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Muslin C. Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action. Front Public Health 2024; 12:1376748. [PMID: 38807996 PMCID: PMC11130434 DOI: 10.3389/fpubh.2024.1376748] [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: 01/26/2024] [Accepted: 04/24/2024] [Indexed: 05/30/2024] Open
Abstract
Cervical cancer, primarily caused by human papillomavirus (HPV) infection, poses a significant global health challenge. Due to higher levels of poverty and health inequities, Indigenous women worldwide are more vulnerable to cervical cancer than their non-Indigenous counterparts. However, despite constituting nearly 10% of the population in Latin America and the Caribbean (LAC), the true extent of the burden of cervical cancer among Indigenous people in this region remains largely unknown. This article reviews the available information on cervical cancer incidence and mortality, as well as HPV infection prevalence, among Indigenous women in LAC. The limited existing data suggest that Indigenous women in this region face a heightened risk of cervical cancer incidence and mortality compared to non-Indigenous women. Nevertheless, a substantial knowledge gap persists that must be addressed to comprehensively assess the burden of cervical cancer among Indigenous populations, especially through enhancing cancer surveillance across LAC countries. Numerous structural, social and cultural barriers hindering Indigenous women's access to HPV vaccination and cervical cancer screening worldwide have been identified and are reviewed in this article. The discussion highlights the critical role of culturally sensitive education, community engagement, and empowerment strategies in overcoming those barriers. Drawing insights from the success of targeted strategies in certain high-income countries, the present article advocates for research, policies and healthcare interventions tailored to the unique context of LAC countries.
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Affiliation(s)
- Claire Muslin
- One Health Research Group, Faculty of Health Sciences, Universidad de las Américas, Quito, Ecuador
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Tremblay M, Sydora BC, Listener LJ, Kung JY, Lightning R, Rabbit C, Oster RT, Kruschke Z, Ross S. Indigenous gender and wellness: a scoping review of Canadian research. Int J Circumpolar Health 2023; 82:2177240. [PMID: 36803328 PMCID: PMC9946324 DOI: 10.1080/22423982.2023.2177240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
This scoping review examined research publications related to health and/or wellness along with gender among Canadian Indigenous populations. The intent was to explore the range of articles on this topic and to identify methods for improving gender-related health and wellness research among Indigenous peoples. Six research databases were searched up to 1 February 2021. The final selection of 155 publications represented empirical research conducted in Canada, included Indigenous populations, investigated health and/or wellness topics and focused on gender. Among the diverse range of health and wellness topics, most publications focused on physical health issues, primarily regarding perinatal care and HIV- and HPV-related issues. Gender diverse people were seldom included in the reviewed publications. Sex and gender were typically used interchangeably. Most authors recommended that Indigenous knowledge and culture be integrated into health programmes and further research. More health research with Indigenous peoples must be conducted in ways that discern sex from gender, uplift the strengths of Indigenous peoples and communities, privilege community perspectives, and attend to gender diversity; using methods that avoid replicating colonialism, promote action, change stories of deficit, and build on what we already know about gender as a critical social determinant of health.
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Affiliation(s)
- Melissa Tremblay
- Department of Educational Psychology, University of Alberta, 5-127 Education North, University of Alberta, Edmonton, Alberta, Canada,CONTACT Melissa Tremblay Department of Educational Psychology, University of Alberta, 5-127 Education North, University of Alberta, Edmonton, AB T6G 2G5, Canada
| | - Beate C. Sydora
- Department of Obstetrics & Gynecology, University of Alberta, Position: Research Associate, 626-1 Community Service Centre, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Luwana Joyce Listener
- Department of Obstetrics & Gynecology, University of Alberta, Position: Research Assistant, 5S141 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Janice Y. Kung
- University of Alberta, Position: Librarian, John W. Scott Health Sciences Library, 2K3.28 Walter C. Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada
| | | | - Chevi Rabbit
- Community member, Position: Human rights advocate
| | - Richard T. Oster
- Indigenous Wellness Core, Alberta Health Services, Edmonton, Alberta, Canada
| | - Zoë Kruschke
- Department of Educational Psychology, University of Alberta, Position: Research Coordinator, University of Alberta, Edmonton, Alberta, Canada
| | - Susan Ross
- Departments of Obstetrics and Gynecology, and Women and Children’s Health Research Institute (WCHRI) University of Alberta, Position: Professor and Cavarzan Chair of Mature Women’s Health Research, 5S141 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, Edmonton, Alberta, Canada
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3
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Zhao M, Zhou D, Zhang M, Kang P, Cui M, Zhu L, Luo L. Characteristic of persistent human papillomavirus infection in women worldwide: a meta-analysis. PeerJ 2023; 11:e16247. [PMID: 38025679 PMCID: PMC10655709 DOI: 10.7717/peerj.16247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives We aimed to estimate the genotype distribution of persistent human papillomavirus (HPV) infection in females worldwide, and provided a scientific basis for the prevention strategies of cervical cancer (CC) and the development of HPV vaccines. Methods Both English and Chinese databases were researched from the inception to July 2023. The pooled persistent HPV infection prevalence was calculated using a random effects model. The subgroup analysis was performed to explore the heterogeneity. Publication bias was evaluated using funnel plot, Egger's and Begg's test. Results Twenty-eight studies with 27,335 participants were included. The pooled prevalence of persistent HPV infection was 29.37% (95% CI [24.05%∼35.31%]), and the genotypes with the persistent infection prevalence were HPV16 (35.01%), HPV52 (28.19%), HPV58 (27.06%), HPV18 (25.99%), HPV33 (24.37%), HPV31 (23.35%), HPV59 (21.87%), HPV39 (19.54%), HPV68 (16.61%) and HPV45 (15.05%). The prevalence of multiple and single HPV persistent infection were 48.66% and 36.71%, respectively; the prevalence of persistent HPV infection in different age groups (<30, 30∼39, 40∼49, >50) were 29.83%, 28.39%, 22.24% and 30.22%, respectively. The follow-up time was significantly associated with heterogeneity by subgroup analysis (P < 0.05), and the prevalence of persistent infection decreased with longer follow-up time. Conclusions Multiple infections were more likely to occur persistent HPV infection than single infection. In addition to HPV vaccination, we should emphasize the follow-up management for women under 30 and over 50 years old, those with high-risk HPV infection (HPV59, 39, 68) and multiple infections.
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Affiliation(s)
- Ming Zhao
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Dan Zhou
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Min Zhang
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Peipei Kang
- Shandong Mental Health Center, Shandong University, Jinan, Shandong, China
| | - Meimei Cui
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
- School of Basic Medical, Weifang Medical College, Weifang, Shandong, China
| | - Liling Zhu
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Limei Luo
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
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MacDonald SE, Kenzie L, Letendre A, Bill L, Shea-Budgell M, Henderson R, Barnabe C, Guichon JR, Colquhoun A, Ganshorn H, Bedingfield N, Vandenboogaard PD, Bednarczyk RA, Glaze S, Nelson G. Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001406. [PMID: 36962871 PMCID: PMC10021254 DOI: 10.1371/journal.pgph.0001406] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023]
Abstract
Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.
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Affiliation(s)
| | - Lisa Kenzie
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Angeline Letendre
- Cancer Prevention and Screening Innovation, Alberta Health Services, Edmonton, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | | | - Rita Henderson
- Department of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Juliet R Guichon
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amy Colquhoun
- Performance Reporting, Alberta Health, Edmonton, Canada
| | - Heather Ganshorn
- Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - Nancy Bedingfield
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Robert A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Sarah Glaze
- Tom Baker Cancer Centre, University of Calgary, Calgary, Canada
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
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Mchome B, Linde DS, Manongi R, Waldstroem M, Lftner T, Wu C, Mwaisalage J, Rasch V, Kjaer SK. Incident detection of human papillomavirus - a prospective follow-up study among Tanzanian women with a focus on HIV status. Int J Infect Dis 2021; 110:165-170. [PMID: 34252573 DOI: 10.1016/j.ijid.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The causative role of human papillomavirus (HPV) in cervical carcinogenesis is well established; however, prospective studies examining high-risk(HR)-HPV acquisition among adult women in HIV-prevalent settings are limited. METHODS We conducted a prospective study among women (25-60 years) attending cervical cancer screening in Tanzania. Cervical specimens obtained at enrolment and follow-up were tested for HPV. Participants were interviewed on lifestyle and tested for HIV. RESULTS Among 3805 eligible women, 3074 (80.8%) attended follow-up (median time between the 2 examinations, 17.3 months); 307 had missing HPV results at enrolment or follow-up, leaving 2767 study participants. Among 2253 women initially HR-HPV negative, 184 acquired HR-HPV-incidence: 54.5 per 1000 person-years (95% CI:47.1-62.9); among HIV-positive women 75.2 per 1000 person-years (95% CI:54.5-103.7), HIV-negative 50.9 per 1000 person-years (95% CI:43.3-60.0). HPV52 and HPV16 were the most frequently acquired types. In multivariable regression analysis, HIV positivity, low CD4 count, younger age, and multiple sexual partners were associated with increased odds of HPV acquisition. CONCLUSION HPV acquisition was higher among HIV-positive than HIV-negative women, especially women with low CD4 counts. Improvement of immune status among HIV-positives may decrease HPV acquisition. Nonavalent HPV vaccination should be considered given the pattern of HR-HPV types acquired.
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Affiliation(s)
- Bariki Mchome
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical University College, Kilimanjaro, United republic of Tanzania.
| | - Ditte S Linde
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, United republic of Tanzania
| | | | - Thomas Lftner
- Department of Experimental Virology, Tubingen University, Tubingen, Germany
| | - Chunsen Wu
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Julius Mwaisalage
- Department of Cancer Prevention Services, Ocean Road Cancer Institute, Dar-es-Salaam, United Republic of Tanzania
| | - Vibeke Rasch
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Susanne K Kjaer
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynaecology, Rigshospitalet, Copenhagen University Hospital, Denmark
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Li M, Liu T, Luo G, Sun X, Hu G, Lu Y, H Xu R, Zou H, Luo X. Incidence, persistence and clearance of cervical human papillomavirus among women in Guangdong, China 2007-2018: A retrospective cohort study. J Infect Public Health 2020; 14:42-49. [PMID: 33341483 DOI: 10.1016/j.jiph.2020.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous studies showed the incidence, persistence and clearance of cervical human papillomavirus (HPV) among women varies from regions. There is no study on dynamic changes of HPV infection among women in Guangdong. METHODS It is a retrospective cohort study that included gynecological outpatients aged ≥15 years and retested for HPV within 24 months in Guangdong Women and Children Hospital to estimate HPV incidence, persistence and clearance. Outcomes were estimated through the proportion of HPV incidence, persistence and clearance in HPV-negative or HPV-positive women. Moreover, we examined HPV incidence, persistence and clearance among women who retested in four calendar periods: 0-6, 6-12, 12-18, 18-24 months after the first test. RESULTS 33,328 gynecological outpatients were included in our study. Incidence rates of any HPV, high-risk (HR) HPV and low-risk (LR) HPV were 10.58%, 8.68% and 4.83%. The most common incident HR HPV were HPV52 (2.69%), HPV16 (1.23%) and HPV58 (1.23%). Persistence rates of any HPV, HR HPV and LR HPV were 47.55%, 42.77% and 33.88%. HPV52 (42.33%), HPV58 (40.74%) and HPV68 (32.36%) were commonly found persistent types. And clearance rates of any HPV, HR HPV and LR HPV were 52.44%, 57.23% and 66.12%.The lowest clearance rates were observed for HPV52 (57.67%), HPV68 (67.64%) and HPV39 (68.56%). HPV incidence and persistence were higher among women aged 15-19 years and ≥55 years. HPV incidence and persistence were found higher among women who retested within 6 months than others in other periods. CONCLUSIONS HPV52, 58, 68, and 39 were the more likely to cause incident and persistent infection, and less likely to be cleared among women in Guangdong. HPV incidence and persistent infection were higher among women aged both younger and older women compared to middle aged women. HPV retesting period may impact the detection of HPV incidence, persistence and clearance.
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Affiliation(s)
- Meijuan Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Tingyan Liu
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Ganfeng Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Xiaoli Sun
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Guiying Hu
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Ying Lu
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China
| | - Richie H Xu
- School of Public Health, University of Minnesota, MN, USA
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China; School of Public Health, Shanghai Jiao Tong University, Shanghai, PR China.
| | - Xiping Luo
- Department of Gynecology, Guangdong Provincial Women and Children Hospital, Guangzhou, PR China.
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Determinants of Acquisition and Clearance of Human Papillomavirus Infection in Previously Unexposed Young Women. Sex Transm Dis 2020; 46:663-669. [PMID: 31464859 PMCID: PMC6887628 DOI: 10.1097/olq.0000000000001053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Global variation in human papillomavirus (HPV) prevalence and persistence may be explained by differences in risk factors, such as sexual activity, oral contraceptive use, and behavioral factors. We evaluated determinants of acquisition and clearance of HPV infection among young women previously unexposed to HPV. METHODS Five hundred thirty-four women aged 15 to 25 years who were cytology and HPV DNA negative, and seronegative for anti-HPV-16/18 antibodies, were recruited (July 2000-September 2001) from study centers in Brazil, the United States, and Canada (NCT00689741/NCT00120848). They were followed up for 76 months. Cervical samples were HPV genotyped via polymerase chain reaction. We used multivariable (forward stepwise, P = 0.15) Cox proportional hazards regression to estimate rate ratios (RR) and 95% confidence intervals (CI), separately according to length of follow-up time. RESULTS On short-term follow-up (0-27 months), 257 (48%; 8535.80 person-months; incidence rate = 30.11; 95% CI, 26.64-34.02) incident HPV infections were detected. Marital status, lifetime number of sex partners, history of any sexually transmitted disease, and occasional use of oral contraceptives were strongly associated with acquisition of any HPV. Having 2 or more lifetime sex partners (RR, 2.03; 95% CI, 1.37-3.02) and a history of any sexually transmitted disease (RR, 1.98; 95% CI, 1.19-3.29) were the most important determinants of high-risk HPV (hrHPV) incidence. During the entire follow-up (0-76 months), an increased hrHPV clearance was found among women in North America (RR, 1.38; 95% CI, 1.08-1.78) and black women (RR, 1.64; 95% CI, 1.04-2.60). Greater number of lifetime partners was associated with reduced clearance rates for any HPV (RR, 0.65; 95% CI, 0.43-0.98). CONCLUSIONS We identified variation in risk of HPV acquisition and clearance among women unexposed to HPV at baseline.
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Oyervides-Muñoz MA, Pérez-Maya AA, Sánchez-Domínguez CN, Berlanga-Garza A, Antonio-Macedo M, Valdéz-Chapa LD, Cerda-Flores RM, Trevino V, Barrera-Saldaña HA, Garza-Rodríguez ML. Multiple HPV Infections and Viral Load Association in Persistent Cervical Lesions in Mexican Women. Viruses 2020; 12:E380. [PMID: 32244347 PMCID: PMC7232502 DOI: 10.3390/v12040380] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/18/2020] [Accepted: 03/22/2020] [Indexed: 12/04/2022] Open
Abstract
Persistent high-risk human papillomavirus (HR-HPV) infections play a major role in the development of invasive cervical cancer (CC), and screening for such infections is in many countries the primary method of detecting and preventing CC. HPV typing can be used for triage and risk stratification of women with atypical squamous cells of undetermined significance (ASC-US)/low-grade cervical lesions (LSIL), though the current clinical practice in Mexico is to diagnose CC or its preceding conditions mainly via histology and HR-HPV detection. Additional information regarding these HPV infections, such as viral load and co-infecting agents, might also be useful for diagnosing, predicting, and evaluating the possible consequences of the infection and of its prevention by vaccination. The goal of this follow-up hospital case study was to determine if HPV types, multiple HPV infections, and viral loads were associated with infection persistence and the cervical lesion grade. A total of 294 cervical cytology samples drawn from patients with gynecological alterations were used in this study. HPV types were identified by real-time PCR DNA analysis. A subset of HPV-positive patients was reevaluated to identify persistent infections. We identified HPV types 16, 18, and 39 as the most prevalent. One hundred five of the patients (59%) were infected with more than one type of HPV. The types of HPV associated with multiple HPV infections were 16, 18, and 39. In the follow-up samples, 38% of patients had not cleared the initially detected HPV infection, and these were considered persistent. We found here an association between multiple HPV infections and high viral loads with and infection persistence. Our findings suggest there are benefits in ascertaining viral load and multiple HPV infections status of HR-HPV infections for predicting the risk of persistence, a requirement for developing CC. These findings contribute to our understanding of HPV epidemiology and may allow screening programs to better assess the cancer-developing risks associated with individual HR-HPV infections.
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Affiliation(s)
- Mariel A. Oyervides-Muñoz
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Antonio A. Pérez-Maya
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Celia N. Sánchez-Domínguez
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Anais Berlanga-Garza
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Mauro Antonio-Macedo
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Lezmes D. Valdéz-Chapa
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Ricardo M. Cerda-Flores
- Facultad de Enfermería, Universidad Autónoma de Nuevo León, Av. Dr. José Eleuterio González 1500, Mitras Centro, 64460 Nuevo León, Mexico;
| | - Victor Trevino
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, 3000 Av. Morones Prieto, Colonia Los Doctores, 64710 Nuevo León, Mexico;
| | - Hugo A. Barrera-Saldaña
- Vitagénesis SA. Blvd. Puerta del Sol 1005. Colinas de San Jerónimo. Monterrey, 64630 Nuevo León, Mexico
| | - María L. Garza-Rodríguez
- Centro Universitario contra el Cancer, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico
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Jongen VW, van Santen DK, Alberts CJ, Schim van der Loeff MF. Estimating incidence rates of grouped HPV types: A systematic review and comparison of the impact of different epidemiological assumptions. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2019; 8:100187. [PMID: 31600572 PMCID: PMC6804437 DOI: 10.1016/j.pvr.2019.100187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Some studies on human papillomavirus (HPV) provide not only type-specific incidence rates (IR), but also IRs of HPV groupings (e.g. the nonavalent grouping). We made an inventory of the different approaches used to calculate such IRs and assessed their impact on the estimated IRs of HPV groupings. METHODS We performed a systematic review assessing all approaches used in literature to estimate IRs. Subsequently we applied these approaches to data of a Dutch cohort study on HPV in men who have sex with men (H2M). IRs were estimated for six different HPV groupings. RESULTS The systematic review yielded six different approaches (A-F) for estimating the IRs, varying in exclusion criteria at baseline, and the definitions of an incident event and person-time. Applying these approaches to the H2M dataset (n = 749), we found differences in the number of participants at risk, number of incidents events, person-time, and IR. For example, for the nonavalent grouping, depending on the approach chosen, the IR varied between 3.09 and 6.54 per 100 person-months. CONCLUSION In published studies different epidemiological assumptions are used to estimate IRs of grouped HPV types, leading to widely differing estimates of IRs. IRs between different studies may therefore not be comparable.
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Affiliation(s)
- Vita W Jongen
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Daniëla K van Santen
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Catharina J Alberts
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; International Agency for Research on Cancer, Lyon, France
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC, Univ of Amsterdam, Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam, Netherlands.
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10
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Adebamowo SN, Famooto A, Dareng EO, Olawande O, Olaniyan O, Offiong R, Adebamowo CA. Clearance of Type-Specific, Low-Risk, and High-Risk Cervical Human Papillomavirus Infections in HIV-Negative and HIV-Positive Women. J Glob Oncol 2019; 4:1-12. [PMID: 30125130 PMCID: PMC6223532 DOI: 10.1200/jgo.17.00129] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose There is a dearth of data on clearance of cervical human papillomavirus (HPV) infection among women in West Africa. We examined the clearance of low-risk (lr) and high-risk (hr) cervical HPV infections, and the factors associated with these measures in HIV-negative and HIV-positive women. Methods We studied 630 Nigerian women involved in a study of HPV infection using short polymerase chain reaction fragment-10 assay and line probe assay-25. Research nurses used a cervical brush to collect samples of exfoliated cervical cells from all the study participants. Cox proportional hazards models were used to estimate associations between HIV and HPV infections. Results The mean age of the study participants was 38 (standard deviation, ± 8) years; 51% were HIV positive. The rate of clearing any HPV infection was 2.0% per month among all women in the study population, 2.5% per month among HIV-negative women, and 1.6% per month, among HIV-positive women. The clearance rate per 1,000 person-months of observation for any lrHPV infection and any hrHPV infection were 9.21 and 8.83, respectively, for HIV-negative women, and 9.38 and 9.37, respectively, for HIV-positive women. In multivariate models, the hazard ratios for HIV-positive compared with HIV-negative women were 0.85 (95% CI, 0.51 to 1.43; P = .55) and 0.95 (95% CI, 0.54 to 1.65; P = .85) for cleared infections with any lrHPV and any hrHPV, respectively. The hazard ratio for HIV-positive compared with HIV-negative women was 0.39 (95% CI, 0.17 to 0.88; P = .02) for cleared infections with any multiple HPV and 0.13 (95% CI, 0.03 to 0.58; P = .007) for cleared infections with multiple hrHPV. Conclusion In this study population, we observed that HIV-positive women were less likely to clear infections with multiple hrHPV types.
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Affiliation(s)
- Sally N Adebamowo
- Sally N. Adebamowo and Clement A. Adebamowo, University of Maryland School of Medicine, Baltimore, MD; Sally N. Adebamowo, Ayotunde Famooto, and Clement A. Adebamowo, Center for Bioethics and Research, Ibadan; Ayotunde Famooto and Oluwatoyosi Olawande, Institute of Human Virology Nigeria; Olayinka Olaniyan, National Hospital Abuja; Richard Offiong, University of Abuja Teaching Hospital, Abuja, Nigeria; Eileen O. Dareng, University of Cambridge, Cambridge, United Kingdom
| | - Ayotunde Famooto
- Sally N. Adebamowo and Clement A. Adebamowo, University of Maryland School of Medicine, Baltimore, MD; Sally N. Adebamowo, Ayotunde Famooto, and Clement A. Adebamowo, Center for Bioethics and Research, Ibadan; Ayotunde Famooto and Oluwatoyosi Olawande, Institute of Human Virology Nigeria; Olayinka Olaniyan, National Hospital Abuja; Richard Offiong, University of Abuja Teaching Hospital, Abuja, Nigeria; Eileen O. Dareng, University of Cambridge, Cambridge, United Kingdom
| | - Eileen O Dareng
- Sally N. Adebamowo and Clement A. Adebamowo, University of Maryland School of Medicine, Baltimore, MD; Sally N. Adebamowo, Ayotunde Famooto, and Clement A. Adebamowo, Center for Bioethics and Research, Ibadan; Ayotunde Famooto and Oluwatoyosi Olawande, Institute of Human Virology Nigeria; Olayinka Olaniyan, National Hospital Abuja; Richard Offiong, University of Abuja Teaching Hospital, Abuja, Nigeria; Eileen O. Dareng, University of Cambridge, Cambridge, United Kingdom
| | - Oluwatoyosi Olawande
- Sally N. Adebamowo and Clement A. Adebamowo, University of Maryland School of Medicine, Baltimore, MD; Sally N. Adebamowo, Ayotunde Famooto, and Clement A. Adebamowo, Center for Bioethics and Research, Ibadan; Ayotunde Famooto and Oluwatoyosi Olawande, Institute of Human Virology Nigeria; Olayinka Olaniyan, National Hospital Abuja; Richard Offiong, University of Abuja Teaching Hospital, Abuja, Nigeria; Eileen O. Dareng, University of Cambridge, Cambridge, United Kingdom
| | - Olayinka Olaniyan
- Sally N. Adebamowo and Clement A. Adebamowo, University of Maryland School of Medicine, Baltimore, MD; Sally N. Adebamowo, Ayotunde Famooto, and Clement A. Adebamowo, Center for Bioethics and Research, Ibadan; Ayotunde Famooto and Oluwatoyosi Olawande, Institute of Human Virology Nigeria; Olayinka Olaniyan, National Hospital Abuja; Richard Offiong, University of Abuja Teaching Hospital, Abuja, Nigeria; Eileen O. Dareng, University of Cambridge, Cambridge, United Kingdom
| | - Richard Offiong
- Sally N. Adebamowo and Clement A. Adebamowo, University of Maryland School of Medicine, Baltimore, MD; Sally N. Adebamowo, Ayotunde Famooto, and Clement A. Adebamowo, Center for Bioethics and Research, Ibadan; Ayotunde Famooto and Oluwatoyosi Olawande, Institute of Human Virology Nigeria; Olayinka Olaniyan, National Hospital Abuja; Richard Offiong, University of Abuja Teaching Hospital, Abuja, Nigeria; Eileen O. Dareng, University of Cambridge, Cambridge, United Kingdom
| | - Clement A Adebamowo
- Sally N. Adebamowo and Clement A. Adebamowo, University of Maryland School of Medicine, Baltimore, MD; Sally N. Adebamowo, Ayotunde Famooto, and Clement A. Adebamowo, Center for Bioethics and Research, Ibadan; Ayotunde Famooto and Oluwatoyosi Olawande, Institute of Human Virology Nigeria; Olayinka Olaniyan, National Hospital Abuja; Richard Offiong, University of Abuja Teaching Hospital, Abuja, Nigeria; Eileen O. Dareng, University of Cambridge, Cambridge, United Kingdom
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Mukanyangezi MF, Rugwizangoga B, Manzi O, Rulisa S, Hellstrand K, Tobin G, Martner A, Bienvenu E, Giglio D. Persistence rate of cervical human papillomavirus infections and abnormal cytology in Rwanda. HIV Med 2019; 20:485-495. [PMID: 31318136 DOI: 10.1111/hiv.12782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES In this study, we determined the incidence and persistence of human papillomavirus (HPV) strains and of squamous intraepithelial lesions (SIL) or worse cytology in 237 HIV-positive and HIV-negative Rwandan women and whether the interleukin (IL)-28B single nucleotide polymorphism (SNP) at rs12979860 correlated with susceptibility to and persistence of HPV infection. METHODS Cervical samples were collected at baseline and after 9, 18 and 24 months for a 40-HPV DNA screening test and a ThinPrep Pap test. Genotyping of the IL-28B SNP rs12979860 was performed using real-time polymerase chain reaction (PCR). RESULTS Chronic high-risk (HR) HPV infections occurred in 56% of HIV-positive women, while no HIV-negative women developed HPV chronicity. High-grade SIL (HSIL) or cancer was diagnosed in 38% of HIV-positive women with persistent HR-HPV infections. HIV and HR-HPV positivity at baseline were factors associated with an increased risk of HPV persistence. Additionally, HR-HPV positivity at baseline was associated with an increased risk of developing HSIL or worse cytology. The unfavourable T/x genotype at rs12979860 is common among Africans, and women with this genotype were found to be more commonly infected with HPV. CONCLUSIONS HPV screening in Rwanda may help to identify women at risk of developing cervical cancer and polymorphism in IL-28B may be associated with risk of contracting HPV infection.
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Affiliation(s)
- M F Mukanyangezi
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - B Rugwizangoga
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - O Manzi
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - S Rulisa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - K Hellstrand
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - G Tobin
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - A Martner
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - E Bienvenu
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - D Giglio
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Gauthier B, Cerigo H, Coutlée F, Franco EL, Brassard P. Persistence of human papillomavirus 16, 18 and 52 variants in Inuit women from Northern Quebec, Canada. Int J Circumpolar Health 2019; 77:1556556. [PMID: 30827197 PMCID: PMC7011783 DOI: 10.1080/22423982.2018.1556556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Intratypic DNA polymorphism has been described for human papillomavirus (HPV) types infecting Inuit women in Nunavik, Quebec, a high-risk population for HPV infection and cervical cancer, but there is no previous research on the association between HPV polymorphism and infection persistence in Inuit women. Polymorphism of HPV types 16, 18 and 52 was described in a subset of 64 participants with multiple clinic visits within a cohort of 677 Nunavik Inuit women aged 15-69 recruited in 2002-2010 with testing results. Logistic regression and Cox proportional hazards models were used to assess the association between HPV variants and infection persistence and clearance. Infections with HPV16 lineage A3 variants cleared 3.13 times faster (95% CI: 1.10-8.97) than those with lineage A1 variants. HPV52 lineage C variants cleared slower than lineage A variants (HR = 0.28, 95% CI: 0.08-0.98). HPV polymorphism may be associated with viral persistence for certain HPV types in this population.
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Affiliation(s)
- Barbara Gauthier
- a Department of Epidemiology, Biostatistics, and Occupational Health , McGill University , Montréal , QC , Canada
| | - Helen Cerigo
- a Department of Epidemiology, Biostatistics, and Occupational Health , McGill University , Montréal , QC , Canada
| | - François Coutlée
- b Département de Microbiologie et Infectiologie , Centre Hospitalier de l'Université de Montréal , Montréal , QC , Canada
| | - Eduardo L Franco
- c Departments of Oncology and of Epidemiology, Biostatistics, and Occupational Health , McGill University , Montréal , QC , Canada
| | - Paul Brassard
- d Departments of Medicine and of Epidemiology, Biostatistics, and Occupational Health , McGill University , Montréal , QC , Canada
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Mrklas KJ, MacDonald S, Shea-Budgell MA, Bedingfield N, Ganshorn H, Glaze S, Bill L, Healy B, Healy C, Guichon J, Colquhoun A, Bell C, Richardson R, Henderson R, Kellner J, Barnabe C, Bednarczyk RA, Letendre A, Nelson GS. Barriers, supports, and effective interventions for uptake of human papillomavirus- and other vaccines within global and Canadian Indigenous peoples: a systematic review protocol. Syst Rev 2018; 7:40. [PMID: 29499749 PMCID: PMC5833130 DOI: 10.1186/s13643-018-0692-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/22/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples. METHODS Eligible studies will include global Indigenous peoples and discuss barriers or supports and/or interventions to improve uptake or to reduce hesitancy, for the HPV vaccine and/or other vaccines. Primary outcomes are documented barriers or supports or interventions. All study designs meeting inclusion criteria will be considered, without restricting by language, location, or data type. We will use an a priori search strategy, comprised of key words and controlled vocabulary terms, developed in consultation with an academic librarian, and reviewed by a second academic librarian using the PRESS checklist. We will search several electronic databases from date of inception, without restrictions. A pre-defined group of global Indigenous websites will be reviewed for relevant gray literature. Bibliographic searches will be conducted for all included studies to identify relevant reviews. Data analysis will include an inductive, qualitative, thematic synthesis and a quantitative analysis of measured barriers and supports, as well as a descriptive synthesis and quantitative summary of measures for interventions. DISCUSSION To our knowledge, this study will contribute the first systematic review of documented barriers, supports, and interventions for vaccination in general and for HPV vaccination. The results of this study are expected to inform future research, policies, programs, and community-driven initiatives to enhance acceptability and uptake of HPV vaccination among Indigenous peoples. SYSTEMATIC REVIEW REGISTRATION PROSPERO Registration Number: CRD42017048844.
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Affiliation(s)
- Kelly J. Mrklas
- Research Innovation and Analytics, Alberta Health Services, Edmonton, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Melissa A. Shea-Budgell
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nancy Bedingfield
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Heather Ganshorn
- Health Sciences Library, Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - Sarah Glaze
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | - Bonnie Healy
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | - Chyloe Healy
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | - Juliet Guichon
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amy Colquhoun
- Analytics and Performance Reporting Branch, Alberta Health, Edmonton, Canada
| | - Christopher Bell
- Analytics and Performance Reporting Branch, Alberta Health, Edmonton, Canada
| | - Ruth Richardson
- Health Canada First Nations and Inuit Health Branch, Edmonton, Canada
| | - Rita Henderson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James Kellner
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Robert A. Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | | | - Gregg S. Nelson
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Huang X, Zhao Q, Yang P, Li Y, Yuan H, Wu L, Chen Z. Metabolic Syndrome and Risk of Cervical Human Papillomavirus Incident and Persistent Infection. Medicine (Baltimore) 2016; 95:e2905. [PMID: 26945384 PMCID: PMC4782868 DOI: 10.1097/md.0000000000002905] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Few studies have been conducted on the relationship between metabolic syndrome (MetS) and cervical human papillomavirus (HPV) incidence and persistent infection. We performed a prospective cohort study including 8598 female employees in Hunan, China. First, the subjects were stratified into HPV-negative (N = 7282) and HPV-positive (N = 1316) subgroups, according to the results of an HPV DNA test at baseline. Second, comparisons of the risks of HPV incident and persistent infection between MetS-positive (exposed) and MetS-negative (unexposed) groups were conducted among the HPV-negative and -positive subgroups, respectively. There were 976 (11.39%) subjects diagnosed with MetS and 1316 subjects diagnosed with HPV infection at baseline. The 12-month cumulative incidence of any type of HPV and high-risk type HPV were 7.28% (530/7282) and 6.26% (456/7282), respectively. Obesity was a modifier of the association between MetS and HPV incident infection. As long as obesity presented, MetS and hypertriglyceridemia were significantly associated with an increased risk of HPV incident infection (any-type or high-risk type) (adjusted risk ratios (RR) were 2.88 (95% confidence interval (CI): 1.16, 7.19) and 3.29 (95% CI: 1.47, 7.38), respectively). Among those infected with HPV at baseline, the 12-month type-specific persistence rates were 51.67% and 53.38% for any-type and high-risk type HPV, respectively. No interaction was found between obesity and MetS with regard to the risk of HPV persistence. After adjustment for confounding factors, MetS was still associated with increased risk of any-type HPV persistence (RRadj = 1.21, 95% CI: 1.05, 1.41) and high-risk type HPV persistence (RRadj = 1.25, 95% CI: 1.09, 1.46). No single metabolic component was associated with the risk of HPV persistence. The prevalence of MetS was 11.39% among the Hunan female occupational population. MetS was associated with an increased risk of persistent cervical HPV infection and also with an increased risk of HPV incident infection when obesity presented as well.
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Affiliation(s)
- Xin Huang
- From the Department of Preventive Medicine, School of Medicine, Hunan Normal University (XH); Department of Health Management (XH, QZ, PY, LW, ZC); Department of Health Management (XH, QZ, PY, LW, ZC); Department of Clinical Pharmacology Center (YL, YH); the Third Xiangya Hospital, Central South University, Changsha, Hunan; and Institute of Aviation Medicine (LW), Beijing, China
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