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HPV-Related Multiphenotypic Sinonasal Carcinoma: Four Cases that Expand the Morpho-Molecular Spectrum and Include Occupational Data. Head Neck Pathol 2019; 14:623-629. [PMID: 31571045 PMCID: PMC7413931 DOI: 10.1007/s12105-019-01079-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 09/13/2019] [Indexed: 12/17/2022]
Abstract
HPV-related multiphenotypic sinonasal carcinoma (HMSC) is a recently described distinct tumor entity of the sinonasal tract associated with high-risk subtypes of human papilloma virus (HPV), predominantly type 33. The biological behavior seems to be less aggressive than the often high-grade, highly proliferative morphology implies; however, recurrences are frequent. Most of the cases present as polypoid tumors within the nasal cavity. Microscopic morphology frequently encompasses adenoid cystic-like features or features reminiscent of other salivary gland tumors. Here, we describe four cases of this rare entity, all observed in women. The polypoid tumors were within the nasal cavity, leading to obstruction, facial pain and epistaxis. The morphology was predominantly basaloid, solid and adenoid cystic-like in two of four cases, one with additional glomeruloid features. Another case showed basaloid tumor cells with prominent mature squamous differentiation and extensive keratinization. A single case showed a predominantly solid and reticular growth pattern. All cases were diffusely positive for p16 (100%), expressed SOX10, LEF-1 and partially S-100, and harbored HPV high-risk types 33, 56 (2×) and 82. No recurrences or metastases were detectable after 3-50 months of follow-up. Of note, three of four patients were nurses/nursing assistant. We expand the morphological spectrum by describing a glomeruloid growth pattern and extensive mature keratinization, and add HPV type 82 to the molecular spectrum. The finding of HMSC among predominantly nurses in our cohort warrants further epidemiological studies in larger cohorts.
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Houlihan CF, Baisley K, Bravo IG, Pavón MA, Changalucha J, Kapiga S, De Sanjosé S, Ross DA, Hayes RJ, Watson-Jones D. Human papillomavirus DNA detected in fingertip, oral and bathroom samples from unvaccinated adolescent girls in Tanzania. Sex Transm Infect 2019; 95:374-379. [PMID: 30636707 PMCID: PMC6678034 DOI: 10.1136/sextrans-2018-053756] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/16/2018] [Accepted: 12/16/2018] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Human papillomavirus (HPV) DNA has been detected in vaginal samples from adolescent girls who report no previous sex and, in high-income settings, from fingertips, raising the possibility of non-sexual transmission. No such studies originate from East Africa which bears among the highest cervical cancer incidence and HPV prevalence worldwide. HPV-related oral cancer incidence is increasing, but oral HPV prevalence data from East Africa are limited. We aimed to describe the HPV DNA prevalence in genital and non-genital sites and in the bathroom of unvaccinated adolescent girls, and examine genotype concordance between sites. METHODS We nested a cross-sectional study of HPV in genital and extragenital sites within a cohort study of vaginal HPV acquisition. Unvaccinated girls age 16-18 years in Tanzania, who reported ever having had sex, were consented, enrolled and tested for the presence of HPV DNA in vaginal samples collected using self-administered swabs, oral samples collected using an oral rinse, and on fingertips and bathroom surfaces collected using a cytobrush. RESULTS Overall, 65 girls were enrolled and 23 (35%, 95% CI 23% to 47%) had detectable vaginal HPV. Adequate (β-globin positive) samples were collected from 36 girls' fingertips and HPV was detected in 7 (19%, 95% CI 6% to 33%). 63 girls provided adequate oral samples, 4 (6%, 95% CI 0% to 13%) of which had HPV DNA detected. In bathroom samples from 58 girls, 4 (7%, 95% CI 0% to 14%) had detectable HPV DNA. Of the 11 girls with extragenital HPV, six had the same genotype in >1 site. CONCLUSION We found a high prevalence of HPV in non-genital sites in adolescent girls and in their bathrooms, in this region with a high cervical cancer incidence. Concordance of genotypes between sites supports the possibility of autoinoculation.
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Affiliation(s)
- Catherine F Houlihan
- Division of Infection and Immunity, University College London, London, UK .,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Kathy Baisley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Ignacio G Bravo
- French National Center for Scientific Research (CNRS), Laboratory MIVEGEC (CNRS IRD Uni Montp), Montpellier, France
| | - Miguel A Pavón
- Infections and Cancer Laboratory, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Barcelona, Spain.,CIBER-ONC, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Saidi Kapiga
- Mwanza Interventional Trials Unit, Mwanza, Tanzania
| | | | - David A Ross
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Deborah Watson-Jones
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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Smelov V, Elfström KM, Eklund C, Sokolova O, Dillner J. Determinants of the presence of human papillomaviruses in the anal canal of Russian men. J Med Virol 2018; 90:1643-1650. [PMID: 29797586 DOI: 10.1002/jmv.25234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 05/14/2018] [Indexed: 11/10/2022]
Abstract
Knowledge of determinants of anal human papillomavirus (HPV) infections among men is still limited as most of the studies are focused on high-risk populations and geographically narrowed. Such knowledge obtained in different populations is essential for better understanding of HPV natural history, transmission dynamics, and its role in the development and prevention of anogenital malignancies in different regions. Here we tested anal canal swab samples from 359 Russian heterosexual (323 human immunodeficiency virus [HIV]-negative and 27 HIV-positive, aged 18-67 years) men attending a sexually transmitted infection clinic 36 HPV types using a proficient Luminex assay. HPV-positivity in anal samples was common for 332 HIV-negative heterosexual men for overall HPV (15.7%, n = 52), oncogenic HPV (9.6%, n = 32), nononcogenic HPV (8.1%, n = 27), and multiple HPV infections (4.5%, n = 14). The most common anal HPV types were HPV16 (5.7%), HPV45, and HPV51 (1.8% each), HPV66, and HPV87 (1.8% each). No association was found with the number of lifetime sexual partners, age of participants at the time of the study, or their sexual debut. Although anal HPV positivity was more common among HIV-positive men, the current study provides additional evidence that anal HPV can be frequently detected in heterosexual HIV-negative men favoring further studies on transmission routes to discriminate between contamination and true HPV infection.
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Affiliation(s)
- Vitaly Smelov
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, World Health Organization, Lyon, France.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.,Department of Urology, North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
| | - K Miriam Elfström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Carina Eklund
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Olga Sokolova
- Faculty of Medicine, St. Petersburg State University, St. Petersburg, Russia.,Outpatient Clinic, S. P. Botkin Memorial Clinical Hospital of Infectious Diseases, St. Petersburg, Russia
| | - Joakim Dillner
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.,Department of Urology, North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia
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Beta and gamma human papillomaviruses in anal and genital sites among men: prevalence and determinants. Sci Rep 2018; 8:8241. [PMID: 29844517 PMCID: PMC5974254 DOI: 10.1038/s41598-018-26589-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/05/2018] [Indexed: 02/08/2023] Open
Abstract
Data regarding the anogenital distribution of and type-specific concordance for cutaneous β- and γ-HPV types in men who have sex with women is limited and geographically narrow. Knowledge of determinants of anogenital detection of cutaneous HPV types in different regions is needed for better understanding of the natural history and transmission dynamics of HPV, and its potential role in the development of anogenital diseases. Genital and anal canal samples obtained from 554 Russian men were screened for 43 β-HPVs and 29 γ-HPVs, using a multiplex PCR combined with Luminex technology. Both β- and γ-HPVs were more prevalent in the anal (22.8% and 14.1%) samples than in the genital (16.8% and 12.3%) samples. Low overall and type-specific concordance for β-HPVs (3.5% and 1.1%) and γ-HPVs (1.3% and 0.6%) were observed between genital and anal samples. HIV-positive men had higher anal β- (crude OR = 12.2, 95% CI: 5.3–28.1) and γ-HPV (crude OR = 7.2, 95% CI: 3.3–15.4) prevalence than HIV-negative men. Due to the lack of genital samples from the HIV-positive men, no comparison was possible for HIV status in genital samples. The lack of type-specific positive concordance between genital and anal sites for cutaneous β- and γ-HPV types in heterosexual men posits the needs for further studies on transmission routes to discriminate between contamination and true HPV infection. HIV-positive status may favor the anal acquisition or modify the natural history of cutaneous HPV types.
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Smelov V, Hanisch R, McKay-Chopin S, Sokolova O, Eklund C, Komyakov B, Gheit T, Tommasino M. Prevalence of cutaneous beta and gamma human papillomaviruses in the anal canal of men who have sex with women. PAPILLOMAVIRUS RESEARCH 2017; 3:66-72. [PMID: 28720458 PMCID: PMC5883282 DOI: 10.1016/j.pvr.2017.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/19/2016] [Accepted: 02/13/2017] [Indexed: 12/15/2022]
Abstract
Background Data regarding anal cutaneous HPV detection among HIV-positive and HIV-negative persons largely relies on studies among men who have sex with men in limited geographical settings. Understanding the distribution, determinants, and potential human health effects of anal cutaneous HPV types among men who have sex with women (MSW) is important. Methods Anal canal swab samples from 415 Russian MSW (384 HIV-negative and 31 HIV-positive) were tested for 43 β-HPVs and 29 γ-HPVs, using a multiplex PCR combined with Luminex technology. Results β-HPV was detected in 24.4% and γ-HPV in 15.9% of anal samples of all Russian MSW. In total, 34 β-HPV and 19 γ-HPV types were detected, with the most commonly detected β-HPV types being 110, 22 and 124 and the most common γ-HPV types being 95, 132 and 50. For both genera, being HIV-positive at the time of testing was a significant determinant of detection (74.2% for β-HPVs and 48.4% for γ-HPVs compared to 20.1% and 12.5% in HIV-negative MSW, respectively). Conclusions A wide spectrum and moderate prevalence of anal β-HPV and γ-HPV types was found in our MSW study sample, suggesting that routes other than penile-anal intercourse may be important in cutaneous HPV transmission. β and γ HPV types commonly colonize the anal canal of MSW, but their geographical variation in prevalence could be wide. HIV-positive men were more likely to have both genera of HPV types detected. Routes other than penile-anal intercourse may be important in cutaneous HPV transmission.
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Affiliation(s)
- Vitaly Smelov
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France; Screening Group, International Agency for Research on Cancer, World Health Organization, Lyon, France; Department of Urology, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia; Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Rachel Hanisch
- Section of Environment and Radiation, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Olga Sokolova
- Faculty of Medicine, St. Petersburg State University, St. Petersburg, Russia; Clinical Infectious Diseases Hospital named after S.P. Botkin,, St. Petersburg, Russia
| | - Carina Eklund
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Boris Komyakov
- Department of Urology, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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Ramanakumar AV, Naud P, Roteli-Martins CM, de Carvalho NS, de Borba PC, Teixeira JC, Blatter M, Moscicki AB, Harper DM, Romanowski B, Tyring SK, Ramjattan B, Schuind A, Dubin G, Franco EL. Incidence and duration of type-specific human papillomavirus infection in high-risk HPV-naïve women: results from the control arm of a phase II HPV-16/18 vaccine trial. BMJ Open 2016; 6:e011371. [PMID: 27566633 PMCID: PMC5013348 DOI: 10.1136/bmjopen-2016-011371] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Persistence of human papillomaviruses (HPVs) is necessary for cervical carcinogenesis. We evaluated incidence and duration of type-specific HPV infections and the influence of age and number of sexual partners. METHODS Data were obtained from 553 women (15-25 years), who were seronegative and DNA-negative for high-risk HPV (HR-HPV) types and were enrolled in the placebo arm of a randomised trial of the HPV-16/18 vaccine (NCT00689741/NCT00120848). They were followed for 6.3 years. Cervicovaginal samples were self-collected at 3-month intervals for up to 27 months, and cervical samples were collected by clinicians at 6-month intervals until study end. Samples were tested for HPV types using a broad-spectrum PCR assay. Incidence rate ratios (RRs) and 95% CIs were used to estimate the association among age, sexual habits and HPV acquisition. RESULTS Incidence rates (95% CI) using cervical samples were 11.8 (10.4 to 13.4) and 5.6 (4.7 to 6.6) per 1000 women-months for HR-HPVs and low-risk HPVs (LR-HPVs), respectively. Equivalent rates in combined cervicovaginal and cervical samples were 17.2 (15.4 to 19.2) and 6.9 (5.9 to 8.0), respectively. 54 per cent of HR-HPV types from combined cervicovaginal and cervical samples persisted for 1 year compared with 32.3% for LR-HPV types. The risk of acquiring any HPV infection was higher among women aged <21 years (RR=1.33, 95% CI 1.1 to 1.7) and women having >1 sexual partner (RR=1.83, 95% CI 1.4 to 2.4) at baseline. CONCLUSIONS HR-HPV infections were more common and lasted longer on average than LR-HPV infections. HPV acquisition was more common in younger women with multiple sexual partners. TRIAL REGISTRATION NUMBER NCT00689741, NCT00120848; Post-results.
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Affiliation(s)
| | - Paulo Naud
- Federal University of Rio Grande do Sul—UFRGS/HCPA—Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Newton S de Carvalho
- Department of Gynecology and Obstetrics, Gynecology and Obstetrics Infectious Diseases Sector, University of Parana, Curitiba, Parana, Brazil
| | | | - Julio C Teixeira
- Department of Gynecology, Oncology Division, State University of Campinas, Campinas, Brazil
| | - Mark Blatter
- Pediatric Alliance, Pittsburgh, Pennsylvania, USA
| | | | - Diane M Harper
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | | | - Stephen K Tyring
- Departments of Microbiology/Molecular Genetics, Dermatology & Internal Medicine, The University of Texas Medical School, Houston, Texas, USA
| | - Brian Ramjattan
- First Line Medical Services Ltd., St. John's, Newfoundland and Labrador, Canada
| | - Anne Schuind
- GSK Vaccines, King of Prussia, Pennsylvania, USA
| | - Gary Dubin
- GSK Vaccines, King of Prussia, Pennsylvania, USA
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
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The Incidence of Human Papillomavirus in Tanzanian Adolescent Girls Before Reported Sexual Debut. J Adolesc Health 2016; 58:295-301. [PMID: 26725717 PMCID: PMC4762460 DOI: 10.1016/j.jadohealth.2015.10.248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Acquisition of human papillomavirus (HPV) in women occurs predominantly through vaginal sex. However, HPV has been detected in girls reporting no previous sex. We aimed to determine incidence and risk factors for HPV acquisition in girls who report no previous sex in Tanzania, a country with high HPV prevalence and cervical cancer incidence. METHODS We followed 503 adolescent girls aged 15-16 years in Mwanza, Tanzania, with face-to-face interviews and self-administered vaginal swabs every 3 months for 18 months; 397 girls reported no sex before enrollment or during follow-up; of whom, 120 were randomly selected. Samples from enrollment, 6-, 12-, and 18-month visits were tested for 37 HPV genotypes. Incidence, clearance, point prevalence, and duration of any HPV and genotype-specific infections were calculated and associated factors were evaluated. RESULTS Of 120 girls who reported no previous sex, 119 were included, contributing 438 samples. HPV was detected in 51 (11.6%) samples. The overall incidence of new HPV infections was 29.4/100 person-years (95% confidence interval: 15.9-54.2). The point prevalence of vaccine types HPV-6,-11,-16, and -18 was .9%, .9%, 2.0%, and 0%, respectively. Spending a night away from home and using the Internet were associated with incident HPV, and reporting having seen a pornographic movie was inversely associated with HPV incidence. CONCLUSIONS Incident HPV infections were detected frequently in adolescent girls who reported no previous sex over 18 months. This is likely to reflect under-reporting of sex. A low-point prevalence of HPV genotypes in licensed vaccines was seen, indicating that vaccination of these girls might still be effective.
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Anderson TA, Schick V, Herbenick D, Dodge B, Fortenberry JD. A study of human papillomavirus on vaginally inserted sex toys, before and after cleaning, among women who have sex with women and men: Table 1. Sex Transm Infect 2014; 90:529-31. [DOI: 10.1136/sextrans-2014-051558] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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