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Kusters JMA, Obels I, van der Klis FRM, King AJ, Heijman T, Heijne JCM, van Benthem BHB, van der Loeff MFS. Prevalence and risk factors for HPV seropositivity and anogenital DNA positivity among men who have sex with men: a repeated cross-sectional study. Int J Infect Dis 2024; 145:107094. [PMID: 38777081 DOI: 10.1016/j.ijid.2024.107094] [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: 01/16/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES This study aimed to assess associations of potential risk factors with human papillomavirus (HPV) seropositivity among men who have sex with men (MSM) and compare these to risk factors for anal and penile (HPV) deoxyribonucleic acid (DNA)-positivity in the same study population. METHODS Seropositivity and anal and penile HPV DNA-positivity were determined for seven high-risk HPV genotypes for MSM aged 16-24 years participating in Papillomavirus Surveillance among STI clinic Youngsters in the Netherlands (PASSYON) 2009-2021. Logistic regression models were conducted to assess risk factors for seropositivity, anal and penile HPV DNA-positivity. RESULTS Overall, 1019 MSM were included. HPV-16 and -18 were most common for serology, and anal and penile HPV DNA-positivity. Although no clear similarities were observed for most risk factors for HPV seropositivity and anal or penile DNA positivity, receptive anal intercourse (RAI) was the strongest associated risk factor for both seropositivity ('RAI ever' adjusted odds ratio [aOR] 3.50, 95% confidence interval [CI] 1.56-7.88; 'RAI previous 6 months' aOR 2.17, 95% CI 1.44-3.26) and anal DNA-positivity ('RAI previous 6 months' aOR 1.67, 95% CI 1.09-2.56). CONCLUSIONS Our study is suggestive of site-specific immune response after HPV infection; RAI might lead to anal HPV infections and consequently to seroconversion. Finally, as the two genotypes that are most oncogenic and preventable by all HPV vaccines were most common, our results underline the importance of gender-neutral vaccination.
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Affiliation(s)
- Johannes M A Kusters
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, Amsterdam, The Netherlands.
| | - Ilja Obels
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Audrey J King
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Titia Heijman
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Janneke C M Heijne
- Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, Amsterdam, The Netherlands; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Birgit H B van Benthem
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Maarten F Schim van der Loeff
- Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, Amsterdam, The Netherlands; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
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2
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Tota JE, Giuliano AR, Goldstone SE, Dubin B, Saah A, Luxembourg A, Velicer C, Palefsky JM. Anogenital Human Papillomavirus (HPV) Infection, Seroprevalence, and Risk Factors for HPV Seropositivity Among Sexually Active Men Enrolled in a Global HPV Vaccine Trial. Clin Infect Dis 2022; 74:1247-1256. [PMID: 34265048 DOI: 10.1093/cid/ciab603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In men, the incidence of human papillomavirus (HPV)-related cancer is rising, but data regarding male HPV infection and seroprevalence are available from only a few countries. METHODS This analysis of a global HPV vaccine trial evaluated baseline data from 1399 human immunodeficiency virus-negative heterosexual men (HM) and men who have sex with men (MSM). Key objectives included assessment of HPV prevalence and risk factors for seropositivity to 9-valent HPV (9vHPV) vaccine types (6, 11, 16, 18, 31, 33, 45, 52, and 58), and concordance between seropositivity and prevalent HPV type. RESULTS Overall, 455 of 3463 HM (13.1%) and 228 of 602 MSM (37.9%) were HPV DNA positive for any 9vHPV vaccine type at baseline. Infection prevalence and seroprevalence (≥1 9vHPV vaccine type) were 13.2% and 8.1%, respectively, among 333 HM from Europe, and 37.9% and 29.9%, respectively, among 335 MSM from Europe or North America. Among men with baseline infection, MSM had higher seroprevalence for concordant HPV types (39.5% vs 10.8% in HM). The seropositivity risk (irrespective of baseline infection status) was higher among MSM versus HM (age-adjusted odds ratio, 3.0 [95% confidence interval, 2.4-6.4]). Among MSM, statistically significant seropositivity risk factors included younger age at sexual debut, higher number of receptive anal sex partners, and less frequent condom use. No factors assessed were associated with seropositivity in HM. CONCLUSIONS Higher proportions of MSM than HM were HPV DNA positive and seropositive, and concordance between HPV DNA positivity and seropositivity, a potential marker of true infection versus carriage, was higher in MSM. Most MSM and HM were seronegative for all 9vHPV vaccine types, suggesting the potential benefit of catch-up vaccination after sexual debut.Clinical Trials Registration. NCT00090285.
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Affiliation(s)
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | | | | | | | | | - Joel M Palefsky
- Department of Infectious Diseases, University of California, San Francisco, San Francisco, California, USA
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3
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Epidemiology and Prevention of HPV-Associated Squamous Cell Carcinoma. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-021-00385-z] [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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4
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Drake VE, Fakhry C, Windon MJ, Stewart CM, Akst L, Hillel A, Chien W, Ha P, Miles B, Gourin CG, Mandal R, Mydlarz WK, Rooper L, Troy T, Yavvari S, Waterboer T, Brenner N, Eisele DW, D'Souza G. Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer. Cancer 2021; 127:1029-1038. [PMID: 33426652 DOI: 10.1002/cncr.33346] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/27/2020] [Accepted: 10/22/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Case-control studies from the early 2000s demonstrated that human papillomavirus-related oropharyngeal cancer (HPV-OPC) is a distinct entity associated with number of oral sex partners. Using contemporary data, we investigated novel risk factors (sexual debut behaviors, exposure intensity, and relationship dynamics) and serological markers on odds of HPV-OPC. METHODS HPV-OPC patients and frequency-matched controls were enrolled in a multicenter study from 2013 to 2018. Participants completed a behavioral survey. Characteristics were compared using a chi-square test for categorical variables and a t test for continuous variables. Adjusted odds ratios (aOR) were calculated using logistic regression. RESULTS A total of 163 HPV-OPC patients and 345 controls were included. Lifetime number of oral sex partners was associated with significantly increased odds of HPV-OPC (>10 partners: odds ratio [OR], 4.3 [95% CI, 2.8-6.7]). After adjustment for number of oral sex partners and smoking, younger age at first oral sex (<18 vs >20 years: aOR, 1.8 [95% CI, 1.1-3.2]) and oral sex intensity (>5 sex-years: aOR, 2.8 [95% CI, 1.1-7.5]) remained associated with significantly increased odds of HPV-OPC. Type of sexual partner such as older partners when a case was younger (OR, 1.7 [95% CI, 1.1-2.6]) or having a partner who had extramarital sex (OR, 1.6 [95% CI, 1.1-2.4]) was associated with HPV-OPC. Seropositivity for antibodies to HPV16 E6 (OR, 286 [95% CI, 122-670]) and any HPV16 E protein (E1, E2, E6, E7; OR, 163 [95% CI, 70-378]) was associated with increased odds of HPV-OPC. CONCLUSION Number of oral sex partners remains a strong risk factor for HPV-OPC; however, timing and intensity of oral sex are novel independent risk factors. These behaviors suggest additional nuances of how and why some individuals develop HPV-OPC.
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Affiliation(s)
- Virginia E Drake
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Melina J Windon
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - C Matthew Stewart
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Lee Akst
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Alexander Hillel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Wade Chien
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Patrick Ha
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California
| | - Brett Miles
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York City, New York
| | - Christine G Gourin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Rajarsi Mandal
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Wojciech K Mydlarz
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Lisa Rooper
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Tanya Troy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Siddhartha Yavvari
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Tim Waterboer
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Nicole Brenner
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - David W Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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5
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King EM, Mesher D, Sonnenberg P, Linley E, Panwar K, Beddows S, Soldan K, Borrow R, Jit M, Gilson R. HPV16 and HPV18 seropositivity and DNA detection among men who have sex with men: a cross-sectional study conducted in a sexual health clinic in London. Sex Transm Infect 2020; 97:382-386. [PMID: 33361466 PMCID: PMC8311088 DOI: 10.1136/sextrans-2020-054726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 01/07/2023] Open
Abstract
Objectives Men who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection and related diseases compared with men who have sex exclusively with women. From April 2018, there has been a phased roll-out of HPV vaccination offered to MSM aged up to 45 years old who are attending sexual health clinics and HIV clinics in England. The vaccine is most effective if delivered prior to HPV infection. We estimated the proportion of MSM with no current vaccine-type infection and no serological evidence of prior infection, in a study undertaken prior to vaccine introduction. Methods We conducted a cross-sectional study among 484 MSM aged 18–40 years old who attended a sexual health clinic in London between 2010 and 2012. We estimated the prevalence of current and past infection by testing for HPV DNA in anogenital samples and for serum antibodies to HPV16 and HPV18. Results The median age was 30 years (IQR 25–35). The prevalence of HPV16 and HPV18 DNA was 13.2% and 6.2%, respectively. Seropositivity for HPV16 and HPV18 was 28.5% and 17.1%, respectively, with 11.4% seropositive for both types. Seropositivity for the same HPV type was strongly associated with anogenital DNA detection. 279 MSM (57.6%) tested negative for both HPV16 and HPV18 serology and were DNA negative for these two types; only 5 MSM (1.0%) were seropositive and DNA positive for both HPV types. Conclusions This is the first study to determine both the prevalence of HPV DNA in anogenital samples and HPV seroprevalence among MSM attending a sexual health clinic in the UK. Over half of MSM in this study had no evidence of a previous or current infection with either of the high-risk HPV types included in the quadrivalent vaccine, which supports the rationale for opportunistic HPV vaccination of MSM attending sexual health clinics.
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Affiliation(s)
- Eleanor M King
- Institute for Global Health, University College London, London, UK
| | - David Mesher
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, Public Health England, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Ezra Linley
- Vaccine Evaluation Unit, Public Health England, Manchester, UK
| | - Kavita Panwar
- Virus Reference Department, Public Health England, London, UK
| | - Simon Beddows
- Virus Reference Department, Public Health England, London, UK
| | - Kate Soldan
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, Public Health England, London, UK
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester, UK
| | - Mark Jit
- Modelling and Economics Unit, Public Health England, London, UK.,Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Gilson
- Institute for Global Health, University College London, London, UK .,The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
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6
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Lewis RM, Markowitz LE, Panicker G, Unger ER. Seroprevalence of Human Papillomavirus 6/11/16/18 Among Self-identified Gay/Bisexual Men Who Have Sex With Men, Men Who Have Sex With Women, and Females, United States, 2003-2010. Clin Infect Dis 2020; 69:1011-1018. [PMID: 30475987 DOI: 10.1093/cid/ciy1002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/20/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Differences in human papillomavirus (HPV) seroprevalence by sex have been observed, likely due to differences in the anatomic site of HPV exposure. Seroconversion may be more likely after exposure at nonkeratinized (mucosal) compared to keratinized epithelium. We compared seroprevalence among self-identified gay/bisexual men who have sex with men (MSM) and females, 2 groups more likely exposed at mucosal epithelium, and men who only have sex with women (MSW), a group likely exposed primarily at keratinized epithelium, using data from the National Health and Nutrition Examination Survey from 2003 to 2010. METHODS HPV 6/11/16/18 serum antibody was detected using a multiplexed, competitive luminex immunoassay. Weighted seroprevalence was estimated among unvaccinated, sexually experienced 18-59 year-old MSM, MSW, and females, overall and by demographic and sexual behavior characteristics. Seroprevalences were compared using prevalence ratios adjusted for sexual behavior (aPRs). RESULTS Overall, seroprevalence in MSM, MSW, and females was 42.6%, 13.2%, and 37.1%, respectively. Seroprevalence in MSM was comparable to females (aPR: 0.85, 95% confidence interval [CI]: 0.68-1.08) and higher than MSW (aPR: 2.72, 95% CI: 2.19-3.38). MSW had a significantly lower seroprevalence than females (aPR: 0.31, 95% CI: 0.28-0.34). Similar associations were seen in all sociodemographic subgroups. Seroprevalence increased with number of lifetime sex partners in all groups. CONCLUSIONS In this population-based survey, HPV seroprevalence among groups likely exposed at mucosal epithelium (MSM, females) was comparable; seroprevalence in both groups was higher than in MSW. Future research could explore whether differences in seropositivity following infection result in differential protection from future infection.
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Affiliation(s)
- Rayleen M Lewis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta
- Synergy America, Inc., Duluth
| | - Lauri E Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta
| | - Gitika Panicker
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth R Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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7
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Pasmans H, Hoes J, Tymchenko L, de Melker HE, van der Klis FRM. Changes in HPV Seroprevalence from an Unvaccinated toward a Girls-Only Vaccinated Population in the Netherlands. Cancer Epidemiol Biomarkers Prev 2020; 29:2243-2254. [PMID: 32856612 DOI: 10.1158/1055-9965.epi-20-0596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/25/2020] [Accepted: 08/05/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In the Netherlands, bivalent human papillomavirus (HPV) vaccination was included in the National Immunization Program for 12-year-old girls in 2010 (vaccination coverage, 45%-60%). We examined possible changes in HPV seroprevalence in the HPV-unvaccinated Dutch population aged 0-89 years, comparing prevaccination data with data of approximately 6 years after implementation of national vaccination. METHODS Serum samples of men and women were used from two cross-sectional population-based serosurveillance studies performed before (2006-07, n = 6,384) and after (2016-17, n = 5,645) implementation of HPV vaccination in the Netherlands. Seven high-risk HPV-specific antibodies (HPV16, 18, 31, 33, 45, 52, and 58) were tested in a virus-like particle-based multiplex immunoassay. RESULTS Type-specific HPV seroprevalence increased in women between 2006-07 and 2016-17. Also, a higher seroprevalence for at least one type in women >15 years was found in 2016-17 (31.7%) compared with 2006-07 (25.2%). In men, overall HPV seroprevalence remained similar; however, a lower seroprevalence was found for HPV16 in 2016-17 (7.5%) compared with 2006-07 (10.6%). CONCLUSIONS Our results indicate an increase in high-risk HPV types in women and a rather stable exposure in men. No clear effects of the strategy of girls-only vaccination were observed in men, probably because of the short time after introduction combined with suboptimal coverage. IMPACT No herd immunity has been observed yet in a population with suboptimal HPV vaccination coverage.
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Affiliation(s)
- Hella Pasmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Joske Hoes
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Liza Tymchenko
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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8
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Mboumba Bouassa RS, Péré H, Jenabian MA, Veyer D, Meye JF, Touzé A, Bélec L. Natural and vaccine-induced B cell-derived systemic and mucosal humoral immunity to human papillomavirus. Expert Rev Anti Infect Ther 2020; 18:579-607. [PMID: 32242472 DOI: 10.1080/14787210.2020.1750950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Human papillomavirus (HPV) are the causative agent of mucosal neoplasia. Both cervical, anal and oropharyngeal cancers incidence is constantly increasing, making the HPV infection, a significant worldwide concern. Together, the CD8+ T cytotoxic cell-mediated response and the HPV-specific antibody response control most of the HPV infections before the development of cancers.Areas covered: We searched the MEDLINE and EMBASE databases and identified 228 eligible studies from 1987 to 2019 which examines both naturally acquired and vaccine induced humoral immunity against HPV infection in female and male subjects from worldwide origin. Herein, we synthesize current knowledge on the features of systemic and mucosal humoral immunity against HPV. We discuss the issues of the balance between the viral clearance or the escape to the host immune response, the differences between natural and vaccine-induced HPV-specific antibodies and their neutralizing capability. We also discuss the protection afforded after natural infection or following prophylactic vaccination.Expert opinion: Understanding the antibody response induced by HPV infection has led to the design of first-generation prophylactic vaccines. Now, prophylactic vaccination induces protective and long-lasting antibody response which would also strengthened the natural moderate humoral response in people previously exposed to the virus.
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Affiliation(s)
- Ralph-Sydney Mboumba Bouassa
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Laboratoire de virologie, Ecole Doctorale Régionale En Infectiologie Tropicale, Franceville, Gabon.,INSERM UMR U970 (Immunothérapie Et Traitement Anti-angiogénique En cancérologie), Paris Centre De Recherche Cardiovasculaire (PARCC), Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Hélène Péré
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,INSERM UMR U970 (Immunothérapie Et Traitement Anti-angiogénique En cancérologie), Paris Centre De Recherche Cardiovasculaire (PARCC), Hôpital Européen Georges Pompidou, AP-HP, Paris, France.,Faculté de Médecine, Université Paris Descartes, Paris, France
| | - Mohammad-Ali Jenabian
- Département Des Sciences Biologiques Et Centre De Recherche BioMed, Université Du Québec À Montréal (UQAM), Montreal, QC, Canada
| | - David Veyer
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Jean-François Meye
- Service De Gynécologie Obstétrique, Centre Hospitalo-Universitaire d'Agondjé Et Faculté De Médecine De Libreville, Université Des Sciences De La Santé, Libreville, Gabon
| | - Antoine Touzé
- UMRINRA ISP 1282, Equipe Biologie Des Infections À Polyomavirus, Université De Tours, Tours, France
| | - Laurent Bélec
- Laboratoire De Virologie, Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,INSERM UMR U970 (Immunothérapie Et Traitement Anti-angiogénique En cancérologie), Paris Centre De Recherche Cardiovasculaire (PARCC), Hôpital Européen Georges Pompidou, AP-HP, Paris, France.,Faculté de Médecine, Université Paris Descartes, Paris, France
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9
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Lieblong BJ, Montgomery BEE, Su LJ, Nakagawa M. Natural history of human papillomavirus and vaccinations in men: A literature review. Health Sci Rep 2019; 2:e118. [PMID: 31139757 PMCID: PMC6529831 DOI: 10.1002/hsr2.118] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/07/2018] [Accepted: 02/09/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIMS Infection with high-risk (HR) genotypes of the human papillomavirus (HPV) is necessary for and causative of almost all cervical cancers and their precursor condition, cervical intraepithelial neoplasia. These conditions have been sharply reduced by cervical cytology screening, and a further decrease is expected because of the recent introduction of prophylactic HPV vaccinations. While significant attention has been given to gynecologic HPV disease, men can be affected by HPV-related cancers of the anus, penis, and oropharynx. This literature review aims to address disparities in HPV-related disease in men, and certain HR male subpopulations, compared with women. DISCUSSION Overall, immunocompetent men are far less likely than women to develop anogenital HPV-related cancers, despite harboring HR HPV infections at anogenital sites. On the other hand, men who have sex with men and men living with human immunodeficiency virus infection are at considerably higher risk of HPV-related disease. Historic rates of prophylactic HPV vaccination in males have trailed those of females due to numerous multilevel factors, although, in recent years, this sex gap in vaccination coverage has been closing. In the absence of routine HPV screening in males, therapeutic vaccinations have emerged as a potential treatment modality for preinvasive neoplasia and are in various phases of clinical testing. CONCLUSION Successful reductions in HPV disease morbidity at the population level must acknowledge and target HPV infections in men.
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Affiliation(s)
- Benjamin J. Lieblong
- College of Medicine, Department of PathologyUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Brooke E. E. Montgomery
- Faye W. Boozman College of Public Health, Department of Health Behavior and Health EducationUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - L. Joseph Su
- Faye W. Boozman College of Public Health, Department of EpidemiologyUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Mayumi Nakagawa
- College of Medicine, Department of PathologyUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
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10
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Loenenbach AD, Poethko-Müller C, Pawlita M, Thamm M, Harder T, Waterboer T, Schröter J, Deleré Y, Wichmann O, Wiese-Posselt M. Mucosal and cutaneous Human Papillomavirus seroprevalence among adults in the prevaccine era in Germany - Results from a nationwide population-based survey. Int J Infect Dis 2019; 83:3-11. [PMID: 30904676 DOI: 10.1016/j.ijid.2019.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) vaccination of girls was introduced in Germany in 2007. However, data on the distribution of vaccine-relevant HPV types in the general population in Germany in the prevaccine era are limited. METHODS Serum samples collected during the German National Health Interview and Examination Survey 1998 (GNHIES98), a nationally representative study including men and women aged 18-79 years, were tested for antibodies to 19 mucosal and cutaneous HPV types. Multivariable regression models were developed to identify associations between demographic and behavioral characteristics and HPV seropositivity. RESULTS Of the 6517 serum samples tested, almost a quarter was seropositive for at least one of the nine HPV vaccine types with no clear age-pattern. HPV-6 and HPV-59 were the most common mucosal types, while HPV-1 and HPV-4 were the most common cutaneous HPV types. Factors independently associated with HPV-16 seroprevalence were seropositive to other sexually transmitted infections and lifetime number of sex partners, as well as urbanity (only among females). CONCLUSIONS Prevalence of naturally acquired antibodies to HPV types which can be prevented by vaccination is high in both sexes and all age groups. These data can serve as baseline estimates to evaluate the population-level impact of the current vaccination strategy.
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Affiliation(s)
- Anna D Loenenbach
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany; Charité - University Medicine Berlin, Berlin, Germany.
| | | | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Thomas Harder
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Tim Waterboer
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Juliane Schröter
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Yvonne Deleré
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Ole Wichmann
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Miriam Wiese-Posselt
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
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11
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Davis KG, Orangio GR. Basic Science, Epidemiology, and Screening for Anal Intraepithelial Neoplasia and Its Relationship to Anal Squamous Cell Cancer. Clin Colon Rectal Surg 2018; 31:368-378. [PMID: 30397396 DOI: 10.1055/s-0038-1668107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Despite the progress made in the reduction of squamous cell carcinoma of the cervix, the incidence of anal squamous cell carcinoma (ASCC) has been increasing since 1992. While it remains an uncommon disease, the prevalence is climbing steadily. Among human immunodeficiency virus (HIV)-infected adults, especially men who have sex with men, ASCC is one of the more common non-AIDS-defining malignancies. The precursor lesion, anal intraepithelial neoplasia (AIN), is prevalent in the HIV-infected population. More than 90% of ASCCs are related to human papilloma virus (HPV), oncogenic types (HPV 16, 18). While the biology of HPV-related intraepithelial neoplasia is consistent in the anogenital area, the natural history of AIN is poorly understood and is not identical to cervical intraepithelial neoplasia (CIN). CIN is also considered an AIDS-defining malignancy, and the methods for screening and prevention of AIN are derived from the CIN literature. This article will discuss the epidemiology of ASCC and its association with HPV and the life cycle of the HPV, and the molecular changes that lead to clearance, productive infection, latency, and persistence. The immunology of HPV infection will discuss natural immunity, humoral and cellular immunity, and how the HPV virus evades and interferes with these mechanisms. We will also discuss high-risk factors for developing AIN in high-risk patient populations with relation to infections (HIV, HPV, and chlamydia infections), prolonged immunocompromised people, and sexual behavior and tobacco abuse. We will also discuss the pre- and post-HAART era and its effect on AINs and ASCC. Finally, we will discuss the importance of anal cytology and high-resolution anoscopy with and without biopsy in this high-risk population.
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Affiliation(s)
- Kurt G Davis
- Section of Colon and Rectal Surgery, LSU Department of Surgery, LSU School of Medicine, New Orleans, Louisiana
| | - Guy R Orangio
- Section of Colon and Rectal Surgery, LSU Department of Surgery, LSU School of Medicine, New Orleans, Louisiana
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12
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Mujtaba H, Wang Y, Duan Y, Cao M, Zhang N, Batool I, Murtaza A, Chen X, Wang Y. Human papillomavirus in tonsillectomy specimen from China and Pakistan - Prevalence and genotype distribution. Pathol Res Pract 2018; 214:1713-1718. [PMID: 30217437 DOI: 10.1016/j.prp.2018.08.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/17/2018] [Accepted: 08/28/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND The expected corresponding increase in tonsillar human papillomavirus (HPV) infection associated with increasing incidence of oropharyngeal squamous cell carcinoma (OPSCC) substantiate the evaluation of normal tonsillar tissue in different population. The epidemiology of HPV in tonsillar tissue varies geographically. This study evaluated samples from two countries to determine the prevalence in respective samples. OBJECTIVE To characterize HPV infection in non-malignant tonsillar tissue from Shaanxi, China (herein after referred to as China) and Punjab, Pakistan (herein after referred to as Pakistan). METHODOLOGY The DNA extracted from formalin-fixed, paraffin-embedded tumor free tonsillar tissue was evaluated using polymerase chain reaction (PCR). A total of 367 cases from China and 139 cases from Pakistan were screened for HPV DNA using GP5+/GP6+ consensus primer. Genotype of the positive cases was determined for common HPV types (6, 11, 16, 18, 52, 58) simultaneously by type-specific PCR. RESULTS The mean age of cohorts in China was 13.42 (Median age 7, Range 2-72 years) while in Pakistan it was 10.77 (Median age 8, Range 3-42 years) the gender distribution was 61.6% male in China and in Pakistan they were 56.8%, rest were females. The overall prevalence of HPV in China was 2.45% and 2.16% in Pakistan. High risk human papillomavirus was 1.63% in China with 5 cases positive for HPV 16 and HPV 58 in 1 case. In Pakistan, 2 cases (1.43%) of HPV 16 were detected. Low-risk types include HPV 11 present in 2 cases from China, while HPV 6 was detected in 1 case each from both the countries. CONCLUSION A low prevalence of HPV was found in China and Pakistan; high-risk and low-risk HPV were detectable in tonsillar tissue from both countries. Age stratification (< 5 years, 5-14 years, 15-25 years, > 25 years) suggest that sexual and non-sexual transmission of the virus can occur. The difference in the genotype distribution geographically within China and with Pakistan was observed in the case of HPV 58. The most common type in both the countries was HPV 16.
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Affiliation(s)
- Hasan Mujtaba
- Institute for Cancer Research, School of Basic Medical Science, Xi'an Jiaotong University, Xian, Shaanxi, 710061, China.
| | - Ying Wang
- Institute for Cancer Research, School of Basic Medical Science, Xi'an Jiaotong University, Xian, Shaanxi, 710061, China.
| | - Yixin Duan
- Institute for Cancer Research, School of Basic Medical Science, Xi'an Jiaotong University, Xian, Shaanxi, 710061, China.
| | - Meng Cao
- Institute for Cancer Research, School of Basic Medical Science, Xi'an Jiaotong University, Xian, Shaanxi, 710061, China.
| | - Nana Zhang
- Institute for Cancer Research, School of Basic Medical Science, Xi'an Jiaotong University, Xian, Shaanxi, 710061, China.
| | - Iffat Batool
- Department of Pediatrics, Fauji Foundation Hospital, Rawalpindi, Pakistan.
| | - Ali Murtaza
- Consultant Pathologist, Ali Laboratory, Rawalpindi, Pakistan.
| | - Xiaoli Chen
- Department of Pathology, Second Affiliated Hospital, Xi'an Jiaotong University, Xian, Shaanxi 710004, China.
| | - Yili Wang
- Institute for Cancer Research, School of Basic Medical Science, Xi'an Jiaotong University, Xian, Shaanxi, 710061, China.
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13
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Pillsbury AJ, Quinn HE, Evans TD, McIntyre PB, Brotherton JML. Population-Level Herd Protection of Males From a Female Human Papillomavirus Vaccination Program: Evidence from Australian Serosurveillance. Clin Infect Dis 2018; 65:827-832. [PMID: 29017279 DOI: 10.1093/cid/cix436] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/07/2017] [Indexed: 12/24/2022] Open
Abstract
Background Australia instituted funded female human papillomavirus (HPV) immunization in 2007, followed by a targeted male vaccination program in 2013. To date, Australia is one of only several countries with a funded male HPV immunization program. In 2012-2013, we conducted a survey of HPV seroprevalence in males to assess whether or not a herd impact of female vaccination could be observed. Methods We conducted a cross-sectional study of de-identified residual diagnostic test serum samples from males aged 15-39 years from laboratories in 3 Australian states and calculated the proportion seropositive to HPV types 6, 11, 16, and 18. We compared type-specific results by age group against those from a baseline 2005 Australian HPV serosurvey. Results There were decreases in proportion seropositive for every HPV type across all age groups, many statistically significant. The largest decrease was observed for HPV-11, with decreases of 8- and 9-fold for ages 20-29 and 30-39 years, respectively. Despite substantial reductions in seroprevalence, at least 9% of males were seropositive for at least 1 of the 4 HPV types. Conclusions This is the first serosurvey confirming broad population-level impact in males from female HPV vaccination. Our research may assist policy makers considering implementing HPV vaccination programs.
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Affiliation(s)
| | - Helen E Quinn
- National Centre for Immunisation Research and Surveillance, Westmead.,Discipline of Paediatrics and Child Health, University of Sydney, New South Wales, Australia
| | | | - Peter B McIntyre
- National Centre for Immunisation Research and Surveillance, Westmead.,Discipline of Paediatrics and Child Health, University of Sydney, New South Wales, Australia
| | - Julia M L Brotherton
- National HPV Vaccination Program Register, Victorian Cytology Service, East Melbourne.,School of Population and Global Health, University of Melbourne, Victoria, Australia
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14
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Beachler DC, Pinto LA, Kemp TJ, Nyitray AG, Hildesheim A, Viscidi R, Schussler J, Kreimer AR, Giuliano AR. An Examination of HPV16 Natural Immunity in Men Who Have Sex with Men (MSM) in the HPV in Men (HIM) Study. Cancer Epidemiol Biomarkers Prev 2018; 27:496-502. [PMID: 29475967 PMCID: PMC5884716 DOI: 10.1158/1055-9965.epi-17-0853] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/11/2017] [Accepted: 02/02/2018] [Indexed: 01/10/2023] Open
Abstract
Background: Evidence suggests that natural antibodies developed after HPV16 infection may protect some women but not men against subsequent HPV16 reacquisition. Less is known whether antibodies developed following HPV16 infection are protective among men who have sex with men (MSM).Methods: Four hundred seventy-five MSM from the Human Papillomavirus Infection in Men (HIM) study were tested for serum antibodies to HPV16 L1 using enzyme-linked immunosorbent assays, and for anal and genital HPV16 DNA using PCR consensus primer system (PGMY 09/11). Adjusted Cox regression was used to evaluate whether baseline HPV16 seropositivity impacts subsequent genital or anal HPV16 DNA.Results: The risk of subsequent genital HPV16 [aHR = 1.05, 95% confidence interval (CI) = 0.66-1.68] and anal HPV16 infections among MSM (aHR = 2.34, 95% CI = 0.92-5.98) was similar or nonsignificantly higher in HPV16-seropositive than HPV16-seronegative MSM. The risk of genital HPV16 was also similar between HPV16-seronegative and HPV16-seropositive MSM in the highest tertile of HPV16 antibody levels and when restricting to those with new sex partners during follow-up (P > 0.20). Among the 118 MSM who were HPV16 seropositive, 90% remained HPV16 seropositive up to 4 years later. When tested together, MSM with the highest antibody titers (top tertile) had similar levels to females (mean = 130.3 vs. 134.5 EU/mL, P = 0.84).Conclusions: Despite years of HPV16 seropositivity persistence and antibody titers comparable with females, this study suggested no evidence of HPV16 natural antibodies protecting against subsequent genital or anal HPV16 infection in MSM.Impact: This could help partially explain the high incidence of genital and anal HPV16 infection and related anal cancer seen in middle-aged and older MSM. Cancer Epidemiol Biomarkers Prev; 27(4); 496-502. ©2018 AACR.
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Affiliation(s)
- Daniel C Beachler
- Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, Maryland.
- Safety and Epidemiology Research, HealthCore Inc., Wilmington, Delaware
| | - Ligia A Pinto
- HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Troy J Kemp
- HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Alan G Nyitray
- Division of Epidemiology, Human Genetics, and Environmental Science, University of Texas School of Public Health, Houston, Texas
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Raphael Viscidi
- Department of Pediatrics and Neurovirology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Aimée R Kreimer
- Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Anna R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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Pérez-Caraballo AM, Suarez E, Unger ER, Palesfky JM, Panicker G, Ortiz AP. Seroprevalence of Human Papillomavirus (HPV) Type 6, 11, 16, 18, by Anatomic Site of HPV Infection, in Women Aged 16-64 Years living in the Metropolitan Area of San Juan, Puerto Rico. PUERTO RICO HEALTH SCIENCES JOURNAL 2018; 37:26-31. [PMID: 29547681 PMCID: PMC6691969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE It is unknown if human papillomavirus (HPV) serum antibody responses vary by anatomic site of infection. We aimed to assess the seroprevalence for HPV 6, 11, 16 and 18 in association with HPV DNA detection in different anatomic sites among women. METHODS This cross sectional population-based study analyzed data from 524 women aged 16-64 years living in the San Juan metropolitan area of Puerto Rico (PR). Questionnaires were used to assess demographic and lifestyle variables, while anogenital and blood samples were collected for HPV analysis. Logistic regression models were used to estimate the adjusted prevalence odds ratio (POR) in order to determine the association between HPV DNA infection status in the cervix and anus and serum antibody status, controlling for different potential confounders. RESULTS Overall, 46.9% of women had detectable antibodies to one or more types whereas 8.7% had HPV DNA for one or more of these types detected in cervix (4.0%) or anus (6.5%). Women with cervical HPV detection tended to be more HPV seropositive than women without cervical detection (adjusted POR (95%CI): 2.41 (0.90, 6.47), p=0.078); however the type-specific association between cervical DNA and serum antibodies was only significant for HPV 18 (adjusted POR (95% CI): 5.9 (1.03, 33.98)). No significant association was detected between anal HPV and seropositivity (p>0.10). CONCLUSION Differences in the anatomic site of infection could influence seroconversion, however, longitudinal studies will be required for further evaluation. This information will be instrumental in advancing knowledge of immune mechanisms involved in anatomic site response.
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Affiliation(s)
- Aixa M. Pérez-Caraballo
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico (UPR), SJ, PR
| | - Erick Suarez
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico (UPR), SJ, PR
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joel M. Palesfky
- University of California at San Francisco School of Medicine, San Francisco, California, United States of America
| | - Gitika Panicker
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ana Patricia Ortiz
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico (UPR), SJ, PR
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, SJ, PR
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Human Immunodeficiency Virus Status Differentially Associated With Genital and Anal Human Papillomavirus Infection Among Chinese Men Who Have Sex With Men: A Cross-Sectional Survey. Sex Transm Dis 2018; 44:656-662. [PMID: 28876311 DOI: 10.1097/olq.0000000000000672] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Little is known about human papillomavirus (HPV) infection and genotypes when considering both anatomic site and human immunodeficiency virus (HIV) status among men who have sex with men (MSM) in low- and middle-income countries. METHODS A cross-sectional study was conducted among MSM in Beijing, China. HIV serostatus was determined, and genital and anal HPV genotyping were performed from respective swabs. RESULTS Of 1155 MSM, 817 (70.7%) had testing for genital (611; 52.9%) and/or anal (671; 58.1%) HPV. Preference for insertive anal sex (adjusted odds ratio [aOR], 2.60; 95% confidence interval [CI], 1.42-4.75) and syphilis (aOR, 1.50; 95% CI, 1.01-2.23) were associated with genital HPV. Inconsistent condom use during receptive anal sex (aOR, 1.82; 95% CI, 1.17-2.84), and HIV seropositivity (aOR, 2.90; 95% CI, 1.91-4.42) were associated with anal HPV. Among 465 (40.3%) MSM with specimens from both anatomic sites, anal HPV (68%) was more common than genital HPV (37.8%). Prevalence of anal HPV was higher among HIV-infected than uninfected MSM (P < 0.01). Some oncogenic HPV types were more commonly found at the anal site of HIV-infected MSM (P < 0.01). CONCLUSIONS Human papillomavirus is highly prevalent among Chinese MSM. Anal HPV was more common than genital HPV, and HIV seropositivity was associated with oncogenic HPV types at the anal site.
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17
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Lifestyle factors and oncogenic papillomavirus infection in a high-risk male population. PLoS One 2017; 12:e0184492. [PMID: 28898279 PMCID: PMC5595320 DOI: 10.1371/journal.pone.0184492] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 08/24/2017] [Indexed: 01/27/2023] Open
Abstract
Background High risk human papillomavirus (HR-HPV) infection in males is a health issue with implications for HPV-related lesions in their partners. The identification of risk factors for male infection may improve our understanding of HR-HPV transmission and prevention. The aim of this study was to evaluate the relationships between lifestyle, genital warts and HR-HPV infection. The study was focused on men with an increased risk of HR-HPV infection: male sexual partners of women diagnosed with high-grade squamous intraepithelial cervical lesions. Methods Men were enrolled and prospectively recruited within the first six months after diagnosis of cervical lesions in their female partners (n = 175, 2013–2016). Epidemiological and sexual behaviour data were obtained. The presence of genital warts was established by visual inspection. Detection and genotyping of HR-HPV infection in genital samples were performed with a Linear Array HPV Genotyping Test. All HR-HPV positive men were offered a follow-up exam at 12 months. SPSS version 19 was used for statistical analysis. Results and discussion The prevalence of HR-HPV infection in men was 45.1% (79/175). Genital warts were observed in 10.3% (18/175) of the subjects. Detection of genital warts (OR 3.5, p = 0.015), smoking habits (OR 2.3, p = 0.006) and sexual debut before 16 years old (OR 2, p = 0.035) were associated with an increased risk for HR-HPV infection (univariate analysis). This association was also observed for genital warts and smoking status in a multivariate analysis. The same genotype was found after one year in 71.4% (20/28) of subjects. Conclusions The presence of genital warts and smoking habits seem to be associated with a higher risk of HR-HPV infection in males. Earlier sexual debut may increase this risk. Extensive knowledge of the natural history of HR-HPV infection in males is an absolute requirement for the design and implementation of prevention strategies for the general population as well as for specific populations such as couples after treatment for high-grade cervical lesions.
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18
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Wasserman P, Rubin DS, Turett G. Review: Anal Intraepithelial Neoplasia in HIV-Infected Men Who Have Sex with Men: Is Screening and Treatment Justified? AIDS Patient Care STDS 2017; 31:245-253. [PMID: 28530494 DOI: 10.1089/apc.2017.0063] [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] [Indexed: 12/12/2022] Open
Abstract
Anal squamous cell carcinoma (SCC) is the fourth most prevalent cancer in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Human papillomavirus (HPV) has been detected in over 90% of anal carcinoma biopsy specimens from MSM, and is considered a necessary, but alone, insufficient factor for carcinogenesis. Anal intraepithelial neoplasia (AIN) may be precursive for SCC, and screening cytology with referral of persons with abnormality for high-resolution anoscopy-guided biopsy, and AIN treatment, has been recommended for prevention. In the absence of either randomized controlled trials or surveillance data demonstrating a reduction in anal SCC incidence, these recommendations were based on analogy with cervical cancer. HPV-mediated genetic changes associated with cervical cancer, and aneuploidy, have been documented in AIN. However, little data exist on the rate of AIN progression to SCC. The treatment of AIN is frequently prolonged and not curative, and if routinized in the care of HIV-infected MSM, would likely be recurring well into their sixth decade of life. Clinical trials demonstrating a reduction in invasive anal carcinoma incidence, as well as acceptable morbidity with repeated AIN destruction, are needed before asking our patients to commit to routine treatment.
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Affiliation(s)
- Peter Wasserman
- Division of Infectious Diseases, Department of Medicine, New York-Presbyterian Queens, Flushing, New York
- Weill Cornell Medical College, New York, New York
| | | | - Glenn Turett
- Division of Infectious Diseases, Department of Medicine, New York-Presbyterian Queens, Flushing, New York
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19
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Schiffman M, Doorbar J, Wentzensen N, de Sanjosé S, Fakhry C, Monk BJ, Stanley MA, Franceschi S. Carcinogenic human papillomavirus infection. Nat Rev Dis Primers 2016; 2:16086. [PMID: 27905473 DOI: 10.1038/nrdp.2016.86] [Citation(s) in RCA: 528] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Infections with human papillomavirus (HPV) are common and transmitted by direct contact. Although the great majority of infections resolve within 2 years, 13 phylogenetically related, sexually transmitted HPV genotypes, notably HPV16, cause - if not controlled immunologically or by screening - virtually all cervical cancers worldwide, a large fraction of other anogenital cancers and an increasing proportion of oropharyngeal cancers. The carcinogenicity of these HPV types results primarily from the activity of the oncoproteins E6 and E7, which impair growth regulatory pathways. Persistent high-risk HPVs can transition from a productive (virion-producing) to an abortive or transforming infection, after which cancer can result after typically slow accumulation of host genetic mutations. However, which precancerous lesions progress and which do not is unclear; the majority of screening-detected precancers are treated, leading to overtreatment. The discovery of HPV as a carcinogen led to the development of effective preventive vaccines and sensitive HPV DNA and RNA tests. Together, vaccination programmes (the ultimate long-term preventive strategy) and screening using HPV tests could dramatically alter the landscape of HPV-related cancers. HPV testing will probably replace cytology-based cervical screening owing to greater reassurance when the test is negative. However, the effective implementation of HPV vaccination and screening globally remains a challenge.
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Affiliation(s)
- Mark Schiffman
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Room 6E544, 9609 Medical Center Drive, Rockville, Maryland 20850, USA
| | - John Doorbar
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Nicolas Wentzensen
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Room 6E544, 9609 Medical Center Drive, Rockville, Maryland 20850, USA
| | - Silvia de Sanjosé
- Catalan Institute of Oncology, IDIBELL, Cancer Epidemiology Research Programme and CIBER Epidemiologia Y Salud Publica, Barcelona, Spain
| | - Carole Fakhry
- Department of Otolaryngology, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Bradley J Monk
- Division of Gynecologic Oncology, US Oncology Network, University of Arizona-Phoenix, Phoenix, Arizona, USA
| | | | - Silvia Franceschi
- International Agency for Research on Cancer, Infections and Cancer Epidemiology Group, Lyon, France
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20
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Rahman S, Pierce Campbell CM, Rollison DE, Wang W, Waterboer T, Michel A, Pawlita M, Villa LL, Lazcano Ponce E, Borenstein AR, Giuliano AR. Seroprevalence and Associated Factors of 9-Valent Human Papillomavirus (HPV) Types among Men in the Multinational HIM Study. PLoS One 2016; 11:e0167173. [PMID: 27902759 PMCID: PMC5130234 DOI: 10.1371/journal.pone.0167173] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/09/2016] [Indexed: 02/02/2023] Open
Abstract
Background Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Recently a 9-valent HPV (9vHPV) prophylactic vaccine was licensed. Seroprevalence prior to vaccine dissemination is needed for monitoring vaccine effectiveness over time. Few studies have assessed the seroprevalence of 9vHPV types in men. Objectives To investigate the seroprevalence of 9vHPV vaccine types and associated risk factors among men residing in Brazil, Mexico, and the United States. Methods Six hundred men were randomly selected from the HPV Infection in Men (HIM) Study. Archived serum specimens collected at enrollment were tested for antibodies against nine HPV types (6, 11, 16, 18, 31, 33, 45, 52 and 58) using a glutathione S-transferase (GST) L1-based multiplex serologic assay. Socio-demographic, lifestyle and sexual behavior data at enrollment were collected through a questionnaire. Binomial proportions were used to estimate seroprevalence and logistic regression was used to examine factors associated with seropositivity of type-specific and grouped (i.e. 9vHPV, high-risk 9vHPV, low risk 9vHPV, and five-additional) HPV types. Results Overall, 28.3% of men were seropositive for at least one of the 9vHPV vaccine types, 14.0% for at least one of the seven high-risk types (16, 18, 31, 33, 45, 52 and 58) and 11.2% for at least one of the five high-risk types (31, 33, 45, 52 and 58) not included in the quadrivalent HPV vaccine, and 17.4% for at least one of the low-risk types (6/11). In multivariate analyses, odds ratios adjusted (AOR) for country of residence, age, marital status, smoking, number of anal sex lifetime partners, compared to men with no anal sex lifetime partners, men with ≥2 partners were more likely to be seropositive for grouped HPV [(9vHPV: AOR 2.52; 95% confidence interval (CI) 1.40–4.54), (high-risk 9vHPV: AOR 2.18; 95%CI: 1.05–4.50) and (low-risk 9vHPV: AOR 2.12; 95%CI: 1.12–4.03)], and individual HPV types 6, 16, 33 and 58 with AORs ranging from 2.19 to 7.36. Compared to men aged 18–30 years, men older than 30 years were significantly more likely to be seropositive for any high-risk 9vHPV, in addition to individual types 18 and 45; and compared to never smokers, current smokers were more likely to be seropositive to 9vHPV, low-risk 9vHPV and HPV 6. In contrast, married men were less likely to be seropositive to any high-risk 9vHPV and individual HPV types 18 and 31 when compared to single men. Conclusions These data indicate that exposure to the nine HPV types included in the 9vHPV vaccine is common in men and that seropositivity to 9vHPV vaccine types is associated with older age and the lifetime number of anal sex partners. Nine valent HPV vaccination of males and females has the potential to prevent HPV related diseases and transmission in both sexes.
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Affiliation(s)
- Shams Rahman
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States of America.,Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States of America
| | | | - Dana E Rollison
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States of America
| | - Wei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States of America
| | - Tim Waterboer
- Molecular Diagnostics of Oncogenic Infections Division; Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Angelika Michel
- Molecular Diagnostics of Oncogenic Infections Division; Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Molecular Diagnostics of Oncogenic Infections Division; Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Luisa L Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Publica, Cuernavaca, Mexico
| | - Amy R Borenstein
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States of America
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States of America
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21
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Spiess PE, Dhillon J, Baumgarten AS, Johnstone PA, Giuliano AR. Pathophysiological basis of human papillomavirus in penile cancer: Key to prevention and delivery of more effective therapies. CA Cancer J Clin 2016; 66:481-495. [PMID: 27314890 DOI: 10.3322/caac.21354] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Answer questions and earn CME/CNE Squamous cell carcinoma (SCC) of the penis is a rare malignancy in the United States, with a significantly higher incidence-up to 20 to 30 times greater-in areas of Africa and South America. This can be explained in part by the significantly greater prevalence of sexually transmitted diseases among high-risk males often having unprotected sex with multiple sexual partners. Human papillomavirus (HPV) has been implicated as the infectious pathway by which several these penile neoplasms originate from precursor lesions. In this regard, a fundamental understanding of HPV in penile carcinogenesis can have meaningful implications in understanding 1) the diagnosis of HPV-related precursor penile lesions, 2) targeting HPV-specific molecular pathways, and 3) cancer prevention. Using vaccination programs not only may improve patient outcomes but also may minimize the need for highly aggressive and often debilitating surgical resection. CA Cancer J Clin 2016;66:481-495. © 2016 American Cancer Society.
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Affiliation(s)
- Philippe E Spiess
- Associate Member, Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Jasreman Dhillon
- Assistant Member, Department of Anatomical Pathology, Moffitt Cancer Center, Tampa, FL
| | - Adam S Baumgarten
- Urology Resident Physician, Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Peter A Johnstone
- Senior Member, Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL
| | - Anna R Giuliano
- Senior Member, Department of Infection and Cancer, Moffitt Cancer Center, Tampa, FL
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22
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Zou H, Tabrizi SN, Grulich AE, Hocking JS, Garland SM, Bradshaw CS, Cornall AM, Fairley CK, Chen MY. Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men. Int J Cancer 2016; 139:639-46. [PMID: 26991809 DOI: 10.1002/ijc.30093] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 02/09/2016] [Accepted: 02/24/2016] [Indexed: 11/11/2022]
Abstract
Men who have sex with men (MSM) are at risk for human papillomavirus (HPV)-related anal cancer. Few data exist on antibody responses following incident anogenital infection with HPV in teenage MSM. A cohort of 200 MSM aged 16-20 years from Melbourne, Australia were assessed at baseline, 3, 6 and 12 months. At each visit anal and penile swabs were collected for HPV DNA and serum for HPV antibodies for genotypes 6, 11, 16 and 18 (Merck's Multiplex Assays using Luminex). The main outcome, seroconversion, was defined as the detection of HPV antibodies following a negative antibody result for the same HPV type at baseline. The seroincidence rates for HPV types 6, 11, 16 and 18 were: 19 (95% CI 12-26), 7 (3-12), 4 (1-8) and 6 (3-11) per 100 person-years, respectively. Men who experienced incident anal HPV infections from types 6/11 were significantly more likely to develop serum antibodies to the same HPV type(s) than those who experienced incident anal infections from types 16/18 [73 vs. 18%, odds ratio (OR) = 15, 95% CI: 2-118]. The median time between incident anal HPV infection and seroconversion for HPV 6, 11, 16 and 18 was: 91, 38, 161 and 182 days, respectively. Antibody responses against HPV types 6/11 were significantly more likely to occur following incident anal compared with incident penile infection with HPV types 6/11 (OR = 6, 95% CI: 2-21). The likelihood of antibody responses following anogenital HPV infections depends on the HPV type and site of infection.
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Affiliation(s)
- Huachun Zou
- Kirby Institute, University of New South Wales, SY, Australia.,Melbourne Sexual Health Centre, Alfred Health, ME, Australia
| | - Sepehr N Tabrizi
- Department of Obstetrics and Gynaecology, University of Melbourne, ME, Australia.,Department of Microbiology and Infectious Diseases, Royal Women's Hospital, ME, Australia.,Murdoch Childrens Research Institute, ME, Australia
| | | | - Jane S Hocking
- School of Population and Global Health, University of Melbourne, ME, Australia
| | - Suzanne M Garland
- Department of Obstetrics and Gynaecology, University of Melbourne, ME, Australia.,Department of Microbiology and Infectious Diseases, Royal Women's Hospital, ME, Australia.,Murdoch Childrens Research Institute, ME, Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, ME, Australia.,Central Clinical School, Monash University, ME, Australia
| | - Alyssa M Cornall
- Department of Microbiology and Infectious Diseases, Royal Women's Hospital, ME, Australia.,Murdoch Childrens Research Institute, ME, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, ME, Australia.,Central Clinical School, Monash University, ME, Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, ME, Australia.,Central Clinical School, Monash University, ME, Australia
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23
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Alemany L, Cubilla A, Halec G, Kasamatsu E, Quirós B, Masferrer E, Tous S, Lloveras B, Hernández-Suarez G, Lonsdale R, Tinoco L, Alejo M, Alvarado-Cabrero I, Laco J, Guimerà N, Poblet E, Lombardi LE, Bergeron C, Clavero O, Shin HR, Ferrera A, Felix A, Germar J, Mandys V, Clavel C, Tzardi M, Pons LE, Wain V, Cruz E, Molina C, Mota JD, Jach R, Velasco J, Carrilho C, López-Revilla R, Goodman MT, Quint WG, Castellsagué X, Bravo I, Pawlita M, Muñoz N, Bosch FX, de Sanjosé S. Role of Human Papillomavirus in Penile Carcinomas Worldwide. Eur Urol 2016; 69:953-61. [PMID: 26762611 DOI: 10.1016/j.eururo.2015.12.007] [Citation(s) in RCA: 166] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/06/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Invasive penile cancer is a rare disease with an approximately 22 000 cases per year. The incidence is higher in less developed countries, where penile cancer can account for up to 10% of cancers among men in some parts of Africa, South America, and Asia. OBJECTIVE To describe the human papillomavirus (HPV) DNA prevalence, HPV type distribution, and detection of markers of viral activity (ie, E6*I mRNA and p16(INK4a)) in a series of invasive penile cancers and penile high-grade squamous intraepithelial lesions (HGSILs) from 25 countries. A total of 85 penile HGSILs and 1010 penile invasive cancers diagnosed from 1983 to 2011 were included. DESIGN, SETTING, AND PARTICIPANTS After histopathologic evaluation of formalin-fixed paraffin-embedded samples, HPV DNA detection and genotyping were performed using the SPF-10/DEIA/LiPA25 system, v.1 (Laboratory Biomedical Products, Rijswijk, The Netherlands). HPV DNA-positive cases were additionally tested for oncogene E6*I mRNA and all cases for p16(INK4a) expression, a surrogate marker of oncogenic HPV activity. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS HPV DNA prevalence and type distributions were estimated. RESULTS AND LIMITATIONS HPV DNA was detected in 33.1% of penile cancers (95% confidence interval [CI], 30.2-36.1) and in 87.1% of HGSILs (95% CI, 78.0-93.4). The warty-basaloid histologic subtype showed the highest HPV DNA prevalence. Among cancers, statistically significant differences in prevalence were observed only by geographic region and not by period or by age at diagnosis. HPV16 was the most frequent HPV type detected in both HPV-positive cancers (68.7%) and HGSILs (79.6%). HPV6 was the second most common type in invasive cancers (3.7%). The p16(INK4a) upregulation and mRNA detection in addition to HPV DNA positivity were observed in 69.3% of HGSILs, and at least one of these HPV activity markers was detected in 85.3% of cases. In penile cancers, these figures were 22.0% and 27.1%, respectively. CONCLUSIONS About a third to a fourth of penile cancers were related to HPV when considering HPV DNA detection alone or adding an HPV activity marker, respectively. The observed HPV type distribution reinforces the potential benefit of current and new HPV vaccines in the reduction of HPV-related penile neoplastic lesions. PATIENT SUMMARY About one-third to one-quarter of penile cancers were related to human papillomavirus (HPV). The observed HPV type distribution reinforces the potential benefit of current and new HPV vaccines to prevent HPV-related penile neoplastic lesions.
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Affiliation(s)
- Laia Alemany
- Institut Català d'Oncologia, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Antonio Cubilla
- Instituto de Investigaciones en Ciencias de la Salud-Universidad Nacional de Asunción, Asunción, Paraguay
| | - Gordana Halec
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elena Kasamatsu
- Instituto de Investigaciones en Ciencias de la Salud-Universidad Nacional de Asunción, Asunción, Paraguay
| | | | | | - Sara Tous
- Institut Català d'Oncologia, Barcelona, Spain
| | | | | | - Ray Lonsdale
- Norfolk and Norwich University Hospital NHS Foundation Trust, Norfolk, UK
| | | | - Maria Alejo
- Hospital General Hospitalet, Barcelona, Spain
| | | | - Jan Laco
- The Fingerland Department of Pathology, Charles University in Prague Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic
| | - Nuria Guimerà
- DDL Diagnostic Laboratory, Rijswijk, The Netherlands
| | - Enrique Poblet
- Hospital General Universitario de Albacete, Albacete, Spain
| | - Luis E Lombardi
- Centro de Investigación Epidemiológica en Salud Sexual y Reproductiva-CIESAR, Hospital General San Juan de Dios, Guatemala City, Guatemala
| | | | | | - Hai-Rim Shin
- National Cancer Center, Goyang-si Gyeonggi-do, South Korea
| | | | - Ana Felix
- Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | | | - Vaclav Mandys
- Third Faculty of Medicine, Charles University and Faculty Hospital King's Vineyards, Prague, Czech Republic
| | | | - Maria Tzardi
- Medical School of University of Crete, Crete, Greece
| | - Luis E Pons
- Hospital de Tortosa Verge de la Cinta, Tarragona, Spain
| | | | - Eugenia Cruz
- Centro de Oncología de Coimbra, Coimbra, Portugal
| | | | - Jose D Mota
- Universidad Central de Venezuela, Caracas, Venezuela
| | - Robert Jach
- Jagiellonian University Medical College, Krakow, Poland
| | | | - Carla Carrilho
- Eduardo Mondlane University and Maputo Central Hospital, Maputo, Mozambique
| | - Ruben López-Revilla
- Instituto Potosino de Investigación Científica y Tecnológica, San Luis Potosí, Mexico
| | - Marc T Goodman
- Cancer Research Center, University of Hawaii, Honolulu, HI, USA; Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Wim G Quint
- DDL Diagnostic Laboratory, Rijswijk, The Netherlands
| | | | | | | | - Nubia Muñoz
- National Cancer Institute of Colombia, Bogota, Colombia
| | | | - Silvia de Sanjosé
- Institut Català d'Oncologia, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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24
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Brouwer AF, Eisenberg MC, Carey TE, Meza R. Trends in HPV cervical and seroprevalence and associations between oral and genital infection and serum antibodies in NHANES 2003-2012. BMC Infect Dis 2015; 15:575. [PMID: 26689203 PMCID: PMC4687319 DOI: 10.1186/s12879-015-1314-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HPV infects multiple sites in the epithelium, including the genitals and oral cavity. The relation between genital and oral infections and serum antibodies can help explain the natural history and epidemiology of HPV. METHODS We analyzed HPV data from NHANES derived from self-collected vaginal swabs (women ages 14-59, 2003-12), oral rinses (men and women 14-69, 2009-12), and serum (men and women 14-59, 2003-10). RESULTS Type-concordance of cervicogenital and oral infections in women was found to vary widely by age. Prevalence of oral infections with type-concordant antibodies was low but varied by sex: 0.2 % (95 % CI 0.0-0.8) for women vs 0.8 % (95 % CI 0.4-1.3) for men. Vaccination was associated with a reduced risk of cervicogenital infection for vaccine genotypes among ages 14-17 (0.2 (95 % CI 0.1-0.8)) and 18-24 (0.2 (95 % CI 0.1-0.3). Seroprevalence trends in women showed a dramatic increase for recent birth cohorts, likely due to vaccination. By contrast, trends for men remained relatively constant. Age-specific cervicogenital prevalence showed a consistent peak in the late teens and twenties. Relative cervicogenital prevalence has largely been decreasing since the 1940-50 birth cohort. CONCLUSIONS There are complex patterns in HPV prevalence trends and type-concordance across infection sites and serum antibodies. A multisite sampling scheme is needed to better understand the epidemiology and natural history of HPV.
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Affiliation(s)
- Andrew F Brouwer
- Department of Epidemiology, University of Michigan, Ann Arbor, 48109, USA
- Department of Mathematics, University of Michigan, Ann Arbor, 48109, USA
| | - Marisa C Eisenberg
- Department of Epidemiology, University of Michigan, Ann Arbor, 48109, USA
| | - Thomas E Carey
- Department of Otorhinolaryngology, University of Michigan, Ann Arbor, 48109, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, 48109, USA.
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25
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Giuliano AR, Viscidi R, Torres BN, Ingles DJ, Sudenga SL, Villa LL, Baggio ML, Abrahamsen M, Quiterio M, Salmeron J, Lazcano-Ponce E. Seroconversion Following Anal and Genital HPV Infection in Men: The HIM Study. PAPILLOMAVIRUS RESEARCH 2015; 1:109-115. [PMID: 26688833 PMCID: PMC4680989 DOI: 10.1016/j.pvr.2015.06.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Protection from naturally acquired human papillomavirus (HPV) antibodies may influence HPV infection across the lifespan. This study describes seroconversion rates following genital, anal, and oral HPV 6/11/16/18 infections in men and examines differences by HPV type and anatomic site. Methods Men with HPV 6/11/16/18 infections who were seronegative for those genotypes at the time of DNA detection were selected from the HPV Infection in Men (HIM) Study. Sera specimens collected ≤36 months after detection were analyzed for HPV 6/11/16/18 antibodies using a virus-like particle-based ELISA. Time to seroconversion was separately assessed for each anatomic site, stratified by HPV type. Results Seroconversion to ≥1 HPV type (6/11/16/18) in this sub-cohort (N=384) varied by anatomic site, with 6.3%, 18.9%, and 0.0% seroconverting following anal, genital, and oral HPV infection, respectively. Regardless of anatomic site, seroconversion was highest for HPV 6 (19.3%). Overall, seroconversion was highest following anal HPV 6 infection (69.2%). HPV persistence was the only factor found to influence seroconversion. Conclusions Low seroconversion rates following HPV infection leave men susceptible to recurrent infections that can progress to HPV-related cancers. This emphasizes the need for HPV vaccination in men to ensure immune protection against new HPV infections and subsequent disease.
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Affiliation(s)
- Anna R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Raphael Viscidi
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - B Nelson Torres
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Donna J Ingles
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Staci L Sudenga
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Luisa L Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Martha Abrahamsen
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Jorge Salmeron
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico ; Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
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26
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HIV is an important risk factor for human papillomavirus types 16 and 18 seropositivity among sexually active men who have sex with men. Sex Transm Dis 2015; 42:129-34. [PMID: 25668644 DOI: 10.1097/olq.0000000000000244] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether HIV infection is a main risk factor for human papillomavirus (HPV)-16 and HPV-18 seropositivity in men who have sex with men (MSM), and what other risk factors are associated with HPV-16 and HPV-18 seropositivity in this population. METHODS Men who have sex with men visiting a sexually transmitted infection (STI) clinic in Amsterdam in 2008 to 2009 answered questions concerning demographics and sexual behavior. Sera were tested for HPV antibodies to the major HPV capsid protein L1 by Luminex-based multiplex serology. As it is known that site of exposure is associated with seropositivity, this analysis was restricted to MSM who reported receptive anal sex during the preceding 6 months. Using multivariable logistic regression, we examined whether HIV was associated with HPV serostatus. RESULTS Included in the study were 415 HIV-negative and 205 HIV-positive MSM reporting receptive anal sex. Median age of the study population was 39 years (interquartile range, 31-44). Human papillomavirus seroprevalence differed significantly between HIV-negative and HIV-positive MSM: 31% versus 65% (P < 0.001) for HPV-16 and 28% versus 51% (P < 0.001) for HPV-18. After adjusting for important risk factors HPV-16 (adjusted odds ratio, 2.80; 95% confidence interval, 1.75-4.49) and HPV-18 (adjusted odds ratio, 1.78; 95% confidence interval, 1.11-2.85), seropositivity was significantly more common in HIV-positive than in HIV-negative MSM. We could not identify other consistent risk factors for HPV-16 and HPV-18 seropositivity. CONCLUSIONS HIV infection is an important risk factor for HPV-16 and HPV-18 seropositivity among MSM reporting receptive anal sex in the preceding 6 months.
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27
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Nyitray AG, Chang M, Villa LL, Carvalho da Silva RJ, Baggio ML, Abrahamsen M, Papenfuss M, Quiterio M, Salmerón J, Lazcano-Ponce E, Giuliano AR. The natural history of genital human papillomavirus among HIV-negative men having sex with men and men having sex with women. J Infect Dis 2015; 212:202-12. [PMID: 25649172 DOI: 10.1093/infdis/jiv061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 01/26/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Although human immunodeficiency virus (HIV)-negative men having sex with men (MSM) bear a substantial burden of human papillomavirus (HPV)-associated disease, prospective studies of genital HPV infection in this population are scarce. METHODS HPV genotyping was conducted on genital samples from men (aged 18-70 years) from Brazil, Mexico, or the United States who provided specimens at 6-month intervals for up to 4 years. Eligibility criteria included no history of genital warts or HIV infection. Evaluable specimens were collected from 564 MSM and 3029 men having sex with women (MSW). Incidence and clearance estimates with 95% confidence intervals were calculated. RESULTS The 12-month cumulative incidence of genital HPV was high in both MSM (25%; 95% confidence interval, 21%-30%) and MSW (21%; 20%-23%). After stratifying by city, MSM and MSW incidence rates were comparable, with 3 exceptions where MSM had higher incidence in ≥1 city: the group of quadrivalent vaccine types, HPV-45, and HPV-11. Median times to HPV-16 clearance were also comparable, with point estimates of >6 months for both MSM and MSW. CONCLUSIONS Unlike with many other sexually transmitted infections, genital HPV natural history may be similar in HIV-negative MSM and MSW. Study periods of ≤6 months, however, may not be long enough to accurately measure the persistence of these infections in men.
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Affiliation(s)
- Alan G Nyitray
- The University of Texas School of Public Health at Houston, Texas
| | - Mihyun Chang
- The University of Texas School of Public Health at Houston, Texas
| | - Luisa L Villa
- School of Medicine, University of São Paulo, School of Medical Sciences, Santa Casa de São Paulo
| | | | - Maria Luiza Baggio
- Center of Translational Oncology, Instituto do Câncer do Estado de São Paulo-ICESP, Brazil
| | | | - Mary Papenfuss
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - Jorge Salmerón
- Instituto Nacional de Salud Pública Instituto Mexicano del Seguro Social
| | | | - Anna R Giuliano
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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Rettig E, Kiess AP, Fakhry C. The role of sexual behavior in head and neck cancer: implications for prevention and therapy. Expert Rev Anticancer Ther 2015; 15:35-49. [PMID: 25193346 PMCID: PMC4385715 DOI: 10.1586/14737140.2015.957189] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
HPV-positive oropharyngeal squamous cell carcinoma (HPV-OSCC) is associated with oral sexual behaviors. The sharp rise in incidence of HPV-OSCC in the USA has been attributed to changes in sexual norms over the past five decades, with lower age at sexual debut and higher numbers of sexual partners per individual. In addition, variations in HPV-OSCC prevalence by race, age cohort and gender may be attributable to differences in oral sexual behaviors among these groups. Oral HPV infection is the putative precursor to HPV-OSCC. Risk factors for oral HPV incidence, prevalence, clearance and persistence are crucial to understanding how, and in whom, oral HPV infection progresses to malignancy. Future investigation should focus on elucidating the natural history of oral HPV infection persistence and malignant transformation, developing effective screening tools and exploring opportunities for prevention such as vaccination and public health education.
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Affiliation(s)
- Eleni Rettig
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, 601 N. Caroline St, Baltimore, MD 21287, USA
| | - Ana Ponce Kiess
- Department of Radiation Oncology, Johns Hopkins Medicine, 401 N. Broadway, Baltimore, MD 21231, USA
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, 601 N. Caroline St, Baltimore, MD 21287, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, USA
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29
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de Araujo-Souza PS, Ramanakumar AV, Candeias JMG, Thomann P, Trevisan A, Franco EL, Villa LL. Determinants of baseline seroreactivity to human papillomavirus type 16 in the Ludwig-McGill cohort study. BMC Infect Dis 2014; 14:578. [PMID: 25730386 PMCID: PMC4247698 DOI: 10.1186/s12879-014-0578-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 10/22/2014] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Immunity plays an important role in controlling human papillomavirus (HPV) infection and associated lesions. Unlike infections caused by other viruses, natural HPV infection does not always result in a protective antibody response. Therefore, HPV antibodies are also considered markers of cumulative exposure. The aim of this study was to identify determinants of HPV16 seroreactivity at enrollment among women from the Ludwig-McGill cohort, a natural history study of HPV infection and risk of cervical neoplasia. METHODS HPV16 serology was assessed by ELISA for L1 and L2 capsid antigens, while HPV typing and viral load measurements were performed by PCR-based methods. The associations were analyzed by unconditional logistic regression. RESULTS Of 2049 subjects, 425 (20.7%) were strongly seropositive for HPV16. In multivariate analysis, seroreactivity was positively correlated with age, lifetime number of sexual partners, frequency of sex, and HPV16 viral load, and negatively associated with duration of smoking. CONCLUSIONS HPV16 seroreactivity is determined by factors that reflect viral exposure.
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Affiliation(s)
- Patrícia S de Araujo-Souza
- />Ludwig Institute for Cancer Research, São Paulo, Brazil
- />Department of Immunobiology, Fluminense Federal University, Niterói, Brazil
- />Program of Cellular Biology, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | | | - João M G Candeias
- />Ludwig Institute for Cancer Research, São Paulo, Brazil
- />Department of Microbiology and Immunology, Institute of Biosciences, Universidade Estadual Paulista, Botucatu, Brazil
| | - Patrícia Thomann
- />Ludwig Institute for Cancer Research, São Paulo, Brazil
- />Institute of Gynaecological Cancer Research, São Paulo, Brazil
| | - Andrea Trevisan
- />Ludwig Institute for Cancer Research, São Paulo, Brazil
- />Division of Gynecologic Oncology, CHUM - Université de Montréal, Montreal, Canada
| | - Eduardo L Franco
- />Department of Oncology, McGill University, Montreal, Canada
- />Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Luisa L Villa
- />Ludwig Institute for Cancer Research, São Paulo, Brazil
- />Molecular Biology Laboratory, São Paulo Cancer Institute, ICESP, São Paulo, Brazil
- />Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
- />School of Medicine, University of São Paulo and Santa Casa de São Paulo, São Paulo, Brazil
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30
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Mooij SH, Landén O, van der Klis FRM, van der Sande MAB, de Melker HE, Xiridou M, van Eeden A, Heijman T, Speksnijder AGCL, Snijders PJF, Schim van der Loeff MF. HPV seroconversion following anal and penile HPV infection in HIV-negative and HIV-infected MSM. Cancer Epidemiol Biomarkers Prev 2014; 23:2455-61. [PMID: 25169974 DOI: 10.1158/1055-9965.epi-14-0199] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We assessed human papillomavirus (HPV) seroconversion following anal and penile HPV infection in HIV-negative and HIV-infected men who have sex with men (MSM). METHODS MSM aged ≥18 years were recruited in Amsterdam, the Netherlands (2010-2011), and followed up semiannually. Antibodies against 7 high-risk HPV types in baseline and 12-month serum samples were tested using a multiplex immunoassay. Baseline, 6-, and 12-month anal and penile samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Statistical analyses were performed using logistic regression with generalized estimating equations. RESULTS Of 644 MSM included in the analysis, 245 (38%) were HIV-infected. Median age was 38 years for HIV-negative and 47 years for HIV-infected MSM (P < 0.001). Seroconversion against ≥1 of the 7 HPV types was observed in 74 of 396 (19%) HIV-negative and 52 of 223 (23%) HIV-infected MSM at risk (P = 0.2). Incident [adjusted OR (aOR) 2.0; 95% confidence interval (CI), 1.1-3.4] and persistent (aOR 3.7; 95% CI, 1.5-9.5) anal HPV infections were independently associated with type-specific seroconversion in HIV-negative MSM. In HIV-infected MSM, there was a nonsignificant positive association between penile HPV infection at any time point and seroconversion (aOR 1.7; 95% CI, 0.9-3.2). CONCLUSIONS Incident or persistent anal HPV infection was an independent determinant of seroconversion in HIV-negative MSM. IMPACT Our data support that seroresponse may vary per anatomic site and that persistent HPV infections are more likely to elicit a detectable humoral immune response.
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Affiliation(s)
- Sofie H Mooij
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, the Netherlands. Center for Infection and Immunity Amsterdam (CINIMA), Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands.
| | - Olivia Landén
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, the Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - Marianne A B van der Sande
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - Maria Xiridou
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - Arne van Eeden
- Department of Internal Medicine, Jan van Goyen Medical Center, Amsterdam, the Netherlands
| | - Titia Heijman
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, the Netherlands
| | - Arjen G C L Speksnijder
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, the Netherlands
| | - Peter J F Snijders
- Department of Pathology, Vrije Universiteit-University Medical Center (VUmc), Amsterdam, the Netherlands
| | - Maarten F Schim van der Loeff
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, the Netherlands. Center for Infection and Immunity Amsterdam (CINIMA), Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands
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Mooij SH, van der Klis FRM, van der Sande MAB, Schepp RM, Speksnijder AGCL, Bogaards JA, de Melker HE, de Vries HJC, Snijders PJF, van der Loeff MFS. Seroepidemiology of high-risk HPV in HIV-negative and HIV-infected MSM: the H2M study. Cancer Epidemiol Biomarkers Prev 2014; 22:1698-708. [PMID: 24097197 DOI: 10.1158/1055-9965.epi-13-0460] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM), in particular HIV-infected MSM, are at increased risk for diseases related to human papilloma virus (HPV). Our goal was to assess the effect of HIV status on the presence of type-specific antibodies against seven high-risk HPV types in HPV-unvaccinated MSM. Moreover, we compared determinants of HPV seropositivity between HIV-negative and HIV-infected MSM. METHODS MSM ≥18 years of age were recruited from the Amsterdam Cohort Studies, a sexually transmitted infection clinic, and an HIV-treatment center in Amsterdam, the Netherlands. Participants completed a risk-factor questionnaire; serum samples were analyzed using a fluorescent bead-based multiplex assay. RESULTS MSM (n = 795) were recruited in 2010 to 2011; 758 MSM were included in this analysis. Median age was 40.1 years (interquartile range 34.8-47.5) and 308 MSM (40.6%) were HIV-infected. Seroprevalence of HPV-16 was 37.1% in HIV-negative and 62.7% in HIV-infected MSM (P < 0.001); seroprevalence of HPV-18 was 29.1% in HIV-negative MSM and 42.5% in HIV-infected MSM (P < 0.001). Similar patterns of seroprevalence were observed for HPV types 31, 33, 45, 52, and 58. In multivariable analyses, HPV seropositivity was associated with HIV infection [adjusted OR = 2.1; 95% confidence interval, 1.6-2.6]. In multivariable analyses stratified by HIV status, increasing age and number of lifetime male sex partners were significantly associated with HPV seropositivity in HIV-negative, but not HIV-infected MSM. CONCLUSIONS Seroprevalence of high-risk HPV types is high among unvaccinated MSM. IMPACT HIV infection is a strong and independent determinant for HPV seropositivity, which we hypothesize is because of increased persistence of HPV infection in HIV-infected MSM.
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Affiliation(s)
- Sofie H Mooij
- Authors' Affiliations: Cluster of Infectious Diseases, Public Health Service Amsterdam; Department of Pathology, Vrije Universiteit-University Medical Center (VUmc); Department of Internal Medicine, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center; Department of Epidemiology & Biostatistics, VU University Medical Center; Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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32
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Mooij SH, Landén O, van der Klis FRM, van der Sande MAB, de Melker HE, Coutinho RA, van Eeden A, van Rooijen MS, Meijer CJLM, Schim van der Loeff MF. No evidence for a protective effect of naturally induced HPV antibodies on subsequent anogenital HPV infection in HIV-negative and HIV-infected MSM. J Infect 2014; 69:375-86. [PMID: 24931579 DOI: 10.1016/j.jinf.2014.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/19/2014] [Accepted: 06/03/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess whether HPV serum antibodies detected after natural infection protect against subsequent anal or penile infection with the same HPV type in HIV-negative and HIV-infected men who have sex with men (MSM). METHODS MSM aged ≥18 years were recruited in Amsterdam, the Netherlands (2010-2011), and followed-up semi-annually. Antibodies against 7 high-risk HPV types in baseline serum samples were tested using a multiplex immunoassay; baseline, 6-, and 12-month anal and penile samples were tested for HPV DNA and genotyped using the SPF10-PCR DEIA/LiPA25 system (version 1). Statistical analyses were performed using the Wei-Lin-Weissfeld method. RESULTS 719 MSM (median age 40 years; IQR 35-48) with baseline and follow-up data were included in these analyses; 287 (40%) were HIV-infected. HPV seropositivity at baseline was not significantly associated with subsequent type-specific HPV infection at 6 or 12 months in multivariable analyses (for anal infection adjusted hazard ratio (aHR) 1.2; 95% CI 0.9-1.6; for penile infection aHR 0.8; 95% CI 0.6-1.2). High antibody concentrations showed no protective effect against subsequent infection either. CONCLUSIONS In a population of highly sexually active, adult MSM, naturally induced HPV antibodies may not protect MSM against subsequent anal or penile HPV infection within one year.
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Affiliation(s)
- Sofie H Mooij
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands; Center for Infection and Immunity Amsterdam (CINIMA), Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
| | - Olivia Landén
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
| | - Marianne A B van der Sande
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands
| | - Roel A Coutinho
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arne van Eeden
- Department of Internal Medicine, Jan van Goyen Medical Center, Amsterdam, The Netherlands
| | - Martijn S van Rooijen
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Chris J L M Meijer
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Maarten F Schim van der Loeff
- Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands; Center for Infection and Immunity Amsterdam (CINIMA), Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
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van Rijn VM, Mooij SH, Mollers M, Snijders PJF, Speksnijder AGCL, King AJ, de Vries HJC, van Eeden A, van der Klis FRM, de Melker HE, van der Sande MAB, van der Loeff MFS. Anal, penile, and oral high-risk HPV infections and HPV seropositivity in HIV-positive and HIV-negative men who have sex with men. PLoS One 2014; 9:e92208. [PMID: 24651691 PMCID: PMC3961332 DOI: 10.1371/journal.pone.0092208] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 02/20/2014] [Indexed: 01/29/2023] Open
Abstract
The effects of single or multiple concordant HPV infections at various anatomical sites on type-specific HPV seropositivity are currently unknown. In this cross-sectional study we assessed whether high-risk HPV infections at various anatomical sites (i.e., anal canal, penile shaft, and oral cavity), as well as concordant infections at multiple anatomical sites, were associated with type-specific seropositivity in HIV-positive and HIV-negative MSM. MSM aged ≥ 18 years were recruited in Amsterdam, the Netherlands (2010-2011). Baseline anal, penile, and oral samples were analyzed for HPV DNA and genotyped using a highly sensitive PCR and reverse line blot assay. Virus-like particle (VLP) based multiplex immunoassay was used to asses HPV-specific serum antibodies against L1 VLPs. The associations between HPV infections and type-specific seropositivity of seven high-risk HPV types (7-hrHPV: types 16, 18, 31, 33, 45, 52, 58) were estimated using logistic regression analyses with generalized estimating equations. We found that 86% of 306 HIV-positive MSM and 62% of 441 HIV-negative MSM were seropositive for at least one 7-hrHPV type. 69% of HIV-positive and 41% of HIV-negative MSM were infected with at least one 7-hrHPV type at the anus, penis, or oral cavity. In multivariable analyses, 7-hrHPV seropositivity was associated with type-specific anal (and not penile) 7-hrHPV infection, and did not significantly increase with a higher number of infected anatomical sites. Oral 7-hrHPV infection showed a positive, albeit non-significant, association with seropositivity. In conclusion, seropositivity among MSM appears to be largely associated with anal HPV infection, irrespective of additionally infected anatomical sites.
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Affiliation(s)
- Vera M. van Rijn
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sofie H. Mooij
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Madelief Mollers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Peter J. F. Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Audrey J. King
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Henry J. C. de Vries
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Arne van Eeden
- Department of Internal Medicine, Jan van Goyen Medical Center, Amsterdam, the Netherlands
| | - Fiona R. M. van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester E. de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Marianne A. B. van der Sande
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maarten F. Schim van der Loeff
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Anal human papillomavirus infection among HIV-infected and uninfected men who have sex with men in Beijing, China. J Acquir Immune Defic Syndr 2013; 64:103-14. [PMID: 23732908 DOI: 10.1097/qai.0b013e31829b6298] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND In light of China's unique ethnic and sociocultural context, and a marked rise in HIV prevalence among MSM, it is important to determine prevalence, genotypes and predictors of anal human papillomavirus (HPV) among HIV-infected and uninfected men who have sex with men (MSM) in Beijing, China. METHODS In 2010-2011, we recruited MSM (age range 18-61; median 28 years) through peer volunteers, and collected demographic/behavioral information via interviewer-administrated questionnaires. Trained health workers collected anal swabs for HPV genotyping by PCR and blood samples for HIV/syphilis serologies. RESULTS We obtained anal specimens from 212 HIV-infected and 459 HIV-uninfected participants. Among HIV-infected MSM, 82.1% were HPV-infected vs. 57.5% in HIV-uninfected (p<0.01). HIV-infected men had the greatest likelihood of multiple types: 17.9% uninfected; 36.3% with one type; 36.8% with 2-3; 9.0% with ≥4. Oncogenic HPV prevalence was higher among HIV- infected (61.3%) than uninfected participants (39.7%; p<0.01). HIV-uninfected MSM reporting always using condoms during insertive anal intercourse (past 6 months) were less likely to be HPV-infected (OR=0.49, 95%CI: 0.31-0.77). Among HIV-uninfected MSM, HPV infection was associated with unprotected receptive anal intercourse (past 6 months; OR=1.92, 95%CI: 1.19-3.11) and being forced to have sex (previous year; OR=3.32, 95%CI: 1.10-10.0). Multivariable logistic analysis among HIV infected MSM suggested that unprotected oral intercourse (past 6 months) was associated with HPV (adjusted OR=2.12, 95%CI: 1.00-4.48). Syphilis occurred in 55.8% of HIV-infected/HPV-infected, 50.0% of HIV-infected/HPV-uninfected, 19.6% of HIV-uninfected/HPV-infected, and 13.0% of HIV-uninfected/HPV-uninfected MSM. CONCLUSIONS HPV anal infections were more common among HIV-infected than uninfected MSM in China, including oncogenic and multiple types. Unprotected oral and receptive anal sex were was independently associated with HPV infection. Promotion of safer sex and HPV vaccination is strongly recommended among MSM.
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Tong WWY, Hillman RJ, Kelleher AD, Grulich AE, Carr A. Anal intraepithelial neoplasia and squamous cell carcinoma in HIV-infected adults. HIV Med 2013; 15:65-76. [PMID: 24007498 DOI: 10.1111/hiv.12080] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2013] [Indexed: 12/25/2022]
Abstract
Anal cancer is one of the most common non-AIDS-defining malignancies in the era of combination antiretroviral therapy. Its precursor lesion, anal intraepithelial neoplasia (AIN), is highly prevalent in HIV-infected populations. More than 90% of anal squamous cell cancers are attributable to human papillomavirus (HPV). While the biology of HPV-related intraepithelial neoplasia is consistent across lower anogenital sites, the natural history of AIN is not well established and cannot be assumed to be identical to that of cervical intraepithelial neoplasia. Screening strategies to prevent anal cancer should be developed based on robust natural history data in HIV-infected and uninfected populations. Likewise, treatments need to be tested in randomized clinical trials, and reserved for those at significant risk of progression to cancer. This review covers the epidemiology, pathogenesis and immunology of HPV infection, AIN and anal cancer, and summarizes the current diagnosis, screening and treatment strategies in HIV-infected adults.
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Affiliation(s)
- W W Y Tong
- Centre for Applied Medical Research, St Vincent's Hospital, Sydney, Australia
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Beachler DC, D'Souza G. Oral human papillomavirus infection and head and neck cancers in HIV-infected individuals. Curr Opin Oncol 2013; 25:503-10. [PMID: 23852381 PMCID: PMC3896303 DOI: 10.1097/cco.0b013e32836242b4] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE OF REVIEW HIV-infected individuals are living longer due to effective antiretroviral therapy and may therefore have a greater opportunity to develop human papillomavirus (HPV)-associated malignancies. This review describes the risk factors and burden of oral HPV infection and HPV-associated head and neck cancer (HNC) among HIV-infected individuals. RECENT FINDINGS Oral HPV infection is commonly detected in HIV-infected individuals and is elevated among those with a higher number of lifetime oral sexual partners, current tobacco use and immunosuppression. There are limited data on the natural history of oral HPV, but initial studies suggest that the majority of infections clear within 2 years. Although HIV-infected individuals are at a much higher risk of most HPV-associated cancers than the general population, studies suggest HIV-infected individuals have a more modest 1.5-4-fold greater risk for HPV-associated HNC. SUMMARY HIV-infected individuals are living longer, have a high prevalence of oral HPV infection and have many of the currently determined risk factors for HPV-associated HNC.
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Affiliation(s)
- Daniel C. Beachler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Heiligenberg M, Alberts CJ, Waterboer T, Speksnijder AGCL, De Vries HJC, Pawlita M, Schim van der Loeff MF. Route of sexual exposure is independently associated with seropositivity to HPV-16 and HPV-18 among clients of an STI clinic in the Netherlands. J Infect Dis 2013; 208:1081-5. [PMID: 23861551 DOI: 10.1093/infdis/jit295] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated the route of sexual exposure as a determinant for human papillomavirus (HPV)-16 and HPV-18 seropositivity. At the Amsterdam sexually transmitted infections clinic we recruited 4 risk groups: (1) men who have sex with women only (MSW; n = 751); (2) women who have sex with men (WSM; n = 749); (3) men who have sex with men (MSM) reporting insertive anal sex only (insMSM; n = 156); and (4) MSM reporting receptive anal sex (recMSM; n = 415). In multivariable analyses, HPV-16 seropositivity was significantly more common in WSM vs MSW, recMSM vs MSW, and recMSM vs insMSM. HPV-18 results were similar. Route of sexual exposure is independently associated with HPV seropositivity.
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Affiliation(s)
- Marlies Heiligenberg
- Department of Infectious Diseases, Public Health Service of Amsterdam, The Netherlands
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38
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Poynten IM, Waterboer T, Jin F, Templeton DJ, Prestage G, Donovan B, Pawlita M, Fairley CK, Garland SM, Grulich AE. Human papillomavirus types 6 and 11 seropositivity: Risk factors and association with ano-genital warts among homosexual men. J Infect 2013; 66:503-11. [DOI: 10.1016/j.jinf.2013.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 01/15/2013] [Accepted: 03/18/2013] [Indexed: 11/30/2022]
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Nicol AF, Grinsztejn B, Friedman RK, Veloso VG, Cunha CB, Georg I, Pilotto JH, Moreira RI, Castro CAV, Silver B, Viscidi RP. Seroprevalence of HPV vaccine types 6, 11, 16 and 18 in HIV-infected and uninfected women from Brazil. J Clin Virol 2013; 57:147-51. [PMID: 23490398 DOI: 10.1016/j.jcv.2013.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 02/04/2013] [Accepted: 02/08/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Information on vaccine-type HPV seroprevalence is essential for vaccine strategies; however, limited data are available on past exposure to HPV-quadrivalent vaccine types in HIV-infected woman in Brazil. OBJECTIVES To assess the seroprevalence for HPV types 6, 11, 16 and 18 in HIV-infected and uninfected women, from Rio de Janeiro, Brazil and to investigate potential associations with age and pregnancy status. STUDY-DESIGN 1100-sera were tested by virus-like particle (VLPs)-based ELISA for antibodies to HPV types 16, 18, 6 and 11. Statistical analysis was carried out by STATA/SE 10.1 and comparisons among HIV-infected and HIV-uninfected women were assessed by Poisson regression models with robust variance. RESULTS HPV-6, 11, 16 and 18 seroprevalence was significantly higher among HIV-positive women (29.9%, 8.5%, 56.2% and 38.0%, respectively) compared to HIV-negative women (10.9%, 3.5%, 30.8% and 21.7%, respectively), when adjusted by age and pregnancy status. Overall, 69.4% of HIV-infected and 41.5% of HIV-uninfected women tested positive for any HPV quadrivalent vaccine type. However 4.7% and 1.1%, respectively, tested positive for all HPV vaccine type. In HIV-uninfected women who were pregnant, we found a higher HPV-11 seroprevalence (8.5% vs. 1.5%; P < 0.001) and a lower HPV 16 seroprevalence (22.6% vs. 34.2%; P = 0.010) compared to not pregnant women. HIV-uninfected women, aged 40 or more years old had a higher HPV 16 seroprevalence compared to women aged less than 40 years old. CONCLUSIONS We did not observe a strong association between age and positive HPV antibodies nor an association between pregnancy and HPV seroprevalence. HPV seroprevalence was significantly higher among HIV-infected women compared to HIV negative women. In both populations the seroprevalence to all four HPV vaccine types was low suggesting that women may potentially benefit from the HPV vaccines.
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Affiliation(s)
- A F Nicol
- Laboratory of Interdisciplinary Medicine, Instituto Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, Brazil.
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