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Misinformation, Gendered Perceptions, and Low Healthcare Provider Communication Around HPV and the HPV Vaccine Among Young Sexual Minority Men in New York City: The P18 Cohort Study. J Community Health 2021; 45:702-711. [PMID: 32016677 DOI: 10.1007/s10900-019-00784-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection among adults in the United States, and can cause several types of cancer. This is of particular concern for sexual minority men, as their increased risk of HIV acquisition increases risk for HPV and HPV-associated cancers, particularly when coupled with low rates of HPV vaccination. As part of a larger study of the syndemic of HIV, substance use, and mental health among young sexual minority men in New York City, we sought to explore what sexual minority men know about HPV and the HPV vaccine, along with their experiences have been communicating about the virus and vaccine. We interviewed 38 young sexual minority men with diverse sociodemographic characteristics and identified three main themes: low knowledge about HPV infection and vaccination, highly gendered misconceptions about HPV only affecting women, and lack of communication from healthcare providers about HPV. The prevalence of incorrect HPV knowledge, coupled with inadequate education and vaccination in healthcare settings, indicates a missed opportunity for HPV prevention in a high-risk and high-need population.
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Mueller SM, Menzi S, Kind AB, Blaich A, Bayer M, Navarini A, Itin P, Brandt O. Sexually transmitted coinfections in patients with anogenital warts - a retrospective analysis of 196 patients. J Dtsch Dermatol Ges 2020; 18:325-332. [PMID: 32291912 DOI: 10.1111/ddg.14060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/23/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Anogenital warts (AGWs) are most commonly caused by low-risk human papillomavirus (HPV) types, and although they are the most frequent viral sexually transmitted infections (STIs), little is known about STI coinfections in affected patients. We therefore sought to assess STI coinfection rates in patients with AGW, specify STI coinfections and calculate the number needed to screen (NNS) for each STI. METHODS A retrospective cross-sectional study analyzing data sets from AGW patients treated in our clinic between 2008-2016. RESULTS 142/196 (72 %) patients had been variably screened for infections with HIV, HBV and HCV, Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and HSV. The STI coinfection rate in all tested patients was 24.6 %, yielding an NNS of 4.1 to detect any STI. Of note, the coinfection rate did not differ significantly between heterosexual men, homosexual men and women, respectively. The NNS for syphilis was 8.4, for HIV 14.0, for HCV 28.5 and for HBV 39.0. The NNS for asymptomatic patients tested for HSV, Chlamydia trachomatis and Mycoplasma genitalium were 1.4, 5.3 and 12.0, respectively. CONCLUSION Due to the high prevalence of STI coinfections, AGW patients should be screened for other STIs.
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Affiliation(s)
- Simon M Mueller
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Sheryl Menzi
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - André B Kind
- Colposcopy Unit, Department of Gynecology, University Hospital Basel, Basel, Switzerland
| | - Annette Blaich
- Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - Michael Bayer
- Department of Dermatology, University Hospital Basel, Basel, Switzerland.,Medici Aerztezentrum, Zell, Switzerland
| | - Alexander Navarini
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Peter Itin
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Oliver Brandt
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Mueller SM, Menzi S, Kind AB, Blaich A, Bayer M, Navarini A, Itin P, Brandt O. Sexuell übertragbare Koinfektionen bei Patienten mit anogenitalen Warzen – eine retrospektive Analyse von 196 Patienten. J Dtsch Dermatol Ges 2020; 18:325-333. [DOI: 10.1111/ddg.14060_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/23/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Sheryl Menzi
- Dermatologische KlinikUniversitätsspital Basel Basel Schweiz
| | - André B. Kind
- Abteilung KolposkopieFrauenklinikUniversitätsspital Basel Basel Schweiz
| | - Annette Blaich
- Abteilung Klinische MikrobiologieUniversitätsspital Basel Basel Schweiz
| | - Michael Bayer
- Dermatologische KlinikUniversitätsspital Basel Basel Schweiz
- Medici Ärztezentrum Zell Schweiz
| | | | - Peter Itin
- Dermatologische KlinikUniversitätsspital Basel Basel Schweiz
| | - Oliver Brandt
- Dermatologische KlinikUniversitätsspital Basel Basel Schweiz
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Pudney J, Wangu Z, Panther L, Fugelso D, Marathe JG, Sagar M, Politch JA, Anderson DJ. Condylomata Acuminata (Anogenital Warts) Contain Accumulations of HIV-1 Target Cells That May Provide Portals for HIV Transmission. J Infect Dis 2019; 219:275-283. [PMID: 30137482 DOI: 10.1093/infdis/jiy505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/16/2018] [Indexed: 11/13/2022] Open
Abstract
Background Condylomata acuminata (anogenital warts [AGWs]) are prevalent in human immunodeficiency virus (HIV)-infected individuals and sexually active populations at risk for HIV acquisition and have been associated with HIV transmission. We compared AGW specimens to control tissue specimens for abundance, types, and location of HIV target cells and for susceptibility to HIV infection in vitro, to provide biologic evidence that AGWs facilitate HIV transmission. Methods We used immunohistologic staining to identify HIV target cells in AGW and control specimens. We also inoculated HIV in vitro into AGW and control specimens from HIV-negative men and assessed infection by means of TZM-bl and p24 assays. Results CD1a+ dendritic cells, CD4+ T cells, and macrophages were significantly more abundant in the epidermis of AGW specimens than control specimens. These HIV target cells also often appeared in large focal accumulations in the dermis of AGW specimens. Two of 8 AGW specimens versus 0 of 8 control specimens showed robust infection with HIV in vitro. Conclusions Compared with normal skin, AGWs contain significantly higher concentrations of HIV target cells that may be susceptible to HIV infection. Condylomata may thus promote HIV transmission, especially in the setting of typical lesion vascularity and friability. Prevention or treatment of AGWs may decrease the sexual transmission of HIV.
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Affiliation(s)
- Jeffrey Pudney
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston
| | - Zoon Wangu
- Division of Pediatric Infectious Diseases and Immunology, UMass Memorial Children's Medical Center, Worcester, Massachusetts
| | - Lori Panther
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston
| | - Dana Fugelso
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston
| | - Jai G Marathe
- Department of Medicine, Boston University School of Medicine, Boston
| | - Manish Sagar
- Department of Medicine, Boston University School of Medicine, Boston
| | - Joseph A Politch
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston
| | - Deborah J Anderson
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston.,Department of Medicine, Boston University School of Medicine, Boston
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Abstract
OBJECTIVES The aim of this study was to determine whether biomarker P16 predicts progression risk for anal low-grade squamous intraepithelial lesions (LSILs). DESIGN A retrospective study. METHODS One hundred and nine HIV-infected and 18 HIV-uninfected patients with biopsy-proven anal LSIL at initial screening underwent surveillance high-resolution anoscopy and biopsy within 2 years of diagnosis. P16 immunohistochemistry was performed on index lesions and evaluated using a semi-quantitative scoring system. The association of predictors and lesional outcomes (progression, persistence or regression) was analysed using ordinal logistic regression models. A subset of p16-positive LSILs was tested for high-risk human papillomavirus (HR-HPV) DNA using real-time PCR. RESULTS Upon follow-up, 46 (36%) LSILs progressed to high-grade squamous intraepithelial lesion (HSIL), 50 (40%) persisted as LSIL and 31 (24%) regressed to benign mucosa (median 16 months, range 5-24 months). Age, sex, race, history of condylomata, CD4 T-cell count and HIV plasma viral load were similar regardless of clinical outcome. P16 immunoreactivity of index lesion was classified as block-positive (n = 36), focal-positive (n = 49) or negative (n = 42). Sixty-four percent of block-positive lesions progressed, as opposed to 35% of focal-positive and 14% of negative lesions (P < 0.001). HR-HPV DNA was detected in 90% of p16 block-positive lesions vs. 55% of focal-positive lesions. In unadjusted analyses, positive p16, HIV and former smoker status were significantly associated with lesional persistence and progression. P16 remained the only significant predictor in an adjusted model. CONCLUSION Biomarker p16 is the strongest predictor for anal LSIL-to-HSIL progression, outperforming other risk factors. To enhance the overall effectiveness of surveillance, we propose using p16 immunohistochemistry to help stratify patients at high vs. low risk of progression.
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Mukanyangezi MF, Sengpiel V, Manzi O, Tobin G, Rulisa S, Bienvenu E, Giglio D. Screening for human papillomavirus, cervical cytological abnormalities and associated risk factors in HIV-positive and HIV-negative women in Rwanda. HIV Med 2017; 19:152-166. [PMID: 29210158 DOI: 10.1111/hiv.12564] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Cervical cancer is the major cause of death from cancer in Africa. We wanted to assess the prevalence of human papillomavirus (HPV) infections and associated risk factors and to determine whether HPV testing could serve as a screening method for squamous intraepithelial lesions (SILs) in Rwanda. We also wanted to obtain a broader understanding of the underlying risk factors for the establishment of HPV infection in Rwanda. METHODS A total of 206 HIV-positive women, 172 HIV-negative women and 22 women with unknown HIV status were recruited at the University Teaching Hospitals of Kigali (UTHK) and of Butare (UTHB) in Rwanda. Participants underwent an interview, cervical sampling for a Thinprep Pap test and a screening test analysing 37 HPV strains. RESULTS Only 27% of HIV-positive women and 7% of HIV-negative women had been screened for cervical cancer before. HPV16 and HPV52 were the most common HPV strains. HIV-positive women were more commonly infected with high-risk (HR) HPV and multitype HPV than HIV-negative women. The sensitivity was 78% and the specificity 87% to detect high-grade SIL (HSIL) with HPV screening. Among HIV-negative women, being divorced was positively associated with HR-HPV infection, while hepatitis B, Trichomonas vaginalis infection and HR-HPV infection were factors positively associated with SILs. Ever having had gonorrhoea was positively associated with HR-HPV infection among HIV-positive women. HR-HPV infection and the number of live births were positively associated with SILs. CONCLUSIONS The currently used quadrivalent vaccine may be insufficient to give satisfactory HPV coverage in Rwanda. HPV Screening may be effective to identify women at risk of developing cervical cancer, particularly if provided to high-risk patients.
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Affiliation(s)
- M F Mukanyangezi
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden.,College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - V Sengpiel
- Department of Obstetrics and Gynecology, The Sahlgrenska University Hospital, Gothenburg, Sweden
| | - O Manzi
- University Teaching Hospital (UTHK), Kigali, Rwanda
| | - G Tobin
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - S Rulisa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.,University Teaching Hospital (UTHK), Kigali, Rwanda
| | - E Bienvenu
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - D Giglio
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden.,Department of Oncology, University of Gothenburg, Gothenburg, Sweden
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Garland SM, Brotherton JML, Moscicki AB, Kaufmann AM, Stanley M, Bhatla N, Sankaranarayanan R, de Sanjosé S, Palefsky JM. HPV vaccination of immunocompromised hosts. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2017; 4:35-38. [PMID: 29179867 PMCID: PMC5883202 DOI: 10.1016/j.pvr.2017.06.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 01/04/2023]
Abstract
It is well-established that immunocompromised people are at increased risk of HPV-related disease compared with those who are immunocompetent. Prophylactic HPV sub-unit vaccines are safe and immunogenic in immunocompromised people and it is strongly recommended that vaccination occur according to national guidelines. When delivered to immunocompromised populations, HPV vaccines should be given as a 3-dose regimen.
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Affiliation(s)
- S M Garland
- Department of Microbiology and Infectious Diseases, Royal Women's Hospital, 30 Flemington Road, Parkville 3052, Australia; Murdoch Childrens Research Institute, 50 Flemington Road, Parkville 3052, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville 3052, Australia.
| | - J M L Brotherton
- VCS Registries, Victorian Cytology Service, Level 6, 176 Wellington Parade, East Melbourne 3002, Australia; School of Population and Global Health, University of Melbourne, Parkville 3052, Australia.
| | - A B Moscicki
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave. MDCC 22-432, MC:175217, Los Angeles, CA 90095, United States.
| | - A M Kaufmann
- Gynäkologische Tumorimmunologie, R. 4503 Gynäkologie, Charite-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
| | - M Stanley
- Department of Pathology, Tennis Court Road, Cambridge CB2 1QP, United Kingdom.
| | - N Bhatla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - R Sankaranarayanan
- Screening Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, World Health Organization, 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.
| | - S de Sanjosé
- Cancer Epidemiology Research Programme, IDIBELL, CIBERESP, Institut Català d'Oncologia, Av. Gran Via de l'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Spain.
| | - J M Palefsky
- University of California, San Francisco, 513 Parnassus Ave Box 0654, San Francisco, CA 94143, United States.
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HPV11 E6 mutation by overexpression of APOBEC3A and effects of interferon-ω on APOBEC3s and HPV11 E6 expression in HPV11.HaCaT cells. Virol J 2017; 14:211. [PMID: 29100527 PMCID: PMC5670706 DOI: 10.1186/s12985-017-0878-2] [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] [Received: 07/20/2017] [Accepted: 10/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Condyloma acuminatum, infected by low-risk human papillomaviruses (e.g., HPV6 and HPV11), is one of the most widespread sexually transmitted diseases. Apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like 3 proteins (APOBEC3s, A3s) are cellular cytidine deaminases acting as antiviral factors through hypermutation of viral genome. However, it remains unknown whether A3s results in HPV11 gene mutations and interferon-ω (IFN-ω) exhibits antiviral activities through the A3s system. Here we investigated whether enhanced APOBEC3A (A3A) resulted in the E6 gene mutations and explore the effects of recombinant human interferon-ω (rhIFN-ω) on A3s/E6 expression in HaCaT keratinocytes containing the genome of HPV 11 (HPV11.HaCaT cells). METHODS A3A-overexpressed HPV11.HaCaT (A3A-HPV11.HaCaT) cells were established by lentiviral infection and verified by immunofluorescence and western-blotting. Cell cycle, E6 gene mutations, APOBEC3s/E6 gene expression and subcellular localization were detected by FACS, 3D-PCR and sequencing, qRT-PCR and immunofluorescence respectively. RESULTS The results suggested that A3A-HPV11.HaCaT cells were successfully established. Enhanced A3A induced S-phase arrest, G > A/C > T mutations and obvious reduction of E6 mRNA expression. A3A/A3B mRNA expression was up-regulated at 6 h and 12 h and obvious A3A staining existed throughout HPV11.HaCaT cells after rhIFN-ω treatment. RhIFN-ω could also inhibit mRNA expression of HPV11 E6 significantly. CONCLUSIONS Enhanced A3A repressed HPV11 E6 expression through gene hypermutation, and rhIFN-ω might be an effective agent against HPV11 infection by up-regulation of A3A.
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Poljak M, Šterbenc A, Lunar MM. Prevention of human papillomavirus (HPV)-related tumors in people living with human immunodeficiency virus (HIV). Expert Rev Anti Infect Ther 2017; 15:987-999. [PMID: 29027811 DOI: 10.1080/14787210.2017.1392854] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION In comparison to their HIV-negative counterparts, people living with HIV (PLWH) have a higher prevalence of human papillomavirus (HPV) infection in various anatomical sites coupled with increased HPV persistence, higher risk of HPV-related tumors, and faster disease progression. Areas covered: Gender-neutral prevention strategies for HPV-related cancers in PLWH discussed: ABC approach, HPV vaccination, antiretroviral treatment (ART), anal cancer screening, and smoking cessation. Gender specific strategies: cervical cancer screening reduces the incidence and mortality of cervical cancer and circumcision might reduce the risk of HPV infections in men. Expert commentary: HPV-related cancer incidence has not declined (e.g. cervical cancer) and has even increased (e.g. anal cancer) in the ART era, demanding an effective HPV prevention strategy. HPV vaccination should be introduced into national prevention programs worldwide immediately because current prophylactic vaccines are safe, tolerable, and immunogenic in PLWH. HPV vaccine efficacy trials in PLWH are essential to determine the most appropriate immunization schedule. The population most at risk of anal cancer is HIV-positive men who have sex with men, who are not protected by herd immunity if only the female population is vaccinated. Unvaccinated PLWH need enhanced surveillance for early detection of HPV-related cancers and their precursors.
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Affiliation(s)
- Mario Poljak
- a Institute of Microbiology and Immunology, Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia
| | - Anja Šterbenc
- a Institute of Microbiology and Immunology, Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia
| | - Maja M Lunar
- a Institute of Microbiology and Immunology, Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia
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Oral and oropharyngeal papillomas are not associated with high-risk human papillomavirus infection. Eur Arch Otorhinolaryngol 2017. [DOI: 10.1007/s00405-017-4649-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Morbidity and Mortality Associated With Anogenital Human Papillomavirus "Low Risk" Genotypes. Sex Transm Dis 2015; 42:545-6. [PMID: 26366506 DOI: 10.1097/olq.0000000000000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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