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Zhang J, Sun Y, Chen X, Ye Y, Shen W, Ye X, Lin Y, Lin Z, Tan S, Gao M, Ding Y, He N, Lin H, Liu X. Incidence, clearance, and factors associated with anal human papilloma virus infection among men with HIV. AIDS 2024; 38:9-20. [PMID: 37861684 DOI: 10.1097/qad.0000000000003755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVES This study aims to estimate the incidence and persistence/clearance of anal human papilloma virus (HPV) infection and related factors among men with HIV in Taizhou, China. DESIGN A prospective cohort study. METHODS Men with HIV were recruited and followed up from 2016 to 2021. Questionnaire surveys were used to collect social-demographic and behavioral characteristics, and anal swabs were collected for HPV Genotyping. RESULTS A total of 675 men with HIV were recruited and followed up. After an average follow-up time of 1.75 years, HPV39 (3.8/100 person-years), HPV52 (3.6/100 person-years), HPV51 (3.1/100 person-years), HPV58 (2.5/100 person-years) and HPV16 (2.4 cases/100 person-years) in the high-risk types showed the highest incidence rate. In marriage with woman [adjusted hazard ratio (aHR) = 0.44, 95% confidence interval (CI) 0.20-0.99] showed an inverse association with HPV incidence, while bisexuality or undetermined sexual orientation (aHR = 2.62, 95% CI 1.08-6.36) showed a positive association. For those infected at baseline, the top three high-risk HPV with the lowest clearance density were HPV52 (32.2/100 person-years), HPV58 (38.1/100 person-years), and HPV16 (43.5/100 person-years). Daily consumption of 1-28 g alcohol (aHR = 0.62, 95% CI 0.41-0.95) showed an inverse association with HPV clearance, while illicit drug use (aHR = 3.24, 95% CI 1.59-6.59) showed a positive association. CONCLUSION Anal HPV infection and clearance were both active in men with HIV in China. Marriage status and sexuality were associated with the incidence of HPV infection, while substance use including alcohol and illicit drug were associated with HPV clearance. More studies are needed to explore the risk factors of HPV persistence.
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Affiliation(s)
- Jing Zhang
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
- Xuhui District Center for Disease Control and Prevention, Shanghai
| | - Yu Sun
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
| | - Xiaoxiao Chen
- Taizhou City Center for Disease Control and Prevention
| | - Yiwen Ye
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
| | - Weiwei Shen
- Taizhou City Center for Disease Control and Prevention
| | - Xiaohong Ye
- Linhai District Center for Disease Control and Prevention
| | - Yajun Lin
- Sanmen District Center for Disease Control and Prevention
| | - Zhebin Lin
- Wenlin District Center for Disease Control and Prevention
| | - Shigang Tan
- Huangyan District Center for Disease Control and Prevention, Zhejiang Province, China
| | - Meiyang Gao
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
| | - Yingying Ding
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
| | - Na He
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
| | - Haijiang Lin
- Taizhou City Center for Disease Control and Prevention
| | - Xing Liu
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
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Tossas KY, Zhu B, Perera RA, Serrano MG, Sullivan S, Sayeed S, Strauss JF, Winn RA, Buck GA, Seewaldt VL. Does the Vaginal Microbiome Operate Differently by Race to Influence Risk of Precervical Cancer? J Womens Health (Larchmt) 2023; 32:553-560. [PMID: 36897755 PMCID: PMC10171949 DOI: 10.1089/jwh.2022.0309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Background: The vaginal microbiome (VMB) plays an important role in the persistence of human papillomavirus (HPV) infection and differs by race and among women with cervical intraepithelial neoplasia (CIN). Materials and Methods: We explored these relationships using 16S rRNA VMB taxonomic profiles of 3050 predominantly Black women. VMB profiles were assigned to three subgroups based on taxonomic markers indicative of vaginal wellness: optimal (Lactobacillus crispatus, L. gasseri, and L. jensenii), moderate (L. iners), and suboptimal (Gardnerella vaginalis, Atopobium vaginae, Ca. Lachnocurva vaginae, and others). Multivariable Firth logistic regression models were adjusted for age, smoking, VMB, HPV, and pregnancy status. Results: VMB prevalence by subgroup was 18%, 30%, and 51% for the optimal, moderate, and suboptimal groups, respectively. In fully adjusted models, the risk of CIN grade 3 (CIN3) among non-Latina (nL) Blacks was twice that of nL Whites (odds ratio [OR] = 2.0, 95% confidence interval [CI]: 1.1, 3.9, p = 0.02). The VMB modified this association (p = 0.04) such that the risk of CIN3 was significantly higher for nL Blacks than for nL Whites only among women with optimal VMBs (OR = 7.8, 95% CI: 1.7, 74.5, p = 0.007). Within racial groups, the risk of CIN3 was only elevated among nL White women with suboptimal VMBs (OR = 6.0, 95% CI: 1.3, 56.9, p = 0.02) compared with their racial counterparts with optimal VMBs. Conclusions: Our findings suggest that race is a modifier of the VMB in HPV carcinogenesis. An optimal VMB does not appear to be protective for nL Black women compared with nL White women.
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Affiliation(s)
- Katherine Y. Tossas
- Department of Health Behavior and Policy and Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Family Medicine and Population Health, Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Bin Zhu
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Robert A. Perera
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Myrna G. Serrano
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Stephanie Sullivan
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sadia Sayeed
- Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jerome F. Strauss
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert A. Winn
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Gregory A. Buck
- Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, Virginia, USA
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Sichero L, Giuliano AR, Villa LL. Human Papillomavirus and Genital Disease in Men: What We Have Learned from the HIM Study. Acta Cytol 2019; 63:109-117. [PMID: 30799416 DOI: 10.1159/000493737] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 09/13/2018] [Indexed: 01/01/2023]
Abstract
It is currently recognized that in addition to the major impact of human papillomavirus (HPV) infection in females, HPV causes considerable disease in men at the genitals, anal canal, and oropharynx. Specifically, genital HPV infections may progress to genital warts and penile carcinoma. Although studies concerning the natural history of HPV infections and associated neoplasias have mainly focused on women, during the last 2 decades considerable attention has been given in further understanding these infections in men. The HIM (HPV infection in men) Study, the only prospective multicenter study of male HPV natural history, consisted of a large prospective international cohort study in which men from Brazil, the United States, and Mexico were enrolled. The design and protocols of this study allowed unraveling crucial information regarding the relationship between HPV infection and clinical consequences in men, and associated risk factors at each of the anatomic sites where HPV is known to cause cancer in men.
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Affiliation(s)
- Laura Sichero
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, and the Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Luisa Lina Villa
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil,
- Department of Radiology and Oncology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil,
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Chotipanich A, Siriarechakul S, Mungkung OO. Role of high-risk human papillomavirus in the etiology of oral and oropharyngeal cancers in Thailand: A case-control study. SAGE Open Med 2018; 6:2050312118765604. [PMID: 29623202 PMCID: PMC5881963 DOI: 10.1177/2050312118765604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 02/26/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Among developing countries, Thailand shows no increase in the incidence of human papillomavirus–driven oropharyngeal cancer. The causal role of human papillomavirus infection in this pathology has not been researched thoroughly. Methods: A hospital-based, case–control study was performed which included 104 patients with newly diagnosed oral and oropharyngeal squamous cell carcinomas and 104 individuals without cancer. The Cervista high-risk human papillomavirus and 16/18 assays were used to detect human papillomavirus. Odds ratios were used to assess the association between high-risk genotypes of human papillomavirus and the cancers. Results: High-risk human papillomavirus was detected in 4 of 52 (7.7%) oral cancer cases, 6 of 52 (11.5%) oropharyngeal cancer cases, and 1 of 104 (0.96%) control subjects. Of 104 cancer patients in the study, 83 were smokers. High-risk human papillomavirus was significantly associated with oropharyngeal cancer (odds ratio = 13.44, 95% confidence interval = 1.6–114.8) but was nonsignificantly associated with oral cancer (odds ratio = 8.58, 95% confidence interval = 0.9–78.9). However, after adjustment for smoking, high-risk human papillomavirus was determined to be nonsignificantly associated with oropharyngeal cancer (adjusted odds ratio = 5.83, 95% confidence interval = 0.8–43.5). Conclusion: Although low human papillomavirus prevalence was observed, the rate of high-risk human papillomavirus infection in the cancer group was still higher than that in the control group. Smoking may have an influence on the etiology of human papillomavirus–related cancers. However, the study is underpowered to clarify the role of human papillomavirus as the independent risk factor for oral and oropharyngeal cancers in the Thai population.
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Affiliation(s)
- Adit Chotipanich
- Head and Neck Unit, Chonburi Cancer Hospital, Department of Medical Services, Ministry of Public Health, Chonburi, Thailand
| | - Surattaya Siriarechakul
- Head and Neck Unit, Lopburi Cancer Hospital, Department of Medical Services, Ministry of Public Health, Lopburi, Thailand
| | - On-Ong Mungkung
- Dentistry Unit, Chonburi Cancer Hospital, Department of Medical Services, Ministry of Public Health, Chonburi, Thailand
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Godar DE, Merrill SJ. Untangling the most probable role for vitamin D 3 in autism. DERMATO-ENDOCRINOLOGY 2017; 9:e1387702. [PMID: 29484101 PMCID: PMC5821151 DOI: 10.1080/19381980.2017.1387702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/02/2017] [Accepted: 09/29/2017] [Indexed: 12/31/2022]
Abstract
Recent studies indicate an important role for vitamin D3 in autism spectrum disorder (ASD), although its mechanism is not completely understood. The most puzzling aspect of ASD is that identical twins, who share identical DNA, do not have 100% concordance rates (∼88% for identical and ∼31% for fraternal twins). These findings provide major clues into the etiology: ASD must involve an environmental factor present in the prenatal milieu that both identical twins are not always exposed to because they do not always share it (i.e., placentas). Combined with the exponential increasing rates of ASD around the world, these observations suggest a contagious disease is probably transferred to the fetus via the placenta becoming infected by a cervical virus. Vitamin D3 boosts immune responses clearing viral infections and increases serotonin and estrogen brain levels. Here we review the different roles and untangle the most probable one vitamin D3 plays in ASD.
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Affiliation(s)
- Dianne E. Godar
- Body of Knowledge, Inc., Division of Human Disease Research Worldwide, Racine, WI, USA
| | - Stephen J. Merrill
- Marquette University, Department of Mathematics, Statistics, and Computer Science, Milwaukee, WI, USA
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Abstract
Rates of cancers attributable to human papillomavirus (HPV) are rising. A safe and extremely effective vaccine is available to prevent many of these cancers. Studies have shown that health care providers' recommendation to immunize is the most important factor in parents' decision. Parents of all adolescent boys and girls should receive a strong and unequivocal recommendation to vaccinate their child against HPV at the 11- or 12-year-old well child visit. Ideally, adolescents complete their HPV vaccine series by their 13th birthday, leading to greater immune response and protection before most adolescents are exposed to sexually transmitted HPV.
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Affiliation(s)
- Diane R Blake
- Department of Pediatrics, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Amy B Middleman
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Avenue, Suite 12200, Oklahoma City, OK 73104, USA
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Zhu Y, Wang Y, Hirschhorn J, Welsh KJ, Zhao Z, Davis MR, Feldman S. Human Papillomavirus and Its Testing Assays, Cervical Cancer Screening, and Vaccination. Adv Clin Chem 2017. [PMID: 28629588 DOI: 10.1016/bs.acc.2017.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Human papillomavirus (HPV) was found to be the causative agent for cervical cancer in the 1980s with almost 100% of cervical cancer cases testing positive for HPV. Since then, many studies have been conducted to elucidate the molecular basis of HPV, the mechanisms of carcinogenesis of the virus, and the risk factors for HPV infection. Traditionally, the Papanicolaou test was the primary screening method for cervical cancer. Because of the discovery and evolving understanding of the role of HPV in cervical dysplasia, HPV testing has been recommended as a new method for cervical cancer screening by major professional organizations including the American Cancer Society, American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology. In order to detect HPV infections, many sensitive and specific HPV assays have been developed and used clinically. Different HPV assays with various principles have shown their unique advantages and limitations. In response to a clear causative relationship between high-risk HPV and cervical cancer, HPV vaccines have been developed which utilize virus-like particles to create an antibody response for the prevention of HPV infection. The vaccines have been shown in long-term follow-up studies to be effective for up to 8 years; however, how this may impact screening for vaccinated women remains uncertain. In this chapter, we will review the molecular basis of HPV, its pathogenesis, and the epidemiology of HPV infection and associated cervical cancer, discuss the methods of currently available HPV testing assays as well as recent guidelines for HPV screening, and introduce HPV vaccines as well as their impact on cervical cancer screening and treatments.
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Affiliation(s)
- Yusheng Zhu
- Pennsylvania State University Hershey Medical Center, Hershey, PA, United States.
| | - Yun Wang
- Medical University of South Carolina, Charleston, SC, United States
| | - Julie Hirschhorn
- Pennsylvania State University Hershey Medical Center, Hershey, PA, United States
| | - Kerry J Welsh
- National Institute of Health, Bethesda, MD, United States
| | - Zhen Zhao
- National Institute of Health, Bethesda, MD, United States
| | - Michelle R Davis
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah Feldman
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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8
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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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Ramer I, Varier I, Zhang D, Demicco EG, Posner MR, Misiukiewicz K, Genden EM, Miles BA, Teng MS, Sikora AG. Racial disparities in incidence of human papillomavirus-associated oropharyngeal cancer in an urban population. Cancer Epidemiol 2016; 44:91-95. [DOI: 10.1016/j.canep.2016.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/03/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
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Meites E, Gorbach PM, Gratzer B, Panicker G, Steinau M, Collins T, Parrish A, Randel C, McGrath M, Carrasco S, Moore J, Zaidi A, Braxton J, Kerndt PR, Unger ER, Crosby RA, Markowitz LE. Monitoring for Human Papillomavirus Vaccine Impact Among Gay, Bisexual, and Other Men Who Have Sex With Men-United States, 2012-2014. J Infect Dis 2016; 214:689-96. [PMID: 27296847 DOI: 10.1093/infdis/jiw232] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/26/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Gay, bisexual, and other men who have sex with men (MSM) are at high risk for human papillomavirus (HPV) infection; vaccination is recommended for US males, including MSM through age 26 years. We assessed evidence of HPV among vaccine-eligible MSM and transgender women to monitor vaccine impact. METHODS During 2012-2014, MSM aged 18-26 years at select clinics completed a computer-assisted self-interview regarding sexual behavior, human immunodeficiency virus (HIV) status, and vaccinations. Self-collected anal swab and oral rinse specimens were tested for HPV DNA (37 types) by L1 consensus polymerase chain reaction; serum was tested for HPV antibodies (4 types) by a multiplexed virus-like particle-based immunoglobulin G direct enzyme-linked immunosorbent assay. RESULTS Among 922 vaccine-eligible participants, the mean age was 23 years, and the mean number of lifetime sex partners was 37. Among 834 without HIV infection, any anal HPV was detected in 69.4% and any oral HPV in 8.4%, yet only 8.5% had evidence of exposure to all quadrivalent vaccine types. In multivariate analysis, HPV prevalence varied significantly (P < .05) by HIV status, sexual orientation, and lifetime number of sex partners, but not by race/ethnicity. DISCUSSIONS Most young MSM lacked evidence of current or past infection with all vaccine-type HPV types, suggesting that they could benefit from vaccination. The impact of vaccination among MSM may be assessed by monitoring HPV prevalence, including in self-collected specimens.
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Affiliation(s)
- Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles
| | | | - Gitika Panicker
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases
| | - Martin Steinau
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases
| | - Tom Collins
- College of Public Health, University of Kentucky, Lexington
| | - Adam Parrish
- College of Public Health, University of Kentucky, Lexington
| | | | - Mark McGrath
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles
| | - Steven Carrasco
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles
| | - Janell Moore
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles
| | - Akbar Zaidi
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jim Braxton
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Peter R Kerndt
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles
| | - Elizabeth R Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases
| | | | - Lauri E Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
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Heard I, Poizot-Martin I, Potard V, Etienney I, Crenn-Hebert C, Moore C, Touraine P, Cubie H, Costagliola D. Prevalence of and Risk Factors for Anal Oncogenic Human Papillomavirus Infection Among HIV-Infected Women in France in the Combination Antiretroviral Therapy Era. J Infect Dis 2015; 213:1455-61. [PMID: 26690345 DOI: 10.1093/infdis/jiv751] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/11/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about the type-specific prevalence of anal human papillomavirus (HPV) infection and risk factors for anal high-risk (HR) HPV infection in human immunodeficiency virus (HIV)-infected women. METHODS A cross-sectional study of anal and cervical HPV infection was nested within a gynecological cohort of HIV-infected women. Specimens were tested for type-specific DNA using a polymerase chain reaction-based assay. RESULTS The study population consisted of 311 women with a median age of 45.3 years, of whom 42.8% originated from sub-Saharan Africa and 96.8% were receiving combination antiretroviral therapy. The median CD4(+)cell count was 612/μL, and the HIV load was <50 copies/mL in 84.1%. HR-HPV types were detected in the anal canal in 148 women (47.6%) and in the cervix in 82 (26.4%). HPV-16 was the most prevalent type in both the anal canal (13.2% of women) and the cervix (5.1%). In multivariable analysis, factors associated with prevalent anal HR-HPV infection were CD4(+)count <350/μL (odds ratio, 2.9; 95% confidence interval, 1.3-6.5), concurrent cervical lesions (2.6; 1.0-4.3), and cervical HR-HPV infection (1.8; 1.0-3.2). CONCLUSIONS The high prevalence of HR-HPV types, including HPV-16, in the anal canal of HIV-positive women is concerning. Anal cancer screening should be considered for HIV-positive women as part of their routine care.
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Affiliation(s)
- Isabelle Heard
- French Human Papillomavirus Reference Laboratory, Institut Pasteur Department of Endocrinology and Reproductive Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, Sainte-Marguerite Hospital, Immuno-hematology Clinic Unit, Assistance Publique, Hôpitaux de Marseille Inserm U912, Marseille
| | - Valérie Potard
- Sorbonne Universités, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique INSERM Transfert, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris
| | - Isabelle Etienney
- Proctologie Unit, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris
| | | | - Catherine Moore
- Scottish HPV Reference Laboratory, Edinburgh, United Kingdom
| | - Philippe Touraine
- Department of Endocrinology and Reproductive Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris
| | - Heather Cubie
- Scottish HPV Reference Laboratory, Edinburgh, United Kingdom
| | - Dominique Costagliola
- Sorbonne Universités, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique
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Ingles DJ, Lin HY, Fulp WJ, Sudenga SL, Lu B, Schabath MB, Papenfuss MR, Abrahamsen ME, Salmeron J, Villa LL, Lazcano Ponce E, Giuliano AR. An analysis of HPV infection incidence and clearance by genotype and age in men: The HPV Infection in Men (HIM) Study. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2015; 1:126-135. [PMID: 27547836 PMCID: PMC4986989 DOI: 10.1016/j.pvr.2015.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 08/31/2015] [Accepted: 09/05/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Genital HPV infection in men causes benign and cancerous lesions, the incidence of which differs by age. The goal of this work was to comprehensively evaluate incidence and clearance of individual HPV genotypes among men by age group. METHODS HIV-negative men ages 18-70 with no history of anogenital cancer were recruited for the HPV Infection in Men (HIM) Study. Participants completed clinical exams and questionnaires every six months for up to ~4 years. Genital specimens underwent HPV genotyping, with associations between age and HPV assessed using Cox analyses. RESULTS 4085 men were followed for a median of 48.6 months (range: 0.3-94.0). Significantly lower HPV incidence rates were observed among the oldest age group (55-70 years) for grouped high-risk (incidence rate ratio [IRR]=0.71), HPV16 (IRR=0.54), grouped low-risk (IRR=0.74), and HPV6 (IRR=0.57) infections compared to men ages 18-24. However, incidence of the grouped 9-valent HPV vaccine types remained constant across the lifespan. Likelihood of HPV6 and HPV16 clearance remained constant until age 54, then increased significantly for men ages 55-70 (adjusted hazard ratio [AHR]=1.92 and 1.65, respectively). CONCLUSIONS Men remain susceptible to HPV infections throughout their lifespan, highlighting the need for prevention efforts with long-lasting duration.
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Affiliation(s)
- Donna J. Ingles
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Hui-Yi Lin
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - William J. Fulp
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Staci L. Sudenga
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Beibei Lu
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | | | - Jorge Salmeron
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Instituto Mexicano del Seguro Social, Mexico
| | | | - Eduardo Lazcano Ponce
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Instituto Mexicano del Seguro Social, Mexico
| | - Anna R. Giuliano
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Seroepidemiology of Human Papillomavirus 16 (HPV16) L2 and Generation of L2-Specific Human Chimeric Monoclonal Antibodies. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:806-16. [PMID: 25972404 DOI: 10.1128/cvi.00799-14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/04/2015] [Indexed: 11/20/2022]
Abstract
Presently, the seroprevalence of human papillomavirus (HPV) minor capsid antigen L2-reactive antibody is not well understood, and no serologic standard exists for L2-specific neutralizing antibodies. Therefore, we screened a total of 1,078 serum samples for HPV16 L2 reactivity, and these were obtained from four prior clinical studies: a population-based (n = 880) surveillance study with a high-risk HPV DNA prevalence of 10.8%, a cohort study of women (n = 160) with high-grade cervical intraepithelial neoplasia (CIN), and two phase II trials in women with high-grade vulvar intraepithelial neoplasia (VIN) receiving imiquimod therapy combined with either photodynamic therapy (PDT) (n = 19) or vaccination with a fusion protein comprising HPV16 L2, E7, and E6 (TA-CIN) (n = 19). Sera were screened sequentially by HPV16 L2 enzyme-linked immunosorbent assay (ELISA) and then Western blot. Seven of the 1,078 serum samples tested had L2-specific antibodies, but none were detectably neutralizing for HPV16. To develop a standard, we substituted human IgG1 sequences into conserved regions of two rodent monoclonal antibodies (MAbs) specific for neutralizing epitopes at HPV16 L2 residues 17 to 36 and 58 to 64, creating JWW-1 and JWW-2, respectively. These chimeric MAbs retained neutralizing activity and together reacted with 33/34 clinically relevant HPV types tested. In conclusion, our inability to identify an HPV16 L2-specific neutralizing antibody response even in the sera of patients with active genital HPV disease suggests the subdominance of L2 protective epitopes and the value of the chimeric MAbs JWW-1 and JWW-2 as standards for immunoassays to measure L2-specific human antibodies.
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