Cancer is the second leading cause of death worldwide, and it is estimated that Human papillomavirus (HPV) related cancers account for 5% of all human cancers. Current HPV vaccines are extremely effective at preventing infection and neoplastic disease; however, they are prophylactic and do not clear established infections. Therapeutic vaccines which trigger cell-mediated immune responses for the treatment of established infections and malignancies are therefore required. The E6 and E7 early genes are ideal targets for vaccine therapy due to their role in disruption of the cell cycle and their constitutive expression in premalignant and malignant tissues. Several strategies have been investigated for the development of therapeutic vaccines, including live-vector, nucleic acid, peptide, protein-based and cell-based vaccines as well as combinatorial approaches, with several vaccine candidates progressing to clinical trials. With the current understanding of the HPV life cycle, molecular mechanisms of infection, carcinogenesis, tumour biology, the tumour microenvironment and immune response mechanisms, an approved HPV therapeutic vaccine seems to be a goal not far from being achieved. In this article, the status of therapeutic HPV vaccines in clinical trials are reviewed, and the potential for plant-based vaccine production platforms described.
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Affiliation(s)
- Aleyo Chabeda
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, Rondebosch 7701, South Africa
| | - Romana J R Yanez
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, Rondebosch 7701, South Africa
| | - Renate Lamprecht
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, Rondebosch 7701, South Africa
| | - Ann E Meyers
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, Rondebosch 7701, South Africa
| | - Edward P Rybicki
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, Rondebosch 7701, South Africa; Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa
| | - Inga I Hitzeroth
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, Rondebosch 7701, South Africa.
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11
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Prevalence of human papillomavirus types associated with cervical lesions in Sergipe state, Northeastern Brazil: high frequency of a possibly carcinogenic type. Epidemiol Infect 2018; 146:1184-1193. [DOI: 10.1017/s095026881800105x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractPersistent infection with high-risk human papillomavirus (HPV) is the main cause of cervical cancer and the prevalence of HPV types varies depending on the geographic region. Therefore, this study assessed the prevalence of HPV types in women with cervical lesions from Sergipe state, Northeastern Brazil. A cross-sectional study was conducted in women with cervical lesions from March to December 2014. These lesions were investigated by PCR and HPV types were identified by DNA sequencing. 432 patients were included, of which 337 patients tested positive for HPV. Eighteen different HPV types were detected, and high-risk HPV types were detected in 69.2%. HPV 16 (63.4%) was the most prevalent HPV type found, followed by HPV 66 (4.6%), HPV 18 (1.6%) and HPV 45 (1.4%). These results highlight the importance of the high prevalence of HPV 66, which is a possibly carcinogenic virus type not covered by the available vaccines. The prevalence of HPV 16 was high in the studied population, reaffirming the importance of young vaccination. However, the high prevalence of HPV 66 found in this study shows the importance of monitoring the diversity of HPV types in different populations and geographic regions to better understand the impacts of current HPV vaccines.
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Boda D, Docea AO, Calina D, Ilie MA, Caruntu C, Zurac S, Neagu M, Constantin C, Branisteanu DE, Voiculescu V, Mamoulakis C, Tzanakakis G, Spandidos DA, Drakoulis N, Tsatsakis AM. Human papilloma virus: Apprehending the link with carcinogenesis and unveiling new research avenues (Review). Int J Oncol 2018; 52:637-655. [PMID: 29393378 PMCID: PMC5807043 DOI: 10.3892/ijo.2018.4256] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 12/28/2017] [Indexed: 12/17/2022] Open
Abstract
Human papilloma viruses (HPV) are a small group of non‑enveloped viruses belonging to the Papillomaviridae family with strong similarities to polyoma viruses. The viral particles consist of a genome in the form of a circular double‑stranded DNA, encompassing eight open reading frames, as well as a non‑enveloped icosahedral capsid. HPV infection is considered the most common sexually transmitted disease in both sexes and is strongly implicated in the pathogenesis of different types of cancer. 'High‑risk' mucosal HPV types, predominantly types 16, 18, 31, 33 and 35, are associated with most cervical, penile, vulvar, vaginal, anal, oropharyngeal cancers and pre‑cancers. Screening for HPV is necessary for the prognosis and for determining treatment strategies for cancer. Novel HPV markers, including proteomic and genomic markers, as well as anti‑papillomavirus vaccines are currently available. The aim of this comprehensive review was to thoroughly present the updated information on virus development, cancer occurrence, treatment and prevention strategies, in an attempt to shed further light into the field, including novel research avenues.
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Affiliation(s)
- Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest
| | | | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova
| | - Mihaela Adriana Ilie
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Department of Biochemistry
| | - Constantin Caruntu
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest
- Department of Physiology
| | - Sabina Zurac
- Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Colentina University Hospital, Sector 2 19-21, Bucharest
| | - Monica Neagu
- ‘Victor Babes’ National Institute of Pathology, 050096 Bucharest
| | | | | | - Vlad Voiculescu
- Department of Dermatology and Allergology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete Medical School
| | | | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Crete
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771 Athens
| | - Aristides M. Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Crete, Greece
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Travassos AG, Netto E, Xavier-Souza E, Nóbrega I, Adami K, Timbó M, Abbehusen K, Fernandes S, Duran C, Haguihara T, Ferreira F, Brites C. Predictors of HPV incidence and clearance in a cohort of Brazilian HIV-infected women. PLoS One 2017; 12:e0185423. [PMID: 28981551 PMCID: PMC5628817 DOI: 10.1371/journal.pone.0185423] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/12/2017] [Indexed: 12/13/2022] Open
Abstract
Persistent infection with high-risk human papillomavirus (HR-HPV) is necessary for the development of precursor lesions and cervical cancer. HPV infection among women living with HIV/AIDS (WLHA) occurs more frequently, presents a higher rate of persistent infections and an earlier progression to cancer. We aimed to evaluate HR-HPV prevalence, incidence and clearance, and its association with HIV viral suppression, immunological response and other risk factors among WLHA followed at an STD/HIV reference center. This was a cohort study conducted at a reference center for STD/AIDS in Northeastern Brazil from September 2013 to September 2015. Follow-up visits were conducted at 6 and 12 months after enrolment, where socio-epidemiological data were obtained. Cervical samples were collected for conventional cytology and HPV DNA research (PCR COBAS® Roche) in addition to blood samples for CD4+ T lymphocyte count and HIV viral load. We prospectively evaluated 333 women. HR-HPV DNA prevalence was 33.3% at baseline. HPV-16 was present in 5.1%, HPV-18 in 3.9% and 29.4% WLHA had other HR-HPV (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68). The HR-HPV incidence during the follow-up was 10.8%, at the 6-month visit was 7.7% and at the 12-month visit was 3.7%. Variables associated with HR-HPV incidence were: nulliparity, combined oral contraceptive use and detectable HIV viral load. The HR-HPV clearance rate was 41.7% and was associated with age >30 years and lymphocyte T CD4 count >500 cells/mm3 at enrolment. These findings contribute to the knowledge about a group of women that need more careful HPV screening and describe the association between an efficient immunological response and HIV viral suppression with lower incidence and increased clearance of HR-HPV.
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Affiliation(s)
- Ana Gabriela Travassos
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
- Colegiado de Medicina, Departamento de Ciências da Vida, Universidade Estadual da Bahia, Salvador, Bahia, Brazil
| | - Eduardo Netto
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | | - Isabella Nóbrega
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Karina Adami
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Maiara Timbó
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Karen Abbehusen
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Sheyla Fernandes
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Camila Duran
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Tatiana Haguihara
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Fábio Ferreira
- Laboratório Central de Saúde Pública Prof. Gonçalo Moniz, Salvador, Bahia, Brazil
| | - Carlos Brites
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
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Shannon B, Yi TJ, Perusini S, Gajer P, Ma B, Humphrys MS, Thomas-Pavanel J, Chieza L, Janakiram P, Saunders M, Tharao W, Huibner S, Shahabi K, Ravel J, Rebbapragada A, Kaul R. Association of HPV infection and clearance with cervicovaginal immunology and the vaginal microbiota. Mucosal Immunol 2017; 10:1310-1319. [PMID: 28120845 PMCID: PMC5526752 DOI: 10.1038/mi.2016.129] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 11/10/2016] [Indexed: 02/04/2023]
Abstract
Cervical human papillomavirus (HPV) infection may increase HIV risk. Since other genital infections enhance HIV susceptibility by inducing inflammation, we assessed the impact of HPV infection and clearance on genital immunology and the cervico-vaginal microbiome. Genital samples were collected from 65 women for HPV testing, immune studies and microbiota assessment; repeat HPV testing was performed after 6 months. All participants were HIV-uninfected and free of bacterial STIs. Cytobrush-derived T cell and dendritic cell subsets were assessed by multiparameter flow cytometry. Undiluted cervico-vaginal secretions were used to determine cytokine levels by multiplex ELISA, and to assess bacterial community composition and structure by 16S rRNA gene sequence analysis. Neither HPV infection nor clearance were associated with broad differences in cervical T cell subsets or cytokines, although HPV clearance was associated with increased Langerhans cells and HPV infection with elevated IP-10 and MIG. Individuals with HPV more frequently had a high diversity cervico-vaginal microbiome (community state type IV) and were less likely to have an L. gasseri predominant microbiome. In summary, HPV infection and/or subsequent clearance was not associated with inflammation or altered cervical T cell subsets, but associations with increased Langerhans cells and the composition of the vaginal microbiome warrant further exploration.
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Affiliation(s)
- B Shannon
- Departments of Medicine (BS, TJY, SH, KS, RK), Immunology (BS, TJY, RK), and Laboratory Medicine and Pathobiology (AR), University of Toronto, Toronto, Ontario, Canada
| | - TJ Yi
- Departments of Medicine (BS, TJY, SH, KS, RK), Immunology (BS, TJY, RK), and Laboratory Medicine and Pathobiology (AR), University of Toronto, Toronto, Ontario, Canada
| | - S Perusini
- Public Health Ontario – Toronto Public Health Laboratory, Toronto, Ontario, Canada
| | - P Gajer
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD
| | - B Ma
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD
| | - MS Humphrys
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD
| | - J Thomas-Pavanel
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada (LC, JT, MS, PJ, WT)
| | - L Chieza
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada (LC, JT, MS, PJ, WT)
| | - P Janakiram
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada (LC, JT, MS, PJ, WT)
| | - M Saunders
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada (LC, JT, MS, PJ, WT)
| | - W Tharao
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada (LC, JT, MS, PJ, WT)
| | - S Huibner
- Departments of Medicine (BS, TJY, SH, KS, RK), Immunology (BS, TJY, RK), and Laboratory Medicine and Pathobiology (AR), University of Toronto, Toronto, Ontario, Canada
| | - K Shahabi
- Departments of Medicine (BS, TJY, SH, KS, RK), Immunology (BS, TJY, RK), and Laboratory Medicine and Pathobiology (AR), University of Toronto, Toronto, Ontario, Canada
| | - J Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD
| | - A Rebbapragada
- Departments of Medicine (BS, TJY, SH, KS, RK), Immunology (BS, TJY, RK), and Laboratory Medicine and Pathobiology (AR), University of Toronto, Toronto, Ontario, Canada, Public Health Ontario – Toronto Public Health Laboratory, Toronto, Ontario, Canada
| | - R Kaul
- Departments of Medicine (BS, TJY, SH, KS, RK), Immunology (BS, TJY, RK), and Laboratory Medicine and Pathobiology (AR), University of Toronto, Toronto, Ontario, Canada, Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada (LC, JT, MS, PJ, WT)
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Ingabire C, Lim MK, Won YJ, Oh JK. Human Papillomavirus Genotype-Specific Persistence and Potential Risk Factors among Korean Women: Results from a 2-Year Follow-up Study. Cancer Res Treat 2017; 50:813-822. [PMID: 28814070 PMCID: PMC6056951 DOI: 10.4143/crt.2017.340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/08/2017] [Indexed: 01/17/2023] Open
Abstract
Purpose High-risk human papillomavirus (HPV) infection progression should be considered a critical factor for preventing cervical cancer, although most infections are transient and rarely persist. This study aimed to examine the specific types of HPV infections, their change patterns, and the potential risk factors among Korean women. Materials and Methods We included 4,588 women who visited hospitals in Busan and Suwon for cervical cancer screening, and 1,224 of thesewomen attended a 2-yearfollow-up. Infection statuswas evaluated using HPV DNA testing (Hybrid Capture 2) and genotyping testing (Linear Array). Data regarding the potential risk factors for HPV infection were collected by trained nurses using structured questionnaires. Results Among the 1,224 women (mean age, 47 years), 105 women (8.6%) were HPV-positive at baseline. HPV infections had been cleared among 92 women (87.6%) within 2 years. Only 13 infections (12.4%) were remained, and the 10 cases of them are high-risk HPV types including genotype 33, 45, 16, 35, and 52. Among women who were negative at baseline, the HPV incidence was 4.8%. The HPV incidence was marginally associated with having multiple sexual partners (odds ratio, 2.0; 95% confidence interval, 1.0 to 3.9), although it was not significantly associated with HPV persistence. Conclusion Most HPV infections (88%) among Korean women were cleared within 2 years, with only a small number of persistent infections. The persistent HPV genotypes were different in our study, compared to those from previous studies. Having multiple sexual partners was associated with acquiring a HPV infection, but not with persistence.
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Affiliation(s)
- Cecile Ingabire
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Cancer Risk Appraisal and Prevention Branch, Division of Cancer Prevention, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Cancer Registration and Statistics Branch, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Cancer Risk Appraisal and Prevention Branch, Division of Cancer Prevention, National Cancer Center, Goyang, Korea
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de Oliveira GR, Vieira VC, Ávila EC, Finger-Jardim F, Caldeira TDM, Gatti FAA, Gonçalves CV, Oliveira SG, da Hora VP, Soares MA, de Martinez AMB. Human papillomavirus type distribution and HPV16 intratype diversity in southern Brazil in women with and without cervical lesions. Mem Inst Oswaldo Cruz 2017; 112:492-498. [PMID: 28591310 PMCID: PMC5452486 DOI: 10.1590/0074-02760160530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/04/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Increasing evidence suggests that human papillomavirus (HPV) intratype variants (specific lineages and sublineages) are associated with pathogenesis and progression from HPV infection to persistence and the development of cervical cancer. OBJECTIVES This study aimed to verify the prevalence of HPV infection and distribution of HPV types and HPV16 variants in southern Brazil in women with normal cytology or intraepithelial lesions. METHODS HPV typing was determined by L1 gene sequencing. To identify HPV16 variants, the LCR and E6 regions were sequenced, and characteristic single nucleotide variants were identified. FINDINGS A total of 445 samples were studied, with 355 from cervical scrapes and 90 from cervical biopsies. HPV was detected in 24% and 91% of these samples, respectively. The most prevalent HPV types observed were 16 (cervical, 24%; biopsies, 57%) and 58 (cervical, 12%; biopsies, 12%). Seventy-five percent of the HPV16-positive samples were classified into lineages, with 88% defined as lineage A, 10% as lineage D, and 2% as lineage B. MAIN CONCLUSIONS This study identified a high frequency of European and North American HPV16 lineages, consistent with the genetic background of the human population in southern Brazil.
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Affiliation(s)
- Gisele R de Oliveira
- Universidade Federal do Rio Grande, Escola de Medicina, Laboratório de Biologia Molecular, Rio Grande, RS, Brasil
- Instituto Nacional de Câncer, Programa de Oncovirologia, Rio de Janeiro, RJ, Brasil
| | - Valdimara C Vieira
- Instituto Nacional de Câncer, Programa de Oncovirologia, Rio de Janeiro, RJ, Brasil
| | - Emiliana C Ávila
- Universidade Federal do Rio Grande, Escola de Medicina, Laboratório de Biologia Molecular, Rio Grande, RS, Brasil
| | - Fabiana Finger-Jardim
- Universidade Federal do Rio Grande, Escola de Medicina, Laboratório de Biologia Molecular, Rio Grande, RS, Brasil
| | - Thaís DM Caldeira
- Universidade Federal do Rio Grande, Escola de Medicina, Laboratório de Biologia Molecular, Rio Grande, RS, Brasil
| | - Fabiane AA Gatti
- Universidade Federal do Rio Grande, Escola de Medicina, Laboratório de Biologia Molecular, Rio Grande, RS, Brasil
| | - Carla V Gonçalves
- Universidade Federal do Rio Grande, Escola de Medicina, Centro de Obstetrícia e Ginecologia, Rio Grande, RS, Brasil
| | | | - Vanusa P da Hora
- Universidade Federal do Rio Grande, Escola de Medicina, Laboratório de Biologia Molecular, Rio Grande, RS, Brasil
| | - Marcelo A Soares
- Instituto Nacional de Câncer, Programa de Oncovirologia, Rio de Janeiro, RJ, Brasil
| | - Ana MB de Martinez
- Universidade Federal do Rio Grande, Escola de Medicina, Laboratório de Biologia Molecular, Rio Grande, RS, Brasil
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Polansky H, Itzkovitz E, Javaherian A. Human papillomavirus (HPV): systemic treatment with Gene-Eden-VIR/Novirin safely and effectively clears virus. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:575-583. [PMID: 28424535 PMCID: PMC5344427 DOI: 10.2147/dddt.s123340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE This paper reports the results of a clinical study that tested the effect of systemic treatment with the botanical product Gene-Eden-VIR/Novirin on the clearance rate (also called time to clearance) of the human papillomavirus (HPV). The study compared the clearance rate in treated and untreated individuals suffering from a symptomatic HPV infection. The data on the untreated individuals were obtained by reverse engineering of the Kaplan-Meier figures in five published papers. MATERIALS AND METHODS The study included 59 treated participants. All participants were suffering from a symptomatic HPV infection prior to the commencement of treatment. The treatment was one to four capsules of Gene-Eden-VIR/Novirin per day. The duration of treatment was 2-12 months. The study included five groups of external controls with diverse characteristics. RESULTS The mean time to clearance in Gene-Eden-VIR/Novirin-treated individuals was 5.1 months or 151.5 days (95% CI: 4.2-5.9 months or 95% CI: 125.7-177.3 days, respectively). The median time to clearance was 3.5 months. The mean time to clearance in the five untreated groups ranged from 6.9 to 20.0 months (P<0.0001 for the difference between treatment group and each untreated group). Also, 100% of the participants in the treatment group were HPV free at the end of 12 months vs 53%, 52%, 65%, 20%, and 77% in the untreated control groups. The treated participants reported no adverse experiences. CONCLUSION This clinical study has two major contributions. First, it showed that systemic treatment with the natural Gene-Eden-VIR/Novirin decreased the time to HPV clearance, increased the percentage of HPV-free individuals, and caused no adverse experiences in individuals suffering from a symptomatic HPV infection. Since there are no other systemic treatments for symptomatic HPV infections, this study presents highly valuable information on the clinical effects of the first treatment in this category. Second, the study presents a new method for conducting clinical studies that addresses one of the major deficiencies associated with the practice of the randomized controlled trial method.
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Affiliation(s)
- Hanan Polansky
- The Center for the Biology of Chronic Disease, Valley Cottage, NY, USA
| | - Edan Itzkovitz
- The Center for the Biology of Chronic Disease, Valley Cottage, NY, USA
| | - Adrian Javaherian
- The Center for the Biology of Chronic Disease, Valley Cottage, NY, USA
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Robial R, Longatto-Filho A, Roteli-Martins CM, Silveira MF, Stauffert D, Ribeiro GG, Linhares IM, Tacla M, Zonta MA, Baracat EC. Frequency of Chlamydia trachomatis infection in cervical intraepithelial lesions and the status of cytological p16/Ki-67 dual-staining. Infect Agent Cancer 2017; 12:3. [PMID: 28074107 PMCID: PMC5219725 DOI: 10.1186/s13027-016-0111-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 12/13/2016] [Indexed: 12/24/2022] Open
Abstract
Background Chlamydia trachomatis (Ct) is not a disease subject to mandatory reporting in Brazil, and the prevalence rate of this genital infection varies according to the region in which studies are conducted, as well as by the detection technique employed. Ct has been associated with persistence of Human papillomavirus (HPV) infection and the facilitation of cervical carcinoma development. We evaluated the Chlamydia trachomatis infection and its association with cytology, p16/Ki-67 dual-stained cytology and cervical intraepithelial lesions status in a screening cohort in Brazil. Methods This was a cross-sectional study of 1481 cervical samples from asymptomatic women aged 18 to 64. Samples were collected for liquid-based cytology and Ct detection by polymerase chain reaction. p16/Ki-67 double staining was performed on samples with abnormal cytology. Statistical analysis was by chi-square and likelihood-ratio tests. Odds ratio (OR) and 95% confidence intervals (95% CI) were determined. Results The frequency of Ct was 15.6% and its presence was not associated with detection of p16/Ki-67 [OR = 1.35 (0.5–3.4)]. There was also no association between abnormal cervical cytology and Ct-positivity [OR = 1.21 (0.46–3.2)]. Associations were observed between p16/Ki-67 and high-grade lesions detected by cytology and in biopsies [OR = 3.55 (1.50–8.42) and OR = 19.00 (0.6–7.2), respectively]. Conclusions The asymptomatic women in our study had a high frequency of Ct infection but this was not associated with p16/Ki-67 detection in samples with abnormal cytology. The expression of p16/Ki-67 was highest in women with high-grade CIN (p = 0.003).
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Affiliation(s)
- R Robial
- Division of Gynecologic Clinic, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - A Longatto-Filho
- Laboratory of Medical Investigation (LIM) 14, Faculty of Medicine, University of São Paulo, São Paulo, Brazil ; Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil ; Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal ; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - C M Roteli-Martins
- Leonor M De Barros Hospital - Secretaria de Saúde de São Paulo, São Paulo, Brazil
| | - M F Silveira
- Federal University of Pelotas - Pelotas, Rio Grande do Sul, Brazil
| | - D Stauffert
- Federal University of Pelotas - Pelotas, Rio Grande do Sul, Brazil
| | - G G Ribeiro
- School of Pharmaceutical Sciences of Ribeirão Preto University of São Paulo, Ribeirão Preto, Brazil
| | - I M Linhares
- Division of Gynecologic Clinic, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - M Tacla
- Division of Gynecologic Clinic, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - M A Zonta
- Discipline of Infectology, Federal University of São Paulo, São Paulo, Brazil
| | - E C Baracat
- Division of Gynecologic Clinic, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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The Role of Chlamydia trachomatis in High-Risk Human Papillomavirus Persistence Among Female Sex Workers in Nairobi, Kenya. Sex Transm Dis 2016; 42:305-11. [PMID: 25970306 DOI: 10.1097/olq.0000000000000287] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Little is known about risk factors for persistent high-risk human papillomavirus (hrHPV) infection in low-income settings, and prior research has not quantified the relative duration of hrHPV infections stratified by risk factors. We compared the duration of hrHPV infection among female sex workers (FSWs) by exposure to sexually transmitted infections (STIs), using a highly sensitive biomarker assay. METHODS From 2009 to 2011, 350 FSWs enrolled in this longitudinal study. Every 3 months, sociodemographic and sexual behavior data were collected via questionnaire, and APTIMA assays were used to detect the rRNA of Chlamydia trachomatis (CT), Neisseria gonorrhea, Trichomonas vaginalis, Mycoplasma genitalium, and messenger RNA of the E6/E7 oncoproteins expressed by hrHPV. Among 173 FSW who were infected with hrHPV during the observation period, accelerated failure time models estimated time ratios (TRs) for duration of hrHPV infection, comparing FSW infected with STIs at baseline to STI-uninfected FSWs. RESULTS Median follow-up time was 26.2 months (interquartile range, 18.8-27.5 months). The median duration of hrHPV infection among all FSWs was 9.3 months (95% confidence interval [CI], 9.3-11.5). The duration of hrHPV infection among FSW infected with CT at baseline was greater than that among FSWs who were uninfected (adjusted TR, 1.7; 95% CI, 1.2-2.6). Among FSWs who were coinfected with hrHPV and CT at baseline, the adjusted TR was 3.4 (95% CI, 2.5-5.4) compared with FSWs infected with hrHPV only. No other STI was associated with hrHPV duration. CONCLUSIONS Recent or concurrent CT infection was associated with prolonged hrHPV infection among a cohort of Nairobi FSWs. Management of CT could reduce risk for hrHPV persistence.
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Lorenzi AT, Fregnani JHT, Possati-Resende JC, Antoniazzi M, Scapulatempo-Neto C, Syrjänen S, Villa LL, Longatto-Filho A. Can the careHPV test performed in mobile units replace cytology for screening in rural and remote areas? Cancer Cytopathol 2016; 124:581-8. [DOI: 10.1002/cncy.21718] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Adriana T. Lorenzi
- Institute of Education and Research and Molecular Oncology Center, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - José Humberto T. Fregnani
- Institute of Education and Research and Molecular Oncology Center, Department of Researcher Support, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - Júlio César Possati-Resende
- Institute of Education and Research and Molecular Oncology Center, Department of Prevention, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - Márcio Antoniazzi
- Institute of Education and Research and Molecular Oncology Center, Department of Prevention, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - Cristovam Scapulatempo-Neto
- Institute of Education and Research and Molecular Oncology Center, Department of Pathology, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
| | - Stina Syrjänen
- Medicity Research Laboratory and Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine; University of Turku; Turku Finland
- Department of Pathology; Turku University Central Hospital; Turku Finland
| | - Luisa L. Villa
- Faculty of Medical Sciences of Santa Casa of São Paulo; São Paulo Brazil
- Department of Radiology and Oncology, Faculty of Medicine; Universidade de São Paulo; São Paulo Brazil
| | - Adhemar Longatto-Filho
- Institute of Education and Research and Molecular Oncology Center, Barretos Cancer Hospital; Pio XII Foundation; Barretos São Paulo Brazil
- Laboratory of Medical Investigation 14, Faculty of Medicine; Universidade de São Paulo; São Paulo Brazil
- Life and Health Sciences Research Institute, School of Health Sciences; University of Minho; Braga Portugal
- Life and Health Sciences Research Institute/3Bs-PT Government Associate Laboratory; Braga Portugal
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Pedersen K, Sørbye SW, Burger EA, Lönnberg S, Kristiansen IS. Using Decision-Analytic Modeling to Isolate Interventions That Are Feasible, Efficient and Optimal: An Application from the Norwegian Cervical Cancer Screening Program. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2015; 18:1088-1097. [PMID: 26686795 DOI: 10.1016/j.jval.2015.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 07/10/2015] [Accepted: 08/03/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Decision makers often need to simultaneously consider multiple criteria or outcomes when deciding whether to adopt new health interventions. OBJECTIVES Using decision analysis within the context of cervical cancer screening in Norway, we aimed to aid decision makers in identifying a subset of relevant strategies that are simultaneously efficient, feasible, and optimal. METHODS We developed an age-stratified probabilistic decision tree model following a cohort of women attending primary screening through one screening round. We enumerated detected precancers (i.e., cervical intraepithelial neoplasia of grade 2 or more severe (CIN2+)), colposcopies performed, and monetary costs associated with 10 alternative triage algorithms for women with abnormal cytology results. As efficiency metrics, we calculated incremental cost-effectiveness, and harm-benefit, ratios, defined as the additional costs, or the additional number of colposcopies, per additional CIN2+ detected. We estimated capacity requirements and uncertainty surrounding which strategy is optimal according to the decision rule, involving willingness to pay (monetary or resources consumed per added benefit). RESULTS For ages 25 to 33 years, we eliminated four strategies that did not fall on either efficiency frontier, while one strategy was efficient with respect to both efficiency metrics. Compared with current practice in Norway, two strategies detected more precancers at lower monetary costs, but some required more colposcopies. Similar results were found for women aged 34 to 69 years. CONCLUSIONS Improving the effectiveness and efficiency of cervical cancer screening may necessitate additional resources. Although efficient and feasible, both society and individuals must specify their willingness to accept the additional resources and perceived harms required to increase effectiveness before a strategy can be considered optimal.
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Affiliation(s)
- Kine Pedersen
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | | | - Emily Annika Burger
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway; Center for Health Decision Science, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA
| | - Stefan Lönnberg
- The Norwegian Cervical Cancer Screening Program, The Cancer Registry of Norway, Oslo, Norway
| | - Ivar Sønbø Kristiansen
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
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22
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Fonseca AJ, Taeko D, Chaves TA, Amorim LDDC, Murari RSW, Miranda AE, Chen Z, Burk RD, Ferreira LCL. HPV Infection and Cervical Screening in Socially Isolated Indigenous Women Inhabitants of the Amazonian Rainforest. PLoS One 2015. [PMID: 26207895 PMCID: PMC4514624 DOI: 10.1371/journal.pone.0133635] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective Indigenous women from the Amazon regions have some of the highest rates of cervical cancer in the world. This study evaluated cervical cytology and human papillomavirus (HPV) in native women that differ by lifestyle and interaction with western society. Yanomami women are isolated deep in the Amazon with a hunter/gatherer lifestyle. Macuxi and Wapishana women live in proximity to western society. Methods To select a representative group of women from each district, random cluster sampling was used, considering each registered village as a cluster. Cervical samples were collected for cytology and HPV detection and typing by PCR amplification and next generation sequencing. The study was approved by the National IRB and by tribal leaders. Results 664 native women were enrolled from 13 indigenous villages (76% participation rate). Yanomami women had higher rates of abnormal cytology (5.1% vs. 1.8%, p = 0.04) and prevalent HR-HPV (34.1% vs. 19.2%, p<0.001). Yanomami women >35y of age were significantly more likely to have HR-HPV, whereas women ≤35y did not significantly differ between groups. Prevalence of HPV was significantly different amongst geographically clustered Yanomami women (p<0.004). The most prevalent HPV types in the entire group were HPV31 (8.7%), HPV16 (5.9%) and HPV18 (4.4%). Conclusion Isolated endogenous Yanomami women were more likely to be HPV+ and rates increased with age. Study of HPV in isolated hunter-gather peoples suggests that long-term persistence is a characteristic of prehistoric humans and patterns reflecting decreased prevalence with age in western society represents recent change. These studies have implications for cervical cancer prevention and viral-host relationships.
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Affiliation(s)
- Allex Jardim Fonseca
- Postgraduate Program in Tropical Medicine, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Department of Health Sciences Research, Universidade Federal de Roraima, Boa Vista, Brazil
- * E-mail:
| | - Daniela Taeko
- Department of Health Sciences Research, Universidade Federal de Roraima, Boa Vista, Brazil
| | - Thiciane Araújo Chaves
- Department of Health Sciences Research, Universidade Federal de Roraima, Boa Vista, Brazil
| | | | | | | | - Zigui Chen
- Department of Pediatrics, Albert Einstein College of Medicine, New York, United States of America
| | - Robert David Burk
- Department of Pediatrics, Albert Einstein College of Medicine, New York, United States of America
- Department of Microbiology & Immunology, Albert Einstein College of Medicine, New York, United States of America
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, United States of America
- Department of Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine, New York, United States of America
| | - Luiz Carlos Lima Ferreira
- Department of Tropical Pathology, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
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23
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Entiauspe LG, Silveira M, Nunes EM, Basgalupp SP, Stauffert D, Dellagostin OA, Collares T, Seixas FK. High incidence of oncogenic HPV genotypes found in women from Southern Brazil. Braz J Microbiol 2014; 45:689-94. [PMID: 25242959 PMCID: PMC4166300 DOI: 10.1590/s1517-83822014005000047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 09/09/2013] [Indexed: 11/26/2022] Open
Abstract
Oncogenic HPV genotypes are strongly associated with premalignant and malignant cervical lesion. The purpose was to determine human papillomavirus (HPV) prevalence and genotypes, and to estimate cervical cancer risk factor associations. Cervical samples were obtained from 251 women seeking gynecological care at the Pelotas School of Medicine Clinic. This is a cross-sectional study. HPV-DNA was amplified by nested-PCR using MY09/11 and GP5/6 primers, and the sequencing was used for genotyping. Sociodemographic and behavioral risk factors were obtained by closed questionnaire, and its relationship to HPV infection prevalence were analyzed. Statistical analyses were performed using SPSS 16.0 software, and differences were considered significant at p < 0.05. As results, the prevalence of HPV infection was 29.9%. The most frequent genotype was HPV-16 (41.3%), followed by HPV-18 (17.3%), and HPV-33 (9.3%). Others nine HPV genotypes were also found. On this population, prevalence of oncogenic HPV genotypes was high, but does not seem to confer relationship with the risk factors investigated. Future investigations in larger populations are necessary, for the proposition of more appropriated monitoring strategies and treatment according to the Brazilian health service reality, as well as patients.
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Affiliation(s)
- Ludmila G Entiauspe
- Grupo de Pesquisa em Oncologia Molecular e Celular Centro de Desenvolvimento Tecnológico Universidade Federal de PelotasRS Brasil Grupo de Pesquisa em Oncologia Molecular e Celular, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, RS, Brasil. ; Programa de Pós-Graduação em Biotecnologia CDTec Universidade Federal de Pelotas PelotasRS Brasil Programa de Pós-Graduação em Biotecnologia, CDTec, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Mariângela Silveira
- Programa de Pós-Graduação em Epidemiologia Universidade Federal de Pelotas PelotasRS Brasil Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Emily M Nunes
- Grupo de Pesquisa em Oncologia Molecular e Celular Centro de Desenvolvimento Tecnológico Universidade Federal de PelotasRS Brasil Grupo de Pesquisa em Oncologia Molecular e Celular, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, RS, Brasil
| | - Suélen P Basgalupp
- Grupo de Pesquisa em Oncologia Molecular e Celular Centro de Desenvolvimento Tecnológico Universidade Federal de PelotasRS Brasil Grupo de Pesquisa em Oncologia Molecular e Celular, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, RS, Brasil
| | - Dulce Stauffert
- Laboratório da Faculdade de Medicina Universidade Federal de Pelotas PelotasRS Brasil Laboratório da Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Odir A Dellagostin
- Grupo de Pesquisa em Oncologia Molecular e Celular Centro de Desenvolvimento Tecnológico Universidade Federal de PelotasRS Brasil Grupo de Pesquisa em Oncologia Molecular e Celular, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, RS, Brasil. ; Programa de Pós-Graduação em Biotecnologia CDTec Universidade Federal de Pelotas PelotasRS Brasil Programa de Pós-Graduação em Biotecnologia, CDTec, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Tiago Collares
- Grupo de Pesquisa em Oncologia Molecular e Celular Centro de Desenvolvimento Tecnológico Universidade Federal de PelotasRS Brasil Grupo de Pesquisa em Oncologia Molecular e Celular, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, RS, Brasil. ; Programa de Pós-Graduação em Biotecnologia CDTec Universidade Federal de Pelotas PelotasRS Brasil Programa de Pós-Graduação em Biotecnologia, CDTec, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Fabiana K Seixas
- Grupo de Pesquisa em Oncologia Molecular e Celular Centro de Desenvolvimento Tecnológico Universidade Federal de PelotasRS Brasil Grupo de Pesquisa em Oncologia Molecular e Celular, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, RS, Brasil. ; Programa de Pós-Graduação em Biotecnologia CDTec Universidade Federal de Pelotas PelotasRS Brasil Programa de Pós-Graduação em Biotecnologia, CDTec, Universidade Federal de Pelotas, Pelotas, RS, Brasil
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IPA Analysis of Cervicovaginal Fluid from Precancerous Women Points to the Presence of Biomarkers for the Precancerous State of Cervical Carcinoma. Proteomes 2014; 2:426-450. [PMID: 28250389 PMCID: PMC5302755 DOI: 10.3390/proteomes2030426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/07/2014] [Accepted: 08/05/2014] [Indexed: 01/08/2023] Open
Abstract
Despite large gaps in our knowledge on the intracellular mechanism leading to cervical cancer, the pathways induced by oncogenic high-risk Human Papilloma Virus (HPV) and those finally causing cervical cancer are increasingly being unraveled. Assuming that precancerous tissue is recognized and lysed by the immune system—which is in many cases incomplete because of the counteraction by the HPV virus—we hypothesize that several intracellular factors, involved in induction and development of precancerous lesions and/or cervical cancer are being released into the cervicovaginal fluid (CVF). These factors can then be seen as markers for the precancerous state, and when they persist they are indicative for an increased risk for cervical carcinoma. In a previous study, we analyzed the proteomic profiles of six CVF samples from women with different stages of precancerous lesions and compared these with the CVF proteomes from healthy women. Here, we extend these observations by investigating these proteomes by Ingenuity Pathway Analysis (IPA). We show that proteins in CVF from precancerous women are clearly more involved in pathways that make up the ‘hallmarks of cancer’, as compared to CVF proteins from healthy persons. Moreover, after literature search, proteins classified by IPA in the ‘cancer’ category, were more correlated with cervical cancer when they originated from CVF from precancerous women. Many of these proteins formed a network with angiotensin II as central mediator. The search for ‘network biomarkers’, rather than single biomarkers, could drastically increase specificity, sensitivity and prognostic value of cervical cancer diagnosis, making use of an easy to handle fluid, the CVF.
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25
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Louvanto K, Rautava J, Syrjänen K, Grénman S, Syrjänen S. The clearance of oral high-risk human papillomavirus infection is impaired by long-term persistence of cervical human papillomavirus infection. Clin Microbiol Infect 2014; 20:1167-72. [PMID: 24890849 DOI: 10.1111/1469-0691.12700] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/16/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
Abstract
Persistence of high-risk (HR-) human papillomavirus (HPV) infection of the uterine cervix increases the risk of cervical cancer. Oral HPV infections are among potential covariates of long-term genotype-specific persistent cervical HR-HPV infections. It is not known whether this persistence reflects inability of the host to reject HPV infections in general. A case-control setting was designed to estimate the covariates of long-term persistent cervical HR-HPV infections using multivariate generalized estimating equation (GEE) models. HPV was detected with PCR using GP05+/GP06+-primers and genotyped for 24 HPVs with a Multimetrix-kit. The cases (n=43) included women who had genotype-specific persistent cervical HR-HPV infection for at least 24 months (24M+) and controls were women who tested repeatedly HPV-negative in their cervical samples (n=52). These women represent a sub-cohort of the Finnish Family HPV Study. The cases differed significantly from the HPV-negative controls in several aspects: they were younger, had a longer mean time to incident oral HPV infection (40.7 versus 23.6 months), longer duration of oral HPV persistence (38.4 versus 14.1 months), and longer time to clearance of their oral HPV infection (50.0 versus 28.2 months). In multivariate GEE analysis, the second pregnancy during the follow up was the only independent predictor with significant protective effect against 24M+ persistent cervical HR-HPV infections, OR of 0.15 (95% CI 0.07-0.34). To conclude, long-term persistent cervical HR-HPV infections are associated with a prolonged clearance of oral HR-HPV infections while new pregnancy protects against persistent cervical HR-HPV infections.
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Affiliation(s)
- K Louvanto
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada; Medicity Research Laboratory and Department of Oral Pathology, Faculty of Medicine, Institute of Dentistry, University of Turku, Turku, Finland
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26
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Jalil EM, Bastos FI, Melli PPDS, Duarte G, Simoes RT, Yamamoto AY, Morais RAAD, Quintana SM. HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study. BMC Infect Dis 2013; 13:564. [PMID: 24289532 PMCID: PMC4219400 DOI: 10.1186/1471-2334-13-564] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 11/26/2013] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND HPV persistence is a key determinant of cervical carcinogenesis. The influence of postpartum on HPV clearance has been debated. This study aimed to assess HPV clearance in later pregnancy and postpartum among HIV-positive and negative women. METHODS We conducted a follow-up study with 151 HPV-positive women coinfected with HIV, in 2007-2010. After baseline assessment, all women were retested for HPV infection using PCR in later pregnancy and after delivery. Multivariable logistic regressions assessed the putative association of covariates with HPV status in between each one of the successive visits. RESULTS Seventy-one women (47%) have eliminated HPV between the baseline visit and their second or third visits. HIV-positive women took a significantly longer time (7.0 ± 3.8 months) to clear HPV, compared to those not infected by HIV (5.9 ± 3.0 months). HPV clearance was significantly more likely to take place after delivery than during pregnancy (84.5% x 15.5%). CONCLUSIONS Both HIV-positive and negative women presented a significant reduction in HPV infection during the postpartum period. HIV-positive status was found to be associated with a longer period of time to clear HPV infection in pregnant women.
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Affiliation(s)
- Emilia Moreira Jalil
- ICICT/ENSP - Fundação Oswaldo Cruz - FIOCRUZ, Biblioteca de Manguinhos suite 229, Av. Brasil 4365, Rio de Janeiro RJ 21045-900, Brazil
| | - Francisco Inacio Bastos
- ICICT/ENSP - Fundação Oswaldo Cruz - FIOCRUZ, Biblioteca de Manguinhos suite 229, Av. Brasil 4365, Rio de Janeiro RJ 21045-900, Brazil
- CAPES Visiting scholar, Imperial College London, London, UK
| | | | - Geraldo Duarte
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Sao Paulo, Brazil
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Chen AA, Heideman DAM, Boon D, Chen Z, Burk RD, De Vuyst H, Gheit T, Snijders PJF, Tommasino M, Franceschi S, Clifford GM. Human papillomavirus 33 worldwide genetic variation and associated risk of cervical cancer. Virology 2013; 448:356-62. [PMID: 24314666 DOI: 10.1016/j.virol.2013.10.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/04/2013] [Accepted: 10/22/2013] [Indexed: 11/29/2022]
Abstract
Human papillomavirus (HPV) 33, a member of the HPV16-related alpha-9 species group, is found in approximately 5% of cervical cancers worldwide. The current study aimed to characterize the genetic diversity of HPV33 and to explore the association of HPV33 variants with the risk for cervical cancer. Taking advantage of the International Agency for Research on Cancer biobank, we sequenced the entire E6 and E7 open reading frames of 213 HPV33-positive cervical samples from 30 countries. We identified 28 HPV33 variants that formed 5 phylogenetic groups: the previously identified A1, A2, and B (sub)lineages and the novel A3 and C (sub)lineages. The A1 sublineage was strongly over-represented in cervical cases compared to controls in both Africa and Europe. In conclusion, we provide a classification system for HPV33 variants based on the sequence of E6 and E7 and suggest that the association of HPV33 with cervical cancer may differ by variant (sub)lineage.
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Affiliation(s)
- Alyce A Chen
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
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Persistence or clearance of human papillomavirus infections in women in Ouro Preto, Brazil. BIOMED RESEARCH INTERNATIONAL 2013; 2013:578276. [PMID: 24298551 PMCID: PMC3835752 DOI: 10.1155/2013/578276] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 09/06/2013] [Indexed: 11/22/2022]
Abstract
Persistent high-risk (HR) human papillomavirus (HPV) infection is necessary for development of precursor lesions and cervical cancer. We investigate persistence and clearance of HPV infections and cofactors in unvaccinated women. Cervical samples of 569 women (18–75 years), received for routine evaluation in the Health Department of Ouro Preto, Brazil, were collected and subjected to PCR (MY09/11 or GP5+/6+ primers), followed by RFLP or sequencing. All women were interviewed to collect sociodemographic and behavioral information. Viral infection persistence or clearance was reevaluated after 24 months and was observed in 59.6% and 40.4% of women, respectively. HPVs 16, 33, 59, 66, 69, and 83 (HR) were the most persistent types whereas HPVs 31, 45, and 58 were less persistent. Clearance or persistence did not differ between groups infected by HPVs 18, 53, and 67. In low-risk (LR) types, HPV 6 infected samples were associated with clearance, while HPV 11, 61, 72, or 81 infected samples were persistent in the follow-up. No statistically significant association was detected between persistent HPV infections and sociodemographic and behavioral characteristics analyzed. To study persistence or clearance in HPV infection allows the identification of risk groups, cofactors, and strategies for prevention of cervical cancer.
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Rositch AF, Koshiol J, Hudgens MG, Razzaghi H, Backes DM, Pimenta JM, Franco EL, Poole C, Smith JS. Patterns of persistent genital human papillomavirus infection among women worldwide: a literature review and meta-analysis. Int J Cancer 2013; 133:1271-85. [PMID: 22961444 PMCID: PMC3707974 DOI: 10.1002/ijc.27828] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 08/21/2012] [Indexed: 12/14/2022]
Abstract
Persistent high-risk human papillomavirus (HR-HPV) infection is the strongest risk factor for high-grade cervical precancer. We performed a systematic review and meta-analysis of HPV persistence patterns worldwide. Medline and ISI Web of Science were searched through January 1, 2010 for articles estimating HPV persistence or duration of detection. Descriptive and meta-regression techniques were used to summarize variability and the influence of study definitions and characteristics on duration and persistence of cervical HPV infections in women. Among 86 studies providing data on over 100,000 women, 73% defined persistence as HPV positivity at a minimum of two time points. Persistence varied notably across studies and was largely mediated by study region and HPV type, with HPV-16, 31, 33 and 52 being most persistent. Weighted median duration of any-HPV detection was 9.8 months. HR-HPV (9.3 months) persisted longer than low-risk HPV (8.4 months), and HPV-16 (12.4 months) persisted longer than HPV-18 (9.8 months). Among populations of HPV-positive women with normal cytology, the median duration of any-HPV detection was 11.5 and HR-HPV detection was 10.9 months. In conclusion, we estimated that approximately half of HPV infections persist past 6 to 12 months. Repeat HPV testing at 12-month intervals could identify women at increased risk of high-grade cervical precancer due to persistent HPV infections.
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Affiliation(s)
- Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Chen S, Yang Z, Zhang Y, Qiao Y, Cui B, Zhang Y, Kong B. Genomic amplification patterns of human telomerase RNA gene and C-MYC in liquid-based cytological specimens used for the detection of high-grade cervical intraepithelial neoplasia. Diagn Pathol 2012; 7:40. [PMID: 22500694 PMCID: PMC3379933 DOI: 10.1186/1746-1596-7-40] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 04/13/2012] [Indexed: 01/07/2023] Open
Abstract
Background The amplification of oncogenes initiated by high-risk human papillomavirus (HPV) infection is an early event in cervical carcinogenesis and can be used for cervical lesion diagnosis. We measured the genomic amplification rates and the patterns of human telomerase RNA gene (TERC) and C-MYC in the liquid-based cytological specimens to evaluate the diagnostic characteristics for the detection of high-grade cervical lesions. Methods Two hundred and forty-three residual cytological specimens were obtained from outpatients aged 25 to 64 years at Qilu Hospital, Shandong University. The specimens were evaluated by fluorescence in situ hybridization (FISH) using chromosome probes to TERC (3q26) and C-MYC (8q24). All of the patients underwent colposcopic examination and histological evaluation. A Chi-square test was used for categorical data analysis. Results In the normal, cervical intraepithelial neoplasia grade 1 (CIN1), grade 2 (CIN2), grade 3 (CIN3) and squamous cervical cancer (SCC) cases, the TERC positive rates were 9.2%, 17.2%, 76.2%, 100.0% and 100.0%, respectively; the C-MYC positive rates were 20.7%, 31.0%, 71.4%, 81.8% and 100.0%, respectively. The TERC and C-MYC positive rates were higher in the CIN2+ (CIN2, CIN3 and SCC) cases than in the normal and CIN1 cases (p < 0.01). Compared with cytological analysis, the TERC test showed higher sensitivity (90.0% vs. 84.0%) and higher specificity (89.6% vs. 64.3%). The C-MYC test showed lower sensitivity (80.0% vs. 84.0%) and higher specificity (77.7% vs. 64.3%). Using a cut-off value of 5% or more aberrant cells, the TERC test showed the highest combination of sensitivity and specificity. The CIN2+ group showed more high-level TERC gene copy number (GCN) cells than did the normal/CIN1 group (p < 0.05). For C-MYC, no significant difference between the two histological categories was detected (p > 0.05). Conclusions The TERC test is highly sensitive and is therefore suitable for cervical cancer screening. The C-MYC test is not suitable for cancer screening because of its lower sensitivity. The amplification patterns of TERC become more diverse and complex as the severity of cervical diseases increases, whereas for C-MYC, the amplification patterns are similar between the normal/CIN1 and CIN2+ groups. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1308004512669913.
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Affiliation(s)
- Shaomin Chen
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, Shandong 250012, People's Republic of China
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Siegel EM, Patel N, Lu B, Lee JH, Nyitray AG, Craft NE, Frenkel K, Villa LL, Franco EL, Giuliano AR. Biomarkers of oxidant load and type-specific clearance of prevalent oncogenic human papillomavirus infection: markers of immune response? Int J Cancer 2011; 131:219-28. [PMID: 21858808 DOI: 10.1002/ijc.26363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 07/18/2011] [Indexed: 11/11/2022]
Abstract
Human papillomavirus (HPV) infection is the cause of cervical cancer. Increased production of reactive oxygen species (ROS) maybe the common mechanism through which HPV-cofactors (i.e., smoking and inflammation) influence duration of infections. Biomarkers of total oxidant load may serve as cumulative measures of ROS exposure due to these cofactors. Therefore, we conducted a study evaluating the association between biomarkers of oxidant load and duration of HPV infections, early HPV natural history events. Serum samples were obtained from 444 HPV-positive women in the Ludwig-McGill Cohort Study. Anti-5-hydroxymethyl-2'-deoxyuridine autoantibody (anti-HMdU aAb) and malondialdehyde (MDA) were measured at baseline. Cox-proportional hazard models were used to estimate the probability of clearing any HPV, oncogenic HPV, non-oncogenic HPV and HPV-16 infections. Women with elevated MDA were significantly more likely to clear prevalent oncogenic HPV infections compared to those with lower MDA levels (Adjusted Hazard Ratio (AHR) = 2.7; 95%CI = 1.4-5.1). There did not appear to be an association between elevated MDA and clearance of incident oncogenic HPV infections. Similarly, women with elevated anti-HMdU aAb levels had higher rates of prevalent oncogenic HPV infection clearance (Quartile 3:AHR = 2.2; 95%CI = 1.2-4.4; Quartile 4:AHR = 2.4; 95%CI = 1.2-4.9). Higher levels of oxidant load biomarkers were associated with increased clearance of prevalent HPV infections. However, oxidant load biomarkers measured before incident infections were not associated, suggesting that the elevation of MDA and anti-HMdU aAb may reflect an ongoing effective immune response, such as increased innate immunity. More research focused on the immune responses to HPV and elevated markers of oxidant load is needed.
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Affiliation(s)
- Erin M Siegel
- Cancer Epidemiology Program, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL 33612, USA.
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Chlamydia trachomatis and human papillomavirus coinfection: association with p16INK4a and Ki67 expression in biopsies of patients with pre-neoplastic and neoplastic lesions. Braz J Infect Dis 2011; 15:126-31. [PMID: 21503398 DOI: 10.1016/s1413-8670(11)70157-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 12/10/2010] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to identify the frequency of coinfection by human papillomavirus (HPV) and Chlamydia trachomatis (CT) in cervical lesions and relate it with immunohistochemical expression of p16INK4a and Ki67, both oncogenicity markers. A cross-sectional study with 86 women from primary care units in southern Brazil was conducted. Cervical swabs were collected for HPV-DNA and CT-DNA detection, through the polymerase chain reaction technique (PCR). The immunohistochemical analysis was performed on biopsy cervical tissue material to identify the expression of p16INK4a and Ki67 cell cycle markers. About 83 % were positive for HPV-DNA and 19% had coinfection with CT-DNA. Among coinfected women, 56% expressed p16INK4a. There was a statistically significant association between the histological grade of the lesion and Ki67 expression. All high-grade lesions, 50% of low-grade lesions and 31% of negative biopsies expressed Ki67 (p = 0.004). A total of 37% of coinfected women expressed both markers. In conclusion, although more than half of the coinfected patients have expressed p16INK4a and more than one third have expressed both markers, these results suggest no association between those variables. However, other studies involving larger samples are necessary to corroborate such findings.
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Ayres ARG, Silva GAE. Cervical HPV infection in Brazil: systematic review. Rev Saude Publica 2011; 44:963-74. [PMID: 20877926 DOI: 10.1590/s0034-89102010000500023] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 02/22/2010] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To assess the prevalence of human papillomavirus (HPV) infection in women in Brazil. METHODS A systematic literature review was conducted with an active search in PubMed and Virtual Health Library databases using the terms "human papillomavirus," "HPV," "prevalence," and "Brazil". Of 155 articles retrieved, 82 were selected after reading their title and abstract. After a thorough examination, 14 articles were included in the study. RESULTS The 14 articles selected were published between 1989 and 2008 and comprised studies from four Brazilian macroregions (Southeast - 43%; South - 21.4%; Northeast - 21.4%; and North - 7.1%). Nine were cross-sectional studies. Eight articles used polymerase chain reaction and seven used hybrid capture for HPV detection. The study samples ranged from 49 to 2,329 women. The overall prevalence of HPV cervical infection was between 13.7% and 54.3%; and women with cytologically normal results had 10% to 24.5% prevalence of HPV cervical infection. Four articles described the most common HPV types. CONCLUSIONS The cytology techniques available use different classifications leading to different HPV prevalence estimates. However, considering the studies individually according to the detection technique used, the HPV prevalence has increased. HPV16 was the most prevalent type among women, regardless of the cytology result. The concentration of studies in the Southeast region, especially in metropolitan regions, evidences that further investigations are needed to improve information coverage of Brazilian women.
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Affiliation(s)
- Andréia Rodrigues Gonçalves Ayres
- Programa de Pós-graduação em Saúde Coletiva, Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
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Clements AE, Raker CA, Cooper AS, Boardman LA. Prevalence and patient characteristics associated with CIN 3 in adolescents. Am J Obstet Gynecol 2011; 204:128.e1-7. [PMID: 21145032 DOI: 10.1016/j.ajog.2010.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 08/24/2010] [Accepted: 09/15/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We sought to identify patient characteristics associated with cervical intraepithelial neoplasia (CIN) 3 in adolescents. STUDY DESIGN A cross-sectional cohort study was done using a colposcopic database. Data collected included demographic and clinical information as well as cytologic and histologic results. Variables associated with CIN 3 in the univariable analysis (P ≤ .10) were included in a multivariable logistic regression model. RESULTS Of 614 adolescents evaluated, 48 (8%; 95% confidence interval, 6-10%) had CIN 3. No cancers were detected. In the univariable analysis, parity, ≥ 4 lifetime male sexual partners, and a history of sexually transmitted infections were associated with an increased risk of CIN 3. In the final model, only ≥ 4 sexual partners (compared to <4; adjusted odds ratio, 3.66; 95% confidence interval, 1.26-10.61) was significantly associated with the finding of CIN 3. CONCLUSION CIN 3 was infrequently encountered in adolescents, and those with multiple sexual partners were at increased risk for CIN 3.
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Oliveira-Silva M, Lordello CX, Zardo LMG, Bonvicino CR, Moreira MAM. Human Papillomavirus in Brazilian women with and without cervical lesions. Virol J 2011; 8:4. [PMID: 21208414 PMCID: PMC3024957 DOI: 10.1186/1743-422x-8-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 01/05/2011] [Indexed: 11/24/2022] Open
Abstract
Background Human Papillomavirus (HPV) high-risk (HR) types are the causal factor for cervical cancer and premalignant dysplasia. Data on frequency of HPV types provide a basis to design and evaluate HPV prevention programs. Taking into account the heterogeneity of HPV types across and within populations this study aims to access the HPV frequency in Brazilian women. Results We identified 24 different types of HPV, including a Betapapillomavirus and a likely new type, previously reported, from 132 women positive for the virus analysed by Hybrid Capture II assay. These women were infected by a single or multiple HPV types and 142 HPV strains were identified. HR types were found in 75% of women and HPV types 16, 18, 45, 58, and 66 had the highest frequency. Significant differences in frequency of HR HPV types were found for presence of cervical lesions, and for different HPV species and women age. Conclusions Compared with previous studies in Brazil, our data indicated differences in frequency and HPV type diversity, a significant association of other HR-types but HPV16 and 18 and cervical lesions, and a trend for distinct distribution of HPV types by age.
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Genotype-specific clearance of genital human papillomavirus (HPV) infections among mothers in the Finnish family HPV study. J Clin Microbiol 2010; 48:2665-71. [PMID: 20554830 DOI: 10.1128/jcm.00783-10] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The majority of cervical human papillomavirus (HPV) infections in young women are transient, but whether the clearance differs among different HPV genotypes and the different factors predicting genotype-specific clearance are partly unknown. In the Finnish Family HPV Study, 131 of 252 women (mean age, 25.5 years) cleared their infection during the prospective follow-up of 6 years (median, 62.4 months; range, 1.6 to 94.5 months). Cervical scrapings collected at each visit were tested for 24 low-risk and high-risk (HR) HPV types with multiplex HPV genotyping. Poison regression (panel data) was used to estimate predictors for the clearance of species 7 and 9 HPV genotypes. Of all HPV genotypes detected in these women, multiple-type and HPV type 16 (HPV16) infections showed clearance least frequently (46.1% and 50.5%, respectively). The actuarial and crude mean times to first clearance were variable among different genotypes. The actuarial clearance rate (events/person-time at risk) was highest for HPV16 and multiple-type infections, while HPV66 and -82 had the highest crude clearance rate. Independent predictors increasing type-specific clearance of species 7/9 HPV genotypes were older age (incidence rate ratio [IRR] = 1.1; 95% confidence interval [95% CI], 1.03 to 1.18; P = 0.002) and baseline oral HR HPV DNA-negative status (IRR = 2.94; 95% CI, 1.03 to 8.36; P = 0.042), while a higher number of sexual partners during the follow-up decreased the probability of clearance (IIR = 0.35; 95% CI, 0.15 to 0.83; P = 0.018). To conclude, HPV16 and multiple-type infections showed the lowest clearance among young mothers. Increasing age and negative oral HR HPV DNA status at baseline were associated with increased clearance, whereas a higher number of current sexual partners decreased the probability of species 7/9 HPV genotype clearance.
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