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Krankowska D, Mazzitelli M, Ucak HA, Orviz E, Karakoc HN, Mortimer H, Aebi-Popp K, Gilleece Y. Screening and prevention of HPV-related anogenital cancers in women living with HIV in Europe: Results from a systematic review. HIV Med 2024; 25:769-793. [PMID: 38238990 DOI: 10.1111/hiv.13602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/02/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Women living with HIV (WLWH) are at increased risk of human papillomavirus (HPV)-related cancers. Throughout Europe, there is great heterogeneity among guidelines for screening programmes, access to HPV testing and HPV vaccination. The aim of this systematic review is to summarize available data on screening and prevention measures for HPV-related anogenital cancers in WLWH across the WHO European Region (WER). METHODS The systematic review followed the PRISMA guidelines and was registered on Prospero. PubMed, Embase and Web of Science databases were searched to identify available studies, written in English and published between 2011 and 2022. A metanalysis was conducted using random-effects models to calculate pooled prevalence of HPV. Subgroup analyses were conducted according to country and HPV testing. RESULTS Thirty-four articles involving 10 336 WLWH met the inclusion criteria. Studies were heterogenous in their methodology and presentation of results: 73.5% of studies focused on cervical cancer prevention, and only 4.4% on anal cancer; 76.5% of studies conducted HPV testing as a routine part of screening. The prevalence of high-risk HPV was 30.5-33.9% depending on the detection method used. A total of 77% of WLWH had cervical cytology results reported. Six studies reported the positive association of CD4 cell count <200 cells/μL with HPV prevalence and cervical abnormalities. Anal HPV testing was conducted in <8% of participants. HPV vaccination was completed in 5.6% of women (106/1902) with known vaccination status. There was no information about the vaccination status of the majority of women in the analysed studies (8434/10336). CONCLUSION Data about screening of HPV-related anogenital cancer in WLWH in Europe are heterogenous and lacking, especially in relation to anal cancer. HPV DNA testing is not routinely done as part of screening for HPV-related cancer; guidelines should include indications for when to use this test. Low CD4 count is a risk factor for HPV infection and cytological abnormalities. HPV vaccination data are poor and, when available, vaccination rates are very low among WLWH in Europe. This review concludes that significant improvements are required for data and also consistency on guidelines for HPV screening, prevention and vaccination in WLWH.
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Affiliation(s)
- Dagny Krankowska
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warszawa, Poland
- Hospital for Infectious Diseases in Warsaw, Warsaw, Poland
| | - Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
| | | | - Eva Orviz
- Centro Sanitario Sandoval, Hospital Clinico San Carlos, IdlSSC, Madrid, Spain
| | | | - Harriet Mortimer
- Brighton & Sussex Medical School and University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom
| | - Karoline Aebi-Popp
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Obstetrics and Gynecology, Lindenhofspital, Bern, Switzerland
| | - Yvonne Gilleece
- Brighton & Sussex Medical School and University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom
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2
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Aziz H, Sattar AA, Mahmood H, Fatima S, Khurshid M, Faheem M. Prevalence of HPV types in HIV-positive and negative females with normal cervical cytology or dysplasia. J Clin Lab Anal 2023; 37:e24851. [PMID: 36807631 PMCID: PMC10020845 DOI: 10.1002/jcla.24851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/10/2023] [Accepted: 02/05/2023] [Indexed: 02/19/2023] Open
Abstract
The burden of HPV varies by country and HIV status. The study aimed to evaluate HPV types prevalent in HIV-positive females compared with HIV-negative females in the local population of the federal capital territory in Pakistan. METHOD The selected female population consisted of 65 already diagnosed HIV-positive females and 135 HIV-negative females. Cervical scrap was collected and analyzed for HPV and cytology. RESULTS The prevalence of HPV in HIV-positive patients was 36.9%, higher than HIV-negative patients (4.4%). 12.30% had cervical cytology interpreted as "LSIL" and 87.69% had cytology interpreted as "NIL." The high-risk type was detected in 15.39% while 21.54% showed low-risk HPV types. Among the high-risk types, HPV18 (6.15%), HPV16 (4.62%), HPV45 (3.07%), HPV33 (1.53%), HPV58 (3.07%), and HPV68 (1.53%) were found. In patients with LSIL, high-risk HPV accounts for 62.5%. Risk factors, such as age, marital status, educational status, residence, parity, other STDs, and contraceptives, were analyzed to find the correlation with HPV infection Age ≤35 years (OR 1.21, 95% CI, 0.44-3.34), illiterate and incomplete secondary education (OR 1.08, 95% CI, 0.37-3.15), and those reported not to use contraceptives (OR: 1.90; 95% CI: 0.67-5.42) have an association for increased risk of HPV infection. CONCLUSION HPV18, HPV16, HPV58, HPV45, HPV68, and HPV33 were identified among high-risk HPV types. High-risk HPV was detected in 62.5% of low-grade squamous intraepithelial lesions. The data is useful for health policymakers to develop a strategy for HPV screening and prophylactic vaccination to prevent cervical cancer.
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Affiliation(s)
- Hafsa Aziz
- Nuclear Medicine, Oncology and Radiotherapy InstituteIslamabadPakistan
| | | | - Humera Mahmood
- Nuclear Medicine, Oncology and Radiotherapy InstituteIslamabadPakistan
| | - Shazia Fatima
- Nuclear Medicine, Oncology and Radiotherapy InstituteIslamabadPakistan
| | - Mona Khurshid
- Pakistan Institute of Medical SciencesIslamabadPakistan
| | - Mohammad Faheem
- Nuclear Medicine, Oncology and Radiotherapy InstituteIslamabadPakistan
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3
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Onohuean H, Aigbogun EO, Igere BE. Meta-synthesis and science mapping analysis of HIV/HPV co-infection: a global perspective with emphasis on Africa. Global Health 2022; 18:36. [PMID: 35331267 PMCID: PMC8943940 DOI: 10.1186/s12992-022-00812-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background Viral infections are emerging with diverse clinical relevance both in endemic environments and non-endemic regions of the world. Some of the viruses cause co-infections that are of public health importance. The progress of studies on human immunodeficiency virus / Human papillomavirus (HIV/HPV) co-infection is not well documented especially in Africa where cases are endemic. Method Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a global three-decade meta-synthesis and science mapping analysis on HIV/HPV co-infections. Assessment of progress, Author/Country productivity/trends, topic conceptual framework, and international collaborative networks were analyzed. Results We recovered 196 documents of 115 sources from the web of science database. The meta-synthesis revealed 1203 prolific authors containing nine solo authors, an annual growth rate of 8.09%, a significant average citation per article of 20.7%, and an average citation per year per document of 2.1. A significant high correlation between the mean/TC per article and the mean total citation (TC) per year showed 80.98% of the articles produced between 2005 and 2007 on HPV/HIV co-infection. The co-author per document index were 7.0 and the collaboration index was 6.4. The meta-analysis also revealed inadequate funding from individual or governmental organizations; among the 196 documents dataset, 114 (58.2%) were funded, and only 31 (15.8%) were funded in Africa where HIV/HPV co-infection cases are endemic. Conclusions Authors’ collaboration network, countries’ collaboration, authors’ citations and implementation of research-based finding in previous studies are yet to receive the relevant outcome, especially as various countries in the African continent have received poor funding with a repeated reporting of co-infection associated with HIV/HPV. African needs to re-awaken and stir up research-based interest in HPV/HIV co-infection studies to resolve indigenous public health concerns associated with the viral endemicity.
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Affiliation(s)
- Hope Onohuean
- Biopharmaceutics Unit, Pharmacology and Toxicology, School of Pharmacy, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda. .,Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.
| | - Eric O Aigbogun
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Department of Human Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda
| | - Bright E Igere
- Department of Microbiology and Biotechnology, Western Delta University Oghara, Oghara, Delta State, Nigeria
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4
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Castle PE, Einstein MH, Sahasrabuddhe VV. Cervical cancer prevention and control in women living with human immunodeficiency virus. CA Cancer J Clin 2021; 71:505-526. [PMID: 34499351 PMCID: PMC10054840 DOI: 10.3322/caac.21696] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 12/16/2022] Open
Abstract
Despite being highly preventable, cervical cancer is the fourth most common cancer and cause of cancer death in women globally. In low-income countries, cervical cancer is often the leading cause of cancer-related morbidity and mortality. Women living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome are at a particularly high risk of cervical cancer because of an impaired immune response to human papillomavirus, the obligate cause of virtually all cervical cancers. Globally, approximately 1 in 20 cervical cancers is attributable to HIV; in sub-Saharan Africa, approximately 1 in 5 cervical cancers is due to HIV. Here, the authors provide a critical appraisal of the evidence to date on the impact of HIV disease on cervical cancer risk, describe key methodologic issues, and frame the key outstanding research questions, especially as they apply to ongoing global efforts for prevention and control of cervical cancer. Expanded efforts to integrate HIV care with cervical cancer prevention and control, and vice versa, could assist the global effort to eliminate cervical cancer as a public health problem.
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Affiliation(s)
- Philip E Castle
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Mark H Einstein
- Department of Obstetrics, Gynecology, and Reproductive Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Vikrant V Sahasrabuddhe
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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5
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Sias C, Guarrasi V, Minosse C, Lapa D, Nonno FD, Capobianchi MR, Garbuglia AR, Del Porto P, Paci P. Human Papillomavirus Infections in Cervical Samples From HIV-Positive Women: Evaluation of the Presence of the Nonavalent HPV Genotypes and Genetic Diversity. Front Microbiol 2020; 11:603657. [PMID: 33324386 PMCID: PMC7723855 DOI: 10.3389/fmicb.2020.603657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/03/2020] [Indexed: 12/21/2022] Open
Abstract
Non-nonavalent vaccine (9v) Human papillomavirus (HPV) types have been shown to have high prevalence among HIV-positive women. Here, 1444 cervical samples were tested for HPV DNA positivity. Co-infections of the 9v HPV types with other HPV types were evaluated. The HPV81 L1 and L2 genes were used to investigate the genetic variability of antigenic epitopes. HPV-positive samples were genotyped using the HPVCLART2 assay. The L1 and L2 protein sequences were analyzed using a self-optimized prediction method to predict their secondary structure. Co-occurrence probabilities of the 9v HPV types were calculated. Non9v types represented 49% of the HPV infections; 31.2% of the non9v HPV types were among the low-grade squamous intraepithelial lesion samples, and 27.3% among the high-grade squamous intraepithelial lesion samples, and several genotypes were low risk. The co-occurrence of 9v HPV types with the other genotypes was not correlated with the filogenetic distance. HPV81 showed an amino-acid substitution within the BC loop (N75Q) and the FGb loop (T315N). In the L2 protein, all of the mutations were located outside antigenic sites. The weak cross-protection of the 9v types suggests the relevance of a sustainable and effective screening program, which should be implemented by HPV DNA testing that does not include only high-risk types.
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Affiliation(s)
- Catia Sias
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Valerio Guarrasi
- Dipartimento di Ingegneria Informatica, Automatica e Gestionale “A. Ruberti”, Sapienza Università di Roma, Rome, Italy
| | - Claudia Minosse
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Daniele Lapa
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Franca Del Nonno
- Laboratory of Pathology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Anna Rosa Garbuglia
- Laboratory of Virology, Lazzaro Spallanzani National Institute for Infectious Diseases, IRCCS, Rome, Italy,*Correspondence: Anna Rosa Garbuglia,
| | - Paola Del Porto
- Department of Biology and Biotechnology “C. Darwin”, Sapienza University, Rome, Italy
| | - Paola Paci
- Dipartimento di Ingegneria Informatica, Automatica e Gestionale “A. Ruberti”, Sapienza Università di Roma, Rome, Italy
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Yakub MM, Fowotade A, Anaedobe CG, Manga MM, Bakare RA, Abimiku BA. Human papillomavirus correlates of high grade cervical dysplasia among HIV-Infected women at a major treatment centre in Nigeria: a cross-sectional study. Pan Afr Med J 2019; 33:125. [PMID: 31558924 PMCID: PMC6754827 DOI: 10.11604/pamj.2019.33.125.17589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 01/28/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction Persistent high-risk HPV (hrHPV) infection is higher among women living with HIV/AIDS thus increasing their risk for cervical cancer. We evaluated the virological and immunological correlates of cervical dysplasia in HIV-infected women. Methods A cohort of 220 consenting women attending the antiretroviral clinic of the Federal Medical Centre, Keffi, Nigeria was tested for cervical human papilloma virus (HPV) infection using PCR. The prevalent HPV genotypes were determined by DNA sequencing. CD4+T count and type specific HPV was correlated with cervical cytology. Descriptive and inferential statistical analysis of the data was done using the statistical package for social sciences (SPSS) version 20 (SPSS Inc, Illinois, USA) for analysis after validation. Results Overall HPV prevalence was 54.1% while the hrHPV prevalence was 35.9%. Premalignant and malignant lesions were observed among participants with CD4+T counts between 200-300/mm3. A statistically significant association was observed between cervical premalignant lesions and CD4+ count (X2=24.747, P value=0.001) as well as hrHPV infections (X2=46.800, P<0.001). Conclusion Risk stratification with HPV screening among HIV-infected women will help in early case management of cervical precancerous lesions.
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Affiliation(s)
- Martin Maimako Yakub
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology, Federal Medical Centre, Nassarawa, Keffi, Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chinenye Gloria Anaedobe
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology, Gwagwalada Teaching Hospital, Abuja, Nigeria
| | - Mohammed Mohammed Manga
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology and Immunology, Federal Teaching Hospital Gombe, Gombe State, Nigeria
| | - Rasheed Ajani Bakare
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bawa Ahmed Abimiku
- Department of Histopathology and Forensic Medicine, Gwagwalada Teaching Hospital, Abuja, Nigeria
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7
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Siqueira JD, Curty G, Xutao D, Hofer CB, Machado ES, Seuánez HN, Soares MA, Delwart E, Soares EA. Composite Analysis of the Virome and Bacteriome of HIV/HPV Co-Infected Women Reveals Proxies for Immunodeficiency. Viruses 2019; 11:v11050422. [PMID: 31067713 PMCID: PMC6563245 DOI: 10.3390/v11050422] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/26/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023] Open
Abstract
The human cervical microbiome is complex, and its role in health and disease has just begun to be elucidated. In this study, 57 cervical swab samples from 19 HIV/HPV co-infected women were analyzed for both virome and bacteriome composition. Virome analysis focused on circular DNA viruses through rolling circle amplification followed by next-generation sequencing (NGS). Data were assigned to virus families and genera, and HPV types were identified. NGS data of bacterial 16S from a subset of 24 samples were assigned to operational taxonomic units and classified according to vaginal microbiome community state types (CSTs). Four viral families were found: Papillomaviridae, Anelloviridae, Genomoviridae, and Herpesviridae. Papillomavirus reads were more abundant in women with premalignant cervical lesions, which were also strongly associated with multiple (≥3) high-risk HPV infection. Anellovirus read abundance was negatively correlated with host CD4+ T-cell counts. The bacteriome revealed the presence of CST III and CST IV, and women with ≥1% frequency of genomovirus or herpesvirus reads displayed an increased risk of carrying CST IV. By characterizing the composition of the cervical circular DNA viruses and the bacteriome of HIV/HPV co-infected women, we identified putative interactions between these two microorganism communities and their associations with patients’ clinical characteristics, notably immunodeficiency status.
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Affiliation(s)
- Juliana D Siqueira
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.
| | - Gislaine Curty
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.
| | - Deng Xutao
- Vitalant Research Institute, San Francisco, CA 94118, USA.
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94143, USA.
| | - Cristina B Hofer
- Instituto de Ginecologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro 20211-340, Brazil.
| | - Elizabeth S Machado
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-912, Brazil.
| | - Héctor N Seuánez
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21944-970, Brazil.
| | - Marcelo A Soares
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21944-970, Brazil.
| | - Eric Delwart
- Vitalant Research Institute, San Francisco, CA 94118, USA.
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94143, USA.
| | - Esmeralda A Soares
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro 20231-050, Brazil.
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8
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Sias C, Salichos L, Lapa D, Del Nonno F, Baiocchini A, Capobianchi MR, Garbuglia AR. Alpha, Beta, gamma human PapillomaViruses (HPV) detection with a different sets of primers in oropharyngeal swabs, anal and cervical samples. Virol J 2019; 16:27. [PMID: 30832688 PMCID: PMC6398256 DOI: 10.1186/s12985-019-1132-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/15/2019] [Indexed: 02/05/2023] Open
Abstract
Background Recent studies have shown a 13-fold increase of oropharyngeal cancer in the presence of HPV, while α-HPV detection seems to be rare in oral cavity in comparison to anal or cervical district, many novel β and γ types have been isolated in this anatomical site suggesting a wide tropism range. Currently, there are no guidelines recommending HPV oral cavity screening as a mandatory test, and it remains unknown which HPV types should be included in HPV screening programs. Our goal was to assess HPV prevalence in oropharyngeal, anal, and cervical swabs using different sets of primers,which are able to amplify α, β, γ HPV types. Methods We analysed the presence of HPV DNA in oropharyngeal (n = 124), anal (n = 186), cervical specimens (n = 43) from HIV positive and negative patients using FAP59/64 and MY09/11 primers. All untyped strains were genetically characterized through PCR amplification and direct sequencing of partial L1 region, and the resulting sequences were classified through phylogenetic analysis. Results HPV prevalence was 20.9% in 124 oropharyngeal swab samples, including infections with multiple HPV types (5.6%). HPV prevalence in this anatomical site was significantly associated with serostatus: 63.3%in HIV positive and 36.3% in HIV negative patients (p < 0.05). Unclassified types were detected in 6 specimens. In our analysis, we did not observe any difference in HPV (α, β, γ) prevalence between men and women. Overall, β species were the most frequently detected 69.7%. When using anal swabs, for HIV positive patients, β genus prevalence was 1% and γ genus was 3.7% including 6 unclassified types. In cervical samples from 43 HIV positive women (18 HPV negative and 25 positive by MY09/11 PCR), only one sample was positivite for β1 species (2.4%) using FAP primers. Six of the untyped strains clustered with sequences from species 7, 9, 10, 8,12 of γ genus. Four sequences remained unclassified. Finally, β and γ HPV prevalence was significantly lower than their respective HPV prevalence as identified by the Luminex system in all anatomical sites that were analyzed in previous studies. Conclusion This study provides new information about viral isolates present in oropharyngeal site and it will contribute to improve the monitoring of HPV infection. Electronic supplementary material The online version of this article (10.1186/s12985-019-1132-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catia Sias
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Via Portuense, 292, 00149, Rome, Italy
| | - Leonidas Salichos
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, 06520, USA
| | - Daniele Lapa
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Via Portuense, 292, 00149, Rome, Italy
| | - Franca Del Nonno
- Laboratory of Pathology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Andrea Baiocchini
- Laboratory of Pathology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Via Portuense, 292, 00149, Rome, Italy
| | - Anna Rosa Garbuglia
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Via Portuense, 292, 00149, Rome, Italy.
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9
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Medeiros FS, Martins AES, Gomes RG, de Oliveira SAV, Welkovic S, Maruza M, Menezes MLB, Ximenes RADA, Diniz GTN, Donadi EA, Lucena-Silva N. Variation sites at the HLA-G 3' untranslated region confer differential susceptibility to HIV/HPV co-infection and aneuploidy in cervical cell. PLoS One 2018; 13:e0204679. [PMID: 30278059 PMCID: PMC6168131 DOI: 10.1371/journal.pone.0204679] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 09/12/2018] [Indexed: 01/17/2023] Open
Abstract
Post-transcriptional regulatory elements associated with transcript degradation or transcript instability have been described at the 3' untranslated region (3'UTR) of the HLA-G gene. Considering that HPV infection and aneuploidy, which causes gene instability, are associated with cervical cell malignancy, as well as the fact that HIV infection and HLA-G may modulate the immune response, the present study aimed to compare the frequencies of HLA-G 3'UTR polymorphic sites (14-base pair insertion/deletion, +3142C/G, and +3187A/G) between 226 HIV+ women co-infected (n = 82) or not with HPV (n = 144) and 138 healthy women. We also evaluated the relationship between those HLA-G 3'UTR variants and aneuploidy in cervical cells. HPV types and HLA-G polymorphisms were determined by PCR and sequencing of cervical samples DNA. Aneuploidy in cervical cell was measured by flow cytometry. The HLA-G 3'UTR 14-bp ins/del was not associated with either HIV nor HIV/HPV co-infection. The +3142G allele (p = 0.049) and +3142GG genotype (p = 0.047) were overrepresented in all HIV-infected women. On the other hand, the +3187G allele (p = 0.028) and the +3187GG genotype (p = 0.026) predominated among healthy women. The +3142G (p = 0.023) and +3187A (p = 0.003) alleles were associated with predisposition to HIV infection, irrespective of the presence or not of HIV/HPV co-infection. The diplotype formed by the combination of the +3142CX (CC or CG) and +3187AA genotype conferred the highest risk for aneuploidy in cervical cell induced by HPV. The HLA-G 3'UTR +3142 and +3187 variants conferred distinct susceptibility to HIV infection and aneuploidy.
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Affiliation(s)
- Fernanda Silva Medeiros
- Department of Immunology, Laboratory of Immunogenetics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Albert Eduardo Silva Martins
- Department of Immunology, Laboratory of Immunogenetics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Renan Garcia Gomes
- Department of Immunology, Laboratory of Immunogenetics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | | | - Stefan Welkovic
- Integrated Health Centre Amaury de Medeiros (CISAM), University of Pernambuco, Recife, Brazil
| | - Magda Maruza
- Hospital Correia Picanço, Health Secretariat of Pernambuco, Recife, Brazil
| | - Maria Luiza Bezerra Menezes
- Maternal and Child Department of the Faculty of Medical Sciences—University of Pernambuco (UPE), Recife, Brazil
| | | | - George Tadeu Nunes Diniz
- Department of Public Health, Laboratory Computational Methods, Aggeu Magalhães Institute, Recife, Brazil
| | - Eduardo Antônio Donadi
- Department of Medicine, School of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Norma Lucena-Silva
- Department of Immunology, Laboratory of Immunogenetics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil
- Pediatric Oncology Service, IMIP Hospital, Recife, Brazil
- * E-mail:
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10
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Camargo M, Del Río-Ospina L, Soto-De León SC, Sánchez R, Pineda-Peña AC, Sussmann O, Patarroyo ME, Patarroyo MA. Association of HIV status with infection by multiple HPV types. Trop Med Int Health 2018; 23:1259-1268. [PMID: 30133078 DOI: 10.1111/tmi.13142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To identify the clinical and demographic characteristics of HIV-positive and HIV-negative women infected by multiple HPV types. METHODS 1399 women participated in the study (240 HIV-positive and 1159 HIV-negative women). Samples were provided for Pap tests and for HPV detection and typing by PCR. Data were collected on HPV infection, frequency of multiple infection, and HPV type distribution. Odds ratios were reported from logistic regression models. RESULTS Compared with HIV-negative women, HIV-positive women had higher frequencies of cervical abnormality (30% vs. 20.8%), higher HPV prevalence (68.3% vs. 51.3%) and were more commonly infected with multiple HPV types (78.7% vs. 44.3%). HPV-16 was the most common type detected in the study population, with other types showing variable associations with HIV status. Positive associations were observed between infection by multiple HPV types and HIV status, cervical abnormality and having had more than three pregnancies. The odds of multiple infection by HPV types were higher in HIV-positive women who used an intrauterine device, who had a history of abortions and who had HIV viral loads >100 000 copies/ml, whilst the odds were lower in women with >500 CD4 cells/mm3 . CONCLUSIONS HIV immunosuppression favours infection by multiple high-risk HPV types, mainly in women affected by low-grade squamous intraepithelial lesions. Antiretroviral therapy had no effect on infection by multiple HPV types. Risk factors related to progressive damage to the cervix were positively associated with infection by multiple HPV types in women living with HIV.
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Affiliation(s)
- Milena Camargo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Bogotá DC, Colombia.,PhD Program in Biomedical and Biological Sciences, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá DC, Colombia
| | - Luisa Del Río-Ospina
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Bogotá DC, Colombia
| | - Sara Cecilia Soto-De León
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Bogotá DC, Colombia.,Universidad de Ciencias Aplicadas y Ambientales, Bogotá DC, Colombia
| | - Ricardo Sánchez
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Bogotá DC, Colombia.,Medical School, Universidad Nacional de Colombia, Bogotá DC, Colombia
| | - Andrea Clemencia Pineda-Peña
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Bogotá DC, Colombia
| | - Otto Sussmann
- Asistencia Científica de Alta Complejidad S.A.S., Bogotá DC, Colombia
| | - Manuel Elkin Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Bogotá DC, Colombia.,Medical School, Universidad Nacional de Colombia, Bogotá DC, Colombia
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia, Bogotá DC, Colombia.,Basic Sciences Department, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá DC, Colombia
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11
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Annunziata C, Stellato G, Greggi S, Sanna V, Curcio MP, Losito S, Botti G, Buonaguro L, Buonaguro FM, Tornesello ML. Prevalence of "unclassified" HPV genotypes among women with abnormal cytology. Infect Agent Cancer 2018; 13:26. [PMID: 30061920 PMCID: PMC6056927 DOI: 10.1186/s13027-018-0199-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/13/2018] [Indexed: 12/16/2022] Open
Abstract
Background High risk human papillomaviruses (HPVs) have been unequivocally recognised as the necessary cause of squamous intraepithelial lesions (SIL) and invasive carcinoma of the cervix. The distribution and the role of unclassified risk HPV genotypes in cervical neoplasia has not been fully elucidated. Methods Liquid-based cytological samples were collected from 337 women referred for colposcopy following an abnormal cytological diagnosis. HPV DNA was detected by broad-spectrum PCR and genotypes identified by nucleotide sequencing analysis and reverse line blot (RLB). Results The overall frequency of HPV infection was 36.5% (35 out of 96) in samples negative for intraepithelial lesions or malignancy (NILM), 80% (181 out of 226) in low grade SIL and 93.3% (14 out of 15) in high grade SIL (P < 0.001). Thirty-five different genotypes were identified among the 230 HPV-positive cases. The Group 1 oncogenic viruses (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59) were found in 21.9, 46.5, and 86.7% of NILM, low grade SIL and high grade SIL, respectively. The Group 2A, including the probably oncogenic virus HPV68, was found in 1 and 0.8% of NILM and low grade SIL, respectively. The Group 2b possibly oncogenic HPVs (HPV34, 53, 66, 67, 70, 73, 82 and 85) were found in 4.2, 21.7 and 26.7% of NILM, low grade SIL and high grade SIL, respectively. The unclassified viruses (HPV12, 42, 54, 55, 61, 62, 81, 83, 84, 89, 90, 91) were detected in 8.3 and 14.6% of NILM and low grade SIL, respectively, and never in high grade SIL. Conclusions Group 1 HPVs were mainly prevalent in high grade SIL and low grade SIL while Group 2B were equally distributed among the two groups. The dominant frequency of unclassified HPVs in low grade SIL and NILM and their rarity in high grade SIL suggests their marginal role in cervical neoplasia of the studied population.
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Affiliation(s)
- Clorinda Annunziata
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
| | - Giovanni Stellato
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Stefano Greggi
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Veronica Sanna
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Maria Pia Curcio
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Simona Losito
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Gerardo Botti
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Luigi Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
| | - Franco Maria Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
| | - Maria Lina Tornesello
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
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12
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Badial RM, Dias MC, Stuqui B, Melli PPDS, Quintana SM, do Bonfim CM, Cordeiro JA, Rabachini T, Calmon MDF, Provazzi PJS, Rahal P. Detection and genotyping of human papillomavirus (HPV) in HIV-infected women and its relationship with HPV/HIV co-infection. Medicine (Baltimore) 2018; 97:e9545. [PMID: 29620669 PMCID: PMC5902291 DOI: 10.1097/md.0000000000009545] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
HPV have been identified as high-risk and low-risk, depending on their association with the development of cancer. HPV infections can be facilitated by co-infection with HIV. Here, we investigated HPV prevalence and genotypes and the risk factors affecting HPV/HIV co-infection. Forty HIV-positive patients had 80 cervical swab samples collected in 2 consecutive years. Polymerase chain reaction and DNA direct sequencing were used to perform HPV genotyping. Statistical analyses were performed regarding risk factors for HPV/HIV co-infection and the occurrence of cervical lesions. HPV DNA was detected in 59 samples (73.75%), and high-risk HPVs were predominant (59.3%). The most prevalent type was HPV56 (17%), followed by HPV16 (15.3%). Patient age did not affect the risk of cervical cancer (P = .84) or HPV prevalence in different years (P = .25/P = .63). CD4 count also did not affect the risk for cervical lesions in the tested samples (P = .15/P = .28). Although the HIV viral load was not correlated with an increase in cervical lesion detection in the first group of analyzed samples (P = .12), it did affect cervical cancer risk in the group of samples analyzed in the following year (P = .045). HIV-infected patients presented a high prevalence of HPV co-infection, and HPV16 and HPV56 were the most prevalent genotypes. Considering this, it is possible that immunodeficiency can contribute to increased susceptibility to HPV56 infection in HIV-infected patients. The association between HIV viral load and the lesions also confirmed the importance of monitoring HIV/HPV co-infected patients with high HIV viral loads.
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Affiliation(s)
| | - Marina Carrara Dias
- Department of Biology, São Paulo State University – UNESP, São José do Rio Preto/SP
| | - Bruna Stuqui
- Department of Biology, São Paulo State University – UNESP, São José do Rio Preto/SP
| | | | - Silvana Maria Quintana
- Department of Gynecology and Obstetrics, Medical School of Ribeirão Preto, University of São Paulo – USP
| | | | - José Antônio Cordeiro
- Department of Epidemiology and Public Health, Faculty of Medicine of São José do Rio Preto – FAMERP, São José do Rio Preto/SP, Brazil
| | | | | | | | - Paula Rahal
- Department of Biology, São Paulo State University – UNESP, São José do Rio Preto/SP
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13
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Vergori A, Garbuglia AR, Piselli P, Del Nonno F, Sias C, Lupi F, Lapa D, Baiocchini A, Cimaglia C, Gentile M, Antinori A, Capobianchi M, Ammassari A. Oral human Papillomavirus DNA detection in HIV-positive men: prevalence, predictors, and co-occurrence at anal site. BMC Infect Dis 2018; 18:25. [PMID: 29310590 PMCID: PMC5759194 DOI: 10.1186/s12879-017-2937-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 12/21/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND HIV-positive patients carry an increased risk of HPV infection and associated cancers. Therefore, prevalence and patterns of HPV infection at different anatomical sites, as well as theoretical protection of nonavalent vaccine should be investigated. Aim was to describe prevalence and predictors of oral HPV detection in HIV-positive men, with attention to nonavalent vaccine-targeted HPV types. Further, co-occurrence of HPV DNA at oral cavity and at anal site was assessed. METHODS This cross-sectional, clinic-based study included 305 HIV-positive males (85.9% MSM; median age 44.7 years; IQR: 37.4-51.0), consecutively observed within an anal cancer screening program, after written informed consent. Indication for anal screening was given by the HIV physician during routine clinic visit. Paired oral rinse and anal samples were processed for the all HPV genotypes with QIASYMPHONY and a PCR with MY09/MY11 primers for the L1 region. RESULTS At the oral cavity, HPV DNA was detected in 64 patients (20.9%), and in 28.1% of these cases multiple HPV infections were found. Prevalence of oral HPV was significantly lower than that observed at the anal site (p < 0.001), where HPV DNA was found in 199 cases (85.2%). Oral HPV tended to be more frequent in patients with detectable anal HPV than in those without (p = 0.08). Out of 265 HPV DNA-positive men regardless anatomic site, 59 cases (19.3%) had detectable HPV at both sites, and 51 of these showed completely different HPV types. At least one nonavalent vaccine-targeted HPV type was found in 17/64 (26.6%) of patients with oral and 199/260 (76.5%) with anal infection. At multivariable analysis, factors associated with positive oral HPV were: CD4 cells <200/μL (versus CD4 cells >200/μL, p = 0.005) and >5 sexual partners in the previous 12 months (versus 0-1 partner, p = 0.008). CONCLUSIONS In this study on Italian HIV-positive men (predominantly MSM), oral HPV DNA was detected in approximately one fifth of tested subjects, but prevalence was significantly lower than that observed at anal site. Low CD4 cell count and increasing number of recent sexual partners significantly increased the odds of positive oral HPV. The absence of co-occurrence at the two anatomical sites may suggest different routes or timing of infection.
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Affiliation(s)
| | - Anna Rosa Garbuglia
- Laboratory of Virology, INMI "L.Spallanzani", Rome, Italy. .,National Institute for Infectious Diseases, IRCCS L.Spallanzani, Via Portuense, 292, 00149, Rome, Italy.
| | | | - Franca Del Nonno
- Laboratory of Pathology, INMI "L.Spallanzani", Rome, Italy.,National Institute for Infectious Diseases, IRCCS L.Spallanzani, Via Portuense, 292, 00149, Rome, Italy
| | - Catia Sias
- Laboratory of Virology, INMI "L.Spallanzani", Rome, Italy
| | | | - Daniele Lapa
- Laboratory of Virology, INMI "L.Spallanzani", Rome, Italy
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14
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ORLANDO G, BIANCHI S, FASOLO M, MAZZA F, FRATI E, RIZZARDINI G, MATTEELLI A, ZANCHETTA N, AMENDOLA A, TANZI E. Cervical Human Papillomavirus genotypes in HIV-infected women: a cross-sectional analysis of the VALHIDATE study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2017; 58:E259-E265. [PMID: 29707656 PMCID: PMC5912788 DOI: 10.15167/2421-4248/jpmh2017.58.4.804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/19/2017] [Indexed: 11/24/2022]
Abstract
Introduction Primary-prevention by prophylactic vaccination against HPV-related cancers and HPV-based screening programs are based on HPV-type distribution in immunocompetent individuals. HIV-infected women are at high risk of invasive HPV-disease sustained by a broader range of HPV-types and have higher multi-type infection rates than immunocompetent hosts. Methods This is a cross-sectional analysis of High Risk HPV (HR HPV) type distribution in 805 HIV+ women (HIW) compared with a control group of 1402 immunocompetent HIV- women (SPW) enrolled in the VALHIDATE study in order to define HPV type-specific distribution according to cytology. Results HIW had a 3.8, 3.6, and 2.7 times higher risk of atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL) than SPW respectively. HPV-DNA prevalence was 28.4% in HIW and 11.81% in SPW (p<0.0001). The prevalence of infection increased from normal cytology to HSIL both in HIW (from 21.45% to 90.91%) and SPW (from 9.54% to 75%). The OR for women with normal cytology of having a positive HPV-DNA test result of was 2.6 times higher in HIW than in SPW. The cumulative prevalence of HPV-16/18 in HSIL is much lower in HIW (36.4±28.4) than SPW (62.5±33.5). Conclusions A higher prevalence of infection and broader HPV type distribution were observed in HIV+ women compared to the general population. More than 60% of HSIL lesions of HIW patients are caused by single or multi-type infections from non-HPV16/18 HPVs. The potential 9v-HPV vaccine coverage could be even higher than that expected for the general population given the wide panel of HPV-types observed in the HSIL of HIV+ women.
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Affiliation(s)
- G. ORLANDO
- Infectious Diseases Outpatient Unit, Centro Diagnostico Italiano, Milan, Italy
| | - S. BIANCHI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - M.M. FASOLO
- STD Unit, Infectious Diseases 1, L Sacco University Hospital, Milan, Italy
| | - F. MAZZA
- U.O. Laboratorio Analisi - ASST Santi Paolo e CarloMilano
| | - E.R. FRATI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - G. RIZZARDINI
- Infectious Diseases 1, L Sacco University Hospital, Milan, Italy
| | | | - N. ZANCHETTA
- Clinical Microbiology, Virology and Bioemergency, L. Sacco Teaching Hospital, Milan, Italy
| | - A. AMENDOLA
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - E. TANZI
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- * Correspondence: Elisabetta Tanzi, Department of Biomedical Sciences for Health, University of Milan, Italy - Tel. +39 02 50315139 - E-mail:
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15
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Siqueira JD, Alves BM, Prellwitz IM, Furtado C, Meyrelles ÂR, Machado ES, Seuánez HN, Soares MA, Soares EA. Identification of novel human papillomavirus lineages and sublineages in HIV/HPV-coinfected pregnant women by next-generation sequencing. Virology 2016; 493:202-8. [PMID: 27060563 DOI: 10.1016/j.virol.2016.03.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/29/2016] [Accepted: 03/31/2016] [Indexed: 01/04/2023]
Abstract
Infection by human papillomavirus (HPV) is a necessary condition for development of cervical cancer, and has also been associated with malignancies of other body anatomical sites. Specific HPV types have been associated with premalignant lesions and invasive carcinoma, but mounting evidence suggests that within-type lineages and sublineages also display distinct biological characteristics associated with persistent infections and evolution to cervical cancer. In the present study, we have assessed HPV multiple infection and variation from a cohort of highly susceptible, HIV(+) pregnant women using next-generation sequencing and an in-house pipeline for HPV full-length genome assembly. Seventy-two consensus sequences representing complete or near-complete (>97%) HPV genomes were assembled, spanning 28 different types. Genetic distance and phylogenetic analyses allowed us to propose the classification of novel HPV lineages and sublineages across nine HPV types, including two high-risk types. HPV diversity may be a hallmark of immunosuppressed patients upon HIV infection and AIDS progression.
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Affiliation(s)
- Juliana D Siqueira
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Brunna M Alves
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Isabel M Prellwitz
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Carolina Furtado
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Ângela R Meyrelles
- Instituto de Ginecologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elizabeth S Machado
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Héctor N Seuánez
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil; Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo A Soares
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil; Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Esmeralda A Soares
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
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16
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Park LS, Hernández-Ramírez RU, Silverberg MJ, Crothers K, Dubrow R. Prevalence of non-HIV cancer risk factors in persons living with HIV/AIDS: a meta-analysis. AIDS 2016; 30:273-91. [PMID: 26691548 PMCID: PMC4689318 DOI: 10.1097/qad.0000000000000922] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The burden of cancer among persons living with HIV/AIDS (PLWHA) is substantial and increasing. We assessed the prevalence of modifiable cancer risk factors among adult PLWHA in Western high-income countries since 2000. DESIGN Meta-analysis. METHODS We searched PubMed to identify articles published in 2011-2013 reporting prevalence of smoking, alcohol consumption, overweight/obesity, and infection with human papillomavirus (HPV), hepatitis C virus (HCV) and hepatitis B virus (HBV) among PLWHA. We conducted random effects meta-analyses of prevalence for each risk factor, including estimation of overall, sex-specific, and HIV-transmission-group-specific prevalence. We compared prevalence in PLWHA with published prevalence estimates in US adults. RESULTS The meta-analysis included 113 publications. Overall summary prevalence estimates were current smoking, 54% [95% confidence interval (CI) 49-59%] versus 20-23% in US adults; cervical high-risk HPV infection, 46% (95% CI 34-58%) versus 29% in US females; oral high-risk HPV infection, 16% (95% CI 10-23%) versus 4% in US adults; anal high-risk HPV infection (men who have sex with men), 68% (95% CI 57-79%), with no comparison estimate available; chronic HCV infection, 26% (95% CI 21-30%) versus 0.9% in US adults; and HBV infection, 5% (95% CI 4-5%) versus 0.3% in US adults. Overweight/obesity prevalence (53%; 95% CI 46-59%) was below that of US adults (68%). Meta-analysis of alcohol consumption prevalence was impeded by varying assessment methods. Overall, we observed considerable study heterogeneity in prevalence estimates. CONCLUSION Prevalence of smoking and oncogenic virus infections continues to be extraordinarily high among PLWHA, indicating a vital need for risk factor reduction efforts.
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Affiliation(s)
- Lesley S Park
- aDivision of Endocrinology, Gerontology, and Metabolism, Department of Medicine and Division of Epidemiology, Department of Health Policy and Research, Stanford University School of Medicine, Stanford, CaliforniabDepartment of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, ConnecticutcDivision of Research, Kaiser Permanente, Oakland, CaliforniadDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.*Lesley S. Park and Raúl U. Hernández-Ramírez contributed equally to this article
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17
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Garbuglia AR, Gentile M, Del Nonno F, Lorenzini P, Lapa D, Lupi F, Pinnetti C, Baiocchini A, Libertone R, Cicalini S, Capobianchi MR, Ammassari A. An anal cancer screening program for MSM in Italy: Prevalence of multiple HPV types and vaccine-targeted infections. J Clin Virol 2015; 72:49-54. [PMID: 26397204 DOI: 10.1016/j.jcv.2015.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/06/2015] [Accepted: 09/07/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Elevated HPV infection rates have been described in HIV-positive males, placing these subjects at high risk of anal neoplasia. Bivalent, quadrivalent, and nonavalent vaccines to prevent HPV infection have been developed, and recently proposed for gender-neutral immunization programs. OBJECTIVES In order to estimate the benefit that could be obtained by vaccination of HIV-positive men who have sex with men (MSM), we aimed at describing the frequency of multiple and vaccine-targeted HPV infections in MSM enrolled in an anal cancer screening program. STUDY DESIGN The anal cancer screening program was conducted between July 2009 and October 2012. Mucosal anal samples were tested for HPV DNA using MY09/MY11 PCR primers and, if positive, genotyped using the CLART2HPV Clinical Array (35HPV types). RESULTS A total of 220 MSM were screened and 88.6% were positive for HPV DNA: in 86.5% at least one high-risk (HR) type was found and in 13% only low-risk (LR) HPV were found. Multiple infections accounted for 84.5% of HPV DNA-positive cases and overall 160 different HPV genotype combinations were recognized (only three combinations were detected in more than one patient each). Based on strain coverage, at least one vaccine-targeted HPV type was found in 38.9%, 64%, and 78.4% of cases when considering bivalent, quadrivalent and nonavalent vaccines, respectively. At least one HR vaccine-targeted strain was found in 39% of MSM for bivalent and quadrivalent vaccines, and in 64% of cases for nonavalent prevention. CONCLUSIONS Anal HPV infections in unvaccinated mostly HIV-infected MSM are highly prevalent. The majority of this population has multiple infections with an extremely heterogeneous number of genotype combinations. The nonavalent vaccine could theoretically have prevented a minimum of one HR HPV type in two thirds of subjects.
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Affiliation(s)
| | - Marco Gentile
- Clinical Department, INMI "L. Spallanzani", Rome, Italy
| | | | | | - Daniele Lapa
- Laboratory of Virology, INMI "L. Spallanzani", Rome, Italy
| | - Federico Lupi
- Clinical Department, INMI "L. Spallanzani", Rome, Italy
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18
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Hidalgo-Tenorio C, Rivero-Rodriguez M, Gil-Anguita C, Esquivias J, López-Castro R, Ramírez-Taboada J, de Hierro ML, López-Ruiz MA, Martínez RJ, Llaño JP. The role of polymerase chain reaction of high-risk human papilloma virus in the screening of high-grade squamous intraepithelial lesions in the anal mucosa of human immunodeficiency virus-positive males having sex with males. PLoS One 2015; 10:e0123590. [PMID: 25849412 PMCID: PMC4388587 DOI: 10.1371/journal.pone.0123590] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/19/2015] [Indexed: 01/15/2023] Open
Abstract
Objectives To evaluate the advantages of cytology and PCR of high-risk human papilloma virus (PCR HR-HPV) infection in biopsy-derived diagnosis of high-grade squamous intraepithelial lesions (HSIL = AIN2/AIN3) in HIV-positive men having sex with men (MSM). Methods This is a single-centered study conducted between May 2010 and May 2014 in patients (n = 201, mean age 37 years) recruited from our outpatient clinic. Samples of anal canal mucosa were taken into liquid medium for PCR HPV analysis and for cytology. Anoscopy was performed for histology evaluation. Results Anoscopy showed 33.8% were normal, 47.8% low-grade squamous intraepithelial lesions (LSIL), and 18.4% HSIL; 80.2% had HR-HPV. PCR of HR-HPV had greater sensitivity than did cytology (88.8% vs. 75.7%) in HSIL screening, with similar positive (PPV) and negative predictive value (NPV) of 20.3 vs. 22.9 and 89.7 vs. 88.1, respectively. Combining both tests increased the sensitivity and NPV of HSIL diagnosis to 100%. Correlation of cytology vs. histology was, generally, very low and PCR of HR-HPV vs. histology was non-existent (<0.2) or low (<0.4). Area under the receiver operating characteristics (AUROC) curve analysis of cytology and PCR HR-HPV for the diagnosis of HSIL was poor (<0.6). Multivariate regression analysis showed protective factors against HSIL were: viral suppression (OR: 0.312; 95%CI: 0.099-0.984), and/or syphilis infection (OR: 0.193; 95%CI: 0.045-0.827). HSIL risk was associated with HPV-68 genotype (OR: 20.1; 95%CI: 2.04-197.82). Conclusions When cytology and PCR HR-HPV findings are normal, the diagnosis of pre-malignant HSIL can be reliably ruled-out in HIV-positive patients. HPV suppression with treatment protects against the appearance of HSIL.
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Affiliation(s)
- Carmen Hidalgo-Tenorio
- Infectious Disease Unit, University Hospital Virgen de las Nieves, Granada, Spain
- * E-mail:
| | - Mar Rivero-Rodriguez
- Infectious Disease Unit, University Hospital Virgen de las Nieves, Granada, Spain
| | | | - Javier Esquivias
- Pathology Service, University Hospital Virgen de las Nieves, Granada, Spain
| | | | | | | | - Miguel A. López-Ruiz
- Infectious Disease Unit, University Hospital Virgen de las Nieves, Granada, Spain
| | - R. Javier Martínez
- Infectious Disease Unit, University Hospital Virgen de las Nieves, Granada, Spain
| | - Juan P. Llaño
- Infectious Disease Unit, University Hospital Virgen de las Nieves, Granada, Spain
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Bansal D, Elmi AA, Skariah S, Haddad P, Abu-Raddad LJ, Al Hamadi AH, Mohamed-Nady N, Affifi NM, Ghedira R, Hassen E, Al-Thani AAJ, Al-Ansari AAHM, Sultan AA. Molecular epidemiology and genotype distribution of Human Papillomavirus (HPV) among Arab women in the State of Qatar. J Transl Med 2014; 12:300. [PMID: 25424736 PMCID: PMC4251937 DOI: 10.1186/s12967-014-0300-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human Papilloma Virus (HPV) infection is the major cause of cervical cancer worldwide. With limited data available on HPV prevalence in the Arab countries, this study aimed to identify the prevalence and genotypic distribution of HPV in the State of Qatar. METHODS 3008 cervical samples, exclusively of women with Arabic origin residing in Qatar were collected from the Women's Hospital and Primary Health Care Corporation in Doha, State of Qatar. HPV DNA detection was done using GP5+/6+ primers based real time-polymerase chain reaction (RT-PCR) assay followed by the usage of HPV type specific primers based RT- PCR reactions and Sanger sequencing for genotype identification. RESULTS Similar prevalence rates of HPV infection was identified in both Qatari and non-Qatari women at 6.2% and 5.9% respectively. HPV prevalence rate of 5.8% and 18.4% was identified in women with normal cytology and in women with abnormal cytology respectively. HPV 81, 11 and 16, in decreasing order were the most commonly identified genotypes. HPV 81 was the most frequent low-risk genotype among women with both normal (74.0%) and abnormal (33.3%) cytology. HPV 16 (4.6%) was identified as the predominant high-risk HPV genotype among women with normal cytology and HPV 16, HPV 18, and HPV 56 (22.2% each) were the most common identified high-risk genotypes in women with abnormal cytology. CONCLUSIONS The overall HPV prevalence in Arab women in Qatar was identified as 6.1% with an increased HPV prevalence seen in women with abnormal cytology results and no significant trends seen with age. In contrast to Western countries, we report a varied genotypic profile of HPV with a high prevalence of low-risk HPV genotype 81 among the Arab women residing in Qatar.
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Affiliation(s)
- Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Asha A Elmi
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Sini Skariah
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Pascale Haddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Aysha H Al Hamadi
- Department of laboratory Medicine and Pathology, Cytopathology, Hamad Medical Corporation, Doha, Qatar.
| | - Nady Mohamed-Nady
- Department of Obstetrics & Gynecology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | | | - Randa Ghedira
- Laboratoire d'Immuno-Oncologie Moléculaire Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.
| | - Elham Hassen
- Laboratoire d'Immuno-Oncologie Moléculaire Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.
| | - Asma A J Al-Thani
- Health Sciences Department, Biomedical Sciences Program, University of Qatar, Doha, Qatar.
| | | | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
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Panatto D, Amicizia D, Bianchi S, Frati ER, Zotti CM, Lai PL, Domnich A, Colzani D, Gasparini R, Tanzi E. Chlamydia trachomatis prevalence and chlamydial/HPV co-infection among HPV-unvaccinated young Italian females with normal cytology. Hum Vaccin Immunother 2014; 11:270-6. [PMID: 25483545 DOI: 10.4161/hv.36163] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Infections caused by Chlamydia trachomatis (Ct) and human papillomavirus (HPV) are the two main sexually transmitted infections; however, epidemiological data on Ct prevalence and Ct/HPV co-infection in Italy are scant. This study aimed at estimating the prevalence of Ct infection and Ct/HPV co-infection in young HPV-unvaccinated females with normal cytology, and placed particular attention on the possible association between Ct-DNA positivity and different HPV infecting genotypes. Five hundred 66 healthy females aged 16-26 years without cervical lesions, previously assessed for HPV infection (HPV-DNA prevalence: 18.2%), were tested for Ct-DNA. The overall prevalence of Ct was 5.8% (95% CI: 4.2-8.1), while Ct/HPV co-infection was recorded in 2.7% (95% CI: 1.6-4.3) of subjects. Compared with HPV-DNA-negative females, HPV-DNA positive subjects had significantly (P < 0.001) higher odds of being infected with Ct (odds ratio of 4.20, 95% CI: 2.01-8.71). Both Ct and Ct/HPV infections were much more prevalent in under 18-year-olds than in older women. Subjects positive for single high-risk HPV genotypes and various multiple HPV infections had higher odds of being Ct-DNA positive. Our findings confirm that HPV and Ct infections are very common among asymptomatic young Italian females. This underlines the urgent need for nationwide Ct screening programs and reinforcement of sexual health education, which would be the most important public health strategies, since no Ct vaccines are currently available.
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Martins AES, Lucena-Silva N, Garcia RG, Welkovic S, Barboza A, Menezes MLB, Maruza M, Tenório T, Ximenes RAA. Prevalence of human papillomavirus infection, distribution of viral types and risk factors in cervical samples from human immunodeficiency virus-positive women attending three human immunodeficiency virus-acquired immune deficiency syndrome reference centres in northeastern Brazil. Mem Inst Oswaldo Cruz 2014; 109:738-47. [PMID: 25317701 PMCID: PMC4238765 DOI: 10.1590/0074-0276140070] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 06/20/2014] [Indexed: 01/27/2023] Open
Abstract
Human immunodeficiency virus (HIV)-positive patients have a greater prevalence of coinfection with human papillomavirus (HPV) is of high oncogenic risk. Indeed, the presence of the virus favours intraepithelial squamous cell lesion progression and may induce cancer. The aim of this study was to evaluate the prevalence of HPV infection, distribution of HPV types and risk factors among HIV-positive patients. Cervical samples from 450 HIV-positive patients were analysed with regard to oncotic cytology, colposcopy and HPV presence and type by means of polymerase chain reaction and sequencing. The results were analysed by comparing demographic data and data relating to HPV and HIV infection. The prevalence of HPV was 47.5%. Among the HPV-positive samples, 59% included viral types of high oncogenic risk. Multivariate analysis showed an association between HPV infection and the presence of cytological alterations (p = 0.003), age greater than or equal to 35 years (p = 0.002), number of partners greater than three (p = 0.002), CD4⁺ lymphocyte count < 200/mm³ (p = 0.041) and alcohol abuse (p = 0.004). Although high-risk HPV was present in the majority of the lesions studied, the low frequency of HPV 16 (3.3%), low occurrence of cervical lesions and preserved immunological state in most of the HIV-positive patients were factors that may explain the low occurrence of precancerous cervical lesions in this population.
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Affiliation(s)
- Albert Eduardo Silva Martins
- Laboratório de Imunogenética, Centro de Pesquisas Aggeu
Magalhães-Fiocruz, Recife PE, Brasil
- Laboratório de Biologia Molecular, Departamento de Oncologia
Pediátrica, Hospital de Ensino, Instituto de Medicina Integral Professor Fernando
Figueira, Recife, PE, Brasil
| | - Norma Lucena-Silva
- Laboratório de Imunogenética, Centro de Pesquisas Aggeu
Magalhães-Fiocruz, Recife PE, Brasil
- Laboratório de Biologia Molecular, Departamento de Oncologia
Pediátrica, Hospital de Ensino, Instituto de Medicina Integral Professor Fernando
Figueira, Recife, PE, Brasil
| | - Renan Gomes Garcia
- Laboratório de Imunogenética, Centro de Pesquisas Aggeu
Magalhães-Fiocruz, Recife PE, Brasil
| | - Stefan Welkovic
- Centro Integrado de Saúde Amaury de MedeirosFaculdade de Ciências
Médicas, Universidade de Pernambuco Recife, PE, Brasil
| | - Aureliana Barboza
- Departamento Materno-Infantil, Faculdade de Ciências Médicas,
Universidade de Pernambuco, Recife, PE, Brasil
| | - Maria Luiza Bezerra Menezes
- Departamento Materno-Infantil, Faculdade de Ciências Médicas,
Universidade de Pernambuco, Recife, PE, Brasil
| | - Magda Maruza
- Hospital Correia Picanço, Secretaria de Saúde de Pernambuco, Recife,
PE, Brasil
| | - Terezinha Tenório
- Departamento Materno-Infantil, Universidade Federal de Pernambuco,
Recife, PE, Brasil
| | - Ricardo AA Ximenes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco,
Recife, PE, Brasil
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Martins AES, Lucena-Silva N, Garcia RG, Welkovic S, Barbosa A, Menezes MLB, Tenório T, Maruza M, Ximenes RAA. Prognostic evaluation of DNA index in HIV-HPV co-infected women cervical samples attending in reference centers for HIV-AIDS in Recife. PLoS One 2014; 9:e104801. [PMID: 25144309 PMCID: PMC4140713 DOI: 10.1371/journal.pone.0104801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 07/14/2014] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Persistence of cervical infection caused by human papillomavirus (HPV) types with high oncogenic risk may lead to cervical intraepithelial neoplasia (CIN). The aim of the present study was to evaluate whether, in HIV-positive women, the presence of aneuploidy in cervical cell samples is associated with presence and evolution of CIN. METHODS The present study had two stages. In the first stage, comprising a cross-sectional study, the association between the presence of aneuploidy seen via flow cytometry and sociodemographic characteristics, habits and characteristics relating to HPV and HIV infection was analyzed. In the second stage, comprising a cohort study, it was investigated whether aneuploidy was predictive of CIN evolution. RESULTS No association was observed between the presence of aneuploidy and HPV infection, or between its presence and alterations seen in oncotic cytological analysis. On the other hand, aneuploidy was associated with the presence of CIN (p = 0.030) in histological analysis and with nonuse of antiretroviral therapy (p = 0.001). Most of the HIV-positive women (234/272) presented normal CD4+ T lymphocyte counts (greater than 350 cells/mm3) and showed a greater aneuploidy regression rate (77.5%) than a progression rate (23.9%) over a follow-up of up to two years. CONCLUSION Although there was an association between the presence of cervical tissue lesions and the DNA index, the latter was not predictive of progression of the cervical lesion. This suggests that progression of the cervical lesion to cancer in HIV-positive women may also be changed through improvement of the immunological state enabled by using antiretroviral therapy.
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Affiliation(s)
- Albert Eduardo Silva Martins
- Laboratório de imunogenética, Centro de pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
- Laboratório de biologia molecular, Departamento de oncologia pediátrica, Hospital IMIP, Recife, Brasil
- * E-mail:
| | - Norma Lucena-Silva
- Laboratório de imunogenética, Centro de pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
- Laboratório de biologia molecular, Departamento de oncologia pediátrica, Hospital IMIP, Recife, Brasil
| | - Renan Gomes Garcia
- Laboratório de imunogenética, Centro de pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
| | - Stefan Welkovic
- Departamento Materno-Infantil e Centro Integrado de Saúde Amaury de Medeiro (CISAM-UPE), Universidade de Pernambuco, Recife, Brasil
| | - Aureliana Barbosa
- Departamento Materno-Infantil e Centro Integrado de Saúde Amaury de Medeiro (CISAM-UPE), Universidade de Pernambuco, Recife, Brasil
| | - Maria Luiza Bezerra Menezes
- Departamento Materno-Infantil e Centro Integrado de Saúde Amaury de Medeiro (CISAM-UPE), Universidade de Pernambuco, Recife, Brasil
| | - Terezinha Tenório
- Departamento Materno-Infantil, Universidade Federal de Pernambuco, Recife, Brasil
| | - Magda Maruza
- Hospital Correia Picanço, Secretaria de Saúde de Pernambuco, Recife, Brasil
| | - Ricardo A. A. Ximenes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco (UFPE), Recife, Brasil
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Camargo M, Soto-De Leon SC, Munoz M, Sanchez R, Peña-Herrera D, Pineda-Peña AC, Sussmann O, Paez C, Perez-Prados A, Patarroyo ME, Patarroyo MA. Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia. BMC Cancer 2014; 14:451. [PMID: 24942545 PMCID: PMC4067500 DOI: 10.1186/1471-2407-14-451] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 06/13/2014] [Indexed: 11/28/2022] Open
Abstract
Background HIV infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being HPV. However, studies are needed for determining associations between immunodeficiency caused by HIV and/or the presence of HPV during the course of cervical lesions and their degree of malignancy. This study describes the cytological findings revealed by the Papanicolaou test, laboratory characteristics and HPV molecular profile in women with and without HIV infection. Methods A total of 216 HIV-positive and 1,159 HIV-negative women were invited to participate in the study; PCR was used for the molecular detection of HPV in cervical samples. Statistical analysis (such as percentages, Chi-square test and Fisher’s exact test when applicable) determined human papillomavirus (HPV) infection frequency (single and multiple) and the distribution of six types of high-risk-HPV in women with and without HIV infection. Likewise, a logistic regression model was run to evaluate the relationship between HIV-HPV infection and different risk factors. Results An association was found between the frequency of HPV infection and infection involving 2 or more HPV types (also known as multiple HPV infection) in HIV-positive women (69.0% and 54.2%, respectively); such frequency was greater than that found in HIV-negative women (44.3% and 22.7%, respectively). Statistically significant differences were observed between both groups (p = 0.001) regarding HPV presence (both in infection and multiple HPV infection). HPV-16 was the most prevalent type in the population being studied (p = 0.001); other viral types had variable distribution in both groups (HIV-positive and HIV-negative). HPV detection was associated with <500 cell/mm3 CD4-count (p = 0.004) and higher HIV-viral-load (p = 0.001). HPV-DNA detection, <200 cell/mm3 CD4-count (p = 0.001), and higher HIV-viral-load (p = 0.001) were associated with abnormal cytological findings. Conclusions The HIV-1 positive population in this study had high multiple HPV infection prevalence. The results for this population group also suggested a greater association between HPV-DNA presence and cytological findings. HPV detection, together with low CD4 count, could represent useful tools for identifying HIV-positive women at risk of developing cervical lesions.
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Co NNC, Chu LO, Chow JKF, Tam JWO, Ng EKO. HPV Prevalence and Detection of Rare HPV Genotypes in Hong Kong Women from Southern China with Cytological Abnormalities. ACTA ACUST UNITED AC 2013. [DOI: 10.5402/2013/312706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Human papillomavirus (HPV) has been identified as the primary cause of cervical squamous intraepithelial lesion and invasive cervical cancer. The emergence of various commercial HPV genotyping kits with different characteristics facilitates the detection of most high-risk and low-risk HPV genotypes, but the rare HPV types are usually underdiagnosed. In the present study, HPV detection was performed using the GenoFlow HPV Array Test kit (DiagCor Bioscience), which can identify 33 HPV subtypes by specific probes. Besides, a HPV consensus probe (universal probe) was designed to capture not only the 33 genotypes but also rare subtypes. Of the 1643 Southern Chinese women tested between 2012 and 2013, the HPV prevalence was 42.3%, with HPV 52 (139/1643, 8.5%), HPV 81 (89/1643, 5.4%), and HPV 16 (63/1643, 3.8%) being the most frequent subtypes detected. Among all 695 HPV-positive cases, 56 (8.1%) cases were only detected by the universal probe, in which 5 were either ASCUS or LSIL cases. Sequencing results confirmed HPV types 30, 91, and 74, and the intratypic variants of HPV 72 and 82 were present in the 5 cases. The result suggests that some rare HPV subtypes might be involved in cervical lesions.
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Affiliation(s)
- Ngai Na Chloe Co
- Molecular Diagnostics Division, DiagCor Bioscience Incorporation Ltd, Hong Kong SAR, Hong Kong
| | - Lai-On Chu
- Molecular Diagnostics Division, DiagCor Bioscience Incorporation Ltd, Hong Kong SAR, Hong Kong
| | - Joseph K. F. Chow
- Molecular Diagnostics Division, DiagCor Bioscience Incorporation Ltd, Hong Kong SAR, Hong Kong
| | - Joseph W. O. Tam
- Molecular Diagnostics Division, DiagCor Bioscience Incorporation Ltd, Hong Kong SAR, Hong Kong
| | - Enders K. O. Ng
- Molecular Diagnostics Division, DiagCor Bioscience Incorporation Ltd, Hong Kong SAR, Hong Kong
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Prevalence of human papillomavirus in young Italian women with normal cytology: how should we adapt the national vaccination policy? BMC Infect Dis 2013; 13:575. [PMID: 24313984 PMCID: PMC4029487 DOI: 10.1186/1471-2334-13-575] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 12/02/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) is the most common sexually transmitted infection. In Italy, HPV vaccination is now offered free of charge to 12-year-old females. However, some regional health authorities have extended free vaccination to other age-groups, especially to girls under 18 years of age. We conducted a multicentre epidemiological study to ascertain the prevalence of different genotypes of HPV in young Italian women with normal cytology, with the aim of evaluating the possibility of extending vaccination to older females. METHODS The study was performed in 2010. Women aged 16-26 years with normal cytology were studied. Cervical samples were analyzed to identify the presence of HPV by PCR amplification of a segment of ORF L1 (450 bp). All positive HPV-DNA samples underwent viral genotype analysis by means of a restriction fragment length polymorphism assay. RESULTS Positivity for at least one HPV genotype was found in 18.2% of the 566 women recruited: 48.1% in the 16-17 age-class, 15.4 in the 18-20 age-class, 21.9% in the 21-23 age-class, and 15.5% in the 24-26 age-class; 10.1% of women were infected by at least one high-risk HPV genotype. HPV-16 was the most prevalent genotype. Only 4 (0.7%), 4 (0.7%) and 3 (0.5%) women were infected by HPV-18, HPV-6 and HPV-11, respectively. Of the HPV-DNA-positive women, 64.1% presented only one viral genotype, while 24.3% had multiple infections. The HPV genotypes most often involved in multiple infections were high-risk. A high prevalence was noted in the first years of sexual activity (48.1% of HPV-DNA-positive women aged 16-17 years); HPV prevalence subsequently declined and stabilized.The estimate of cumulative proportions of young women free from any HPV infection at each age was evaluated; 93.3% and 97.1% of 26 year-old women proved free from HPV-16 and/or HPV-18 and from HPV-6 and/or HPV-11, respectively. CONCLUSIONS Our findings confirm the crucial importance of conducting studies on women without cytological damage, in order to optimise and up-date preventive interventions against HPV infection, and suggest that vaccinating 26-year-old females at the time of their first pap-test is to be recommend, though this issue should be further explored.
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Sehnal B, Dusek L, Cibula D, Zima T, Halaska M, Driak D, Slama J. The relationship between the cervical and anal HPV infection in women with cervical intraepithelial neoplasia. J Clin Virol 2013; 59:18-23. [PMID: 24315797 DOI: 10.1016/j.jcv.2013.11.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 11/11/2013] [Accepted: 11/16/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND More than 90% of cases of anal cancers are caused by high-risk human papillomavirus (HR HPV) infection and a history of cervical intraepithelial neoplasia (CIN) is established as possible risk factor. OBJECTIVES To demonstrate relationship between anal and cervical HPV infection in women with different grades of CIN and microinvasive cervical cancer. STUDY DESIGN A total of 272 women were enrolled in the study. The study group included 172 women who underwent conization for high-grade CIN or microinvasive cervical cancer. The control group consisted of 100 women with non-neoplastic gynecologic diseases or biopsy-confirmed CIN 1. All participants completed a questionnaire detailing their medical history and sexual risk factors and were subjected to anal and cervical HPV genotyping using Cobas and Lynear array HPV test. RESULTS Cervical, anal, and concurrent cervical and anal HPV infections were detected in 82.6%, 48.3% and 42.4% of women in the study group, and in 28.0%, 26.0% and 8.0% of women in the control group, respectively. The prevalence of the HR HPV genotypes was higher in the study group and significantly increased with the severity of cervical lesion. Concurrent infections of the cervix and anus occurred 5.3-fold more often in the study group than in the control group. Any contact with the anus was the only significant risk factor for development of concurrent HPV infection. CONCLUSIONS Concurrent anal and cervical HR HPV infection was found in nearly half of women with CIN 2+. The dominant genotype found in both anatomical locations was HPV 16. Any frequency and any type of contact with the anus were shown as the most important risk factor for concurrent HPV infection.
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Affiliation(s)
- Borek Sehnal
- Hospital Na Bulovce and 1st School of Medicine, Charles University, Department of Gynaecology and Obstetrics, Budinova 2, Prague 8, 180 81, Czech Republic.
| | - Ladislav Dusek
- Institute of Biostatistics and Analyses, Masaryk University, Kamenice 3, Brno, 625 00, Czech Republic
| | - David Cibula
- General University Hospital and 1st School of Medicine, Gynaecologic Oncology Centre, Charles University, Apolinarska 18, Prague 2, 128 51, Czech Republic
| | - Tomas Zima
- General University Hospital and 1st School of Medicine, Institute of Medical Biochemistry and Laboratory Diagnostics, Charles University, U Nemocnice 2, Prague 2, 128 08, Czech Republic
| | - Michael Halaska
- Hospital Na Bulovce and 1st School of Medicine, Charles University, Department of Gynaecology and Obstetrics, Budinova 2, Prague 8, 180 81, Czech Republic
| | - Daniel Driak
- Hospital Na Bulovce and 1st School of Medicine, Charles University, Department of Gynaecology and Obstetrics, Budinova 2, Prague 8, 180 81, Czech Republic
| | - Jiri Slama
- General University Hospital and 1st School of Medicine, Gynaecologic Oncology Centre, Charles University, Apolinarska 18, Prague 2, 128 51, Czech Republic
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The Role of Sexually Transmitted Infections in HIV-1 Progression: A Comprehensive Review of the Literature. JOURNAL OF SEXUALLY TRANSMITTED DISEASES 2013; 2013:176459. [PMID: 26316953 PMCID: PMC4437436 DOI: 10.1155/2013/176459] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 05/28/2013] [Indexed: 01/01/2023]
Abstract
Due to shared routes of infection, HIV-infected persons are frequently coinfected with other sexually transmitted infections (STIs). Studies have demonstrated the bidirectional relationships between HIV and several STIs, including herpes simplex virus-2 (HSV-2), hepatitis B and C viruses, human papilloma virus, syphilis, gonorrhea, chlamydia, and trichomonas. HIV-1 may affect the clinical presentation, treatment outcome, and progression of STIs, such as syphilis, HSV-2, and hepatitis B and C viruses. Likewise, the presence of an STI may increase both genital and plasma HIV-1 RNA levels, enhancing the transmissibility of HIV-1, with important public health implications. Regarding the effect of STIs on HIV-1 progression, the most studied interrelationship has been with HIV-1/HSV-2 coinfection, with recent studies showing that antiherpetic medications slow the time to CD4 <200 cells/µL and antiretroviral therapy among coinfected patients. The impact of other chronic STIs (hepatitis B and C) on HIV-1 progression requires further study, but some studies have shown increased mortality rates. Treatable, nonchronic STIs (i.e., syphilis, gonorrhea, chlamydia, and trichomonas) typically have no or transient impacts on plasma HIV RNA levels that resolve with antimicrobial therapy; no long-term effects on outcomes have been shown. Future studies are advocated to continue investigating the complex interplay between HIV-1 and other STIs.
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Sias C, Garbuglia AR, Piselli P, Cimaglia C, Lapa D, Del Nonno F, Baiocchini A, Capobianchi MR. Comparison of the Abbott RealTime High Risk HPV with Genomica HPV Clinical Array for the detection of human papillomavirus DNA. APMIS 2013; 121:1054-63. [PMID: 23398447 DOI: 10.1111/apm.12054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 12/17/2012] [Indexed: 11/29/2022]
Abstract
Human papillomavirus (HPV) has been identified as the major cause of cervical cancer worldwide and HPV DNA testing is recommended in primary cervical cancer screening. Several molecular tests for detection/typing of HPV DNA with different sensitivity and specificity are commercially available. The present study compared the performance of the Abbott RealTime High Risk HPV assay and the Genomica HPV Clinical Array CLART2 in 78 specimens (63 cervical smears and 15 rectal/urethral swabs).The typing results of the Genomica assay were in absolute agreement with each of the four possible result categories of the Abbott assay (HPV16, HPV18, Other HR HPV, not detected) in 87.2% (68/78) of the samples, with a Cohen' kappa agreement coefficient for every HR type of 0.62 (95% CI: 0.39-0.85), higher in cervical swabs (k = 0.74, 95% CI: 0.50-0.99) than in rectal/urethral swabs (k = 0.36, 95% CI: 0.00-0.82). There was an excellent agreement of the Genomica results with those of Abbott in cervical samples harbored HPV single infection (100% agreement). Nonetheless, both methods may lose sensitivity for detecting HPV types in multiple infections, giving discordant results (10/78). This underlines the importance of establishing the analytical sensitivity in HPV type detection in single and multiple HPV infections. In rectal/urethral swabs, 5 of 15 (33%) discordant cases were observed, most of which became compatible when the Genomica assay was performed starting from nucleic acid extracted with the Abbott m2000sp system. These results suggest that nucleic extraction based on the magnetic beads technique is suitable for HPV DNA detection in urethral/rectal swabs.
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29
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Tanzi E, Bianchi S, Fasolo MM, Frati ER, Mazza F, Martinelli M, Colzani D, Beretta R, Zappa A, Orlando G. High performance of a new PCR-based urine assay for HPV-DNA detection and genotyping. J Med Virol 2012; 85:91-8. [PMID: 23097252 DOI: 10.1002/jmv.23434] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2012] [Indexed: 02/05/2023]
Abstract
Human papillomavirus (HPV) testing has been proposed as a means of replacing or supporting conventional cervical screening (Pap test). However, both methods require the collection of cervical samples. Urine sample is easier and more acceptable to collect and could be helpful in facilitating cervical cancer screening. The aim of this study was to evaluate the sensitivity and specificity of urine testing compared to conventional cervical smear testing using a PCR-based method with a new, designed specifically primer set. Paired cervical and first voided urine samples collected from 107 women infected with HIV were subjected to HPV-DNA detection and genotyping using a PCR-based assay and a restriction fragment length polymorphism method. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated using the McNemar's test for differences. Concordance between tests was assessed using the Cohen's unweighted Kappa (k). HPV DNA was detected in 64.5% (95% CI: 55.1-73.1%) of both cytobrush and urine samples. High concordance rates of HPV-DNA detection (k = 0.96; 95% CI: 0.90-1.0) and of high risk-clade and low-risk genotyping in paired samples (k = 0.80; 95% CI: 0.67-0.92 and k = 0.74; 95% CI: 0.60-0.88, respectively) were observed. HPV-DNA detection in urine versus cervix testing revealed a sensitivity of 98.6% (95% CI: 93.1-99.9%) and a specificity of 97.4% (95% CI: 87.7-99.9%), with a very high NPV (97.4%; 95% CI: 87.7-99.9%). The PCR-based assay utilized in this study proved highly sensitive and specific for HPV-DNA detection and genotyping in urine samples. These data suggest that a urine-based assay would be a suitable and effective tool for epidemiological surveillance and, most of all, screening programs.
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Affiliation(s)
- Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
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Meyrelles ARI, Siqueira JD, Hofer CB, Costa TP, Azevedo AP, Guimarães BV, Seuánez HN, Soares MA, Almeida G, Soares EA, Machado ES. HIV/HPV co-infection during pregnancy in southeastern Brazil: prevalence, HPV types, cytological abnormalities and risk factors. Gynecol Oncol 2012; 128:107-112. [PMID: 23063764 DOI: 10.1016/j.ygyno.2012.10.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/03/2012] [Accepted: 10/03/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE HIV(+) pregnant women are at a higher risk of HPV infection and development of cervical cancer. Our objectives were to assess the prevalence and HPV types in HIV(+) pregnant women and to identify risk factors for HPV infection and cytological abnormalities. METHODS Cervicovaginal smears were collected during pregnancy from 140 women. Partial HPV L1 gene and the exon 4 of the human TP53 gene (containing codon 72) were PCR-amplified and sequenced. Amplified products indicating multiple HPV infection were further cloned and sequenced. The association of demographic, obstetric and HIV-related clinical variables with HPV infection and cervical lesions was tested by univariate analyses, and significant factors were subsequently tested by logistic regression multivariate analysis. RESULTS HPV DNA tested positive for 118 patients and HPV types were identified in 104 samples. Twenty-eight different types were found, HPV-16 and HPV-58 being the most prevalent. High-risk types were present in 79.8% of samples and multiple infections in 16.3%. Abnormal cervical smears were found in 44 patients (31.4%). Absolute CD4(+) T-cell counts below 350 were associated with HPV infection. Younger age was associated with cervical abnormalities and higher CD4(+) T-cell count was an apparent protective factor. CONCLUSIONS We found a high prevalence of HPV infection and high-risk types in this cohort. Our results highlighted the relevance of immune system integrity rather than TP53 variants for protecting this highly vulnerable population to HPV infection and carcinogenesis.
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Affiliation(s)
- Angela R I Meyrelles
- Instituto de Ginecologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Programa de Pós Graduação em Ciências Cirúrgicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Juliana D Siqueira
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Cristina B Hofer
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tomaz P Costa
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andrea P Azevedo
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna V Guimarães
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Héctor N Seuánez
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil; Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo A Soares
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil; Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gutemberg Almeida
- Instituto de Ginecologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Programa de Pós Graduação em Ciências Cirúrgicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Esmeralda A Soares
- Programa de Genética, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Elizabeth S Machado
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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