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Morhason-Bello IO, Baisley K, Pavon MA, Adewole IF, Bakare RA, de Sanjosé S, Francis SC, Watson-Jones D. Oral, genital and anal human papillomavirus infections among female sex workers in Ibadan, Nigeria. PLoS One 2022; 17:e0265269. [PMID: 35353833 PMCID: PMC8967011 DOI: 10.1371/journal.pone.0265269] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/25/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There are limited data on the epidemiology of HPV in different anatomical sites of female sex workers (FSW). We investigated the prevalence and concordance of cervical, vulval, oral and anal HPV among FSW in Ibadan, Nigeria. METHODS FSWs aged 18-45 years were enrolled in a cross-sectional survey. After interview and clinical examination, samples were collected from mouth, cervix, vulva and anus. HPV genotyping was done with Anyplex II 28HPV assay. Multivariable analyses were performed to explore associated risk factors and concordance of HPV infections across sites. RESULTS In total, 315 FSWs participated in the study with a mean age of 30-6.5 years. The prevalence of any HPV infection was 88% in the vulva, 84% in the cervix, 75% in the anus and 24% in the oral cavity. HPV 35 was the most prevalent and concordant high-risk type in the four sites. The risk factors for HPV infection by anatomic site varied. CONCLUSION This large study showed a high prevalence and concordance of HPV infections of cervical, vulval, oral and anal HPV among FSWs in Nigeria. The potential to acquire and transmit HPV is high in this population, and we highlighted the urgency to protect young women through HPV vaccination.
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Affiliation(s)
- Imran O. Morhason-Bello
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Institute of Advance Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kathy Baisley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Miquel A. Pavon
- Infection and Cancer Laboratory, Cancer Epidemiology Research Program, ICO, Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Isaac F. Adewole
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rasheed A. Bakare
- Department of Microbiology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Silvia de Sanjosé
- Division of Cancer Epidemiology and Genetics (DCEG), Consultant, National Cancer Institute (NCI), National Institutes of Health (NIH), USA and Associate Researcher, ISGlobal, Barcelona, Spain
| | - Suzanna C. Francis
- International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Deborah Watson-Jones
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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Wu J, Ding C, Liu X, Zhou Y, Tian G, Lan L, Chen C, Yan D, Huang C, Fu X, Li L, Yang S. Worldwide burden of genital human papillomavirus infection in female sex workers: a systematic review and meta-analysis. Int J Epidemiol 2021; 50:527-537. [PMID: 33517415 DOI: 10.1093/ije/dyaa289] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although female sex workers (FSWs) have long been identified as a key human papillomavirus (HPV)-affected population, the burden and scope of their disproportionate risk for HPV infection have not been systematically estimated. We therefore aimed to estimate the prevalence of HPV and the distribution of HPV types in FSWs at the country, regional and global levels. METHODS We searched the PubMed, Embase, SCOPUS, EBSCO, ProQuest, Cochrane Library and Web of Science databases for articles published between 1 January 1990 and 31 June 2019. Studies of genital HPV prevalence in FSWs, or with sufficient data (e.g. adequate number of HPV-positive cases and sample size) to compute prevalence rates in FSWs, were included in this systematic review. The meta-analysis was completed using the random effects model. RESULTS We ultimately identified 107 studies in 45 countries or regions with sufficient data to calculate HPV prevalence in FSWs. The pooled global HPV prevalence among FSWs was 39.5% (95% CI 35.3, 43.9%), with notable variations by WHO region and country. Globally, the five most common HPV types in FSWs were HPV16 (9.0%), HPV 52 (8.3%), HPV89 (7.0%), HPV58 (6.2%), and HPV53 (5.3%). CONCLUSIONS Our findings suggest that FSWs are disproportionately affected by HPV, which is more pronounced in the Western Pacific and African regions, and are therefore in need of prevention, treatment and care services.
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Affiliation(s)
- Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Cheng Ding
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoxiao Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yuqing Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Guo Tian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Lei Lan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Can Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Danying Yan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chenyang Huang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaofang Fu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shigui Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
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Farahmand M, Moghoofei M, Dorost A, Abbasi S, Monavari SH, Kiani SJ, Tavakoli A. Prevalence and genotype distribution of genital human papillomavirus infection in female sex workers in the world: a systematic review and meta-analysis. BMC Public Health 2020; 20:1455. [PMID: 32977797 PMCID: PMC7519561 DOI: 10.1186/s12889-020-09570-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 09/20/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world. METHODS Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the "Metaprop" function in the R package Meta. RESULTS Sixty-two studies involving 21,402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.6% (95% confidence interval (CI): 38.5-46.7%). HPV-16 (10.1, 95% CI: 8.2-12.5%), HPV-52 (7.9, 95% CI: 5.9-10.7%), and HPV-53 (6.0, 95% CI: 4.4-8.1%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.6% (95% CI: 36.1-51.4%) and 41.9% (95% CI: 37.2-46.8%), respectively. CONCLUSION Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.
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Affiliation(s)
- Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Moghoofei
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abolfazl Dorost
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Abbasi
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamidreza Monavari
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Jalal Kiani
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Tavakoli
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
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Schim van der Loeff MF, Vorsters A, Marra E, Van Damme P, Hogewoning A. Should female sex workers be offered HPV vaccination? Hum Vaccin Immunother 2019; 15:1544-1548. [PMID: 31063078 PMCID: PMC6746505 DOI: 10.1080/21645515.2019.1602432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/12/2019] [Accepted: 03/28/2019] [Indexed: 12/29/2022] Open
Abstract
Prophylactic vaccines are efficacious in preventing Human Papillomavirus (HPV) infection and subsequent cervical intraepithelial neoplasia (CIN), cervical cancer, other anogenital cancers, and anogenital warts. Female sex workers (SW) are at increased risk of acquiring sexually transmitted infections, including HPV. There are several reasons to offer HPV vaccination to SW: they are at high risk for HPV and often unvaccinated, and the immunogenicity of the vaccine is also excellent in previously HPV exposed women. Furthermore, women with disease caused by HPV may still benefit from vaccination. The efficacy of vaccinating mid-adult women (26-44 years old) against persistent HPV infection and CIN2+ is good. Although an SW may have been infected or exposed to HPV, she may not have been exposed to all vaccine-included hrHPV types. Vaccination induces mucosal immunity via the production of neutralizing antibodies on the surface of the female genital tract, thus preventing potential transmission to clients. Nevertheless, some considerations argue against offering vaccination to SWs. Current vaccines are only prophylactic and as such, do not affect current HPV infections. Women who have previously cleared HPV infections, may do so again and thus not need vaccination. Fewer SW might be naïve to HPV-types than currently thought. HPV vaccination has probably no effect on latent infections. Vaccinating sometime after sexual debut could be too late, as infections have already occurred. Taken together, some data suggest that vaccination of SW may offer health benefits, also for the community, but sufficient evidence is lacking. In certain cases, HPV vaccination of SW may be recommended. Evidence-based, public health decisions concerning vaccination of SW are challenging and could be facilitated with more research in this high-risk group.
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Affiliation(s)
- Maarten F. Schim van der Loeff
- Department of Infectious Disease, Public Health Service Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerpen, Antwerp, Belgium
| | - Elske Marra
- Department of Infectious Disease, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerpen, Antwerp, Belgium
| | - Arjan Hogewoning
- Department of Infectious Disease, Public Health Service Amsterdam, Amsterdam, The Netherlands
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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5
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Kovachev S, Slavov V. Prevalence of human papillomavirus infection in women in Bulgaria: A 2017 update. J Med Virol 2018; 90:1142-1149. [DOI: 10.1002/jmv.25050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 01/15/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Stefan Kovachev
- Department of Gynecology and Gynecological Oncology; The Military Medical Academy; Sofia Bulgaria
| | - Victor Slavov
- GENICA Genetic Medico-Diagnostic Laboratory; Sofia Bulgaria
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Staykova J, Belovska T, Murad A, Kakid S, Nacheva A, Shikova E. Cervical Viral Infections among Asymptomatic Bulgarian Women. Cent Eur J Public Health 2017; 24:176-179. [PMID: 27760284 DOI: 10.21101/cejph.a4299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/25/2016] [Indexed: 11/15/2022]
Abstract
AIM Although sexually transmitted viral infections are significant and increasing public health concern, little is known about their prevalence among Bulgarian women. The aim of this study was to investigate cervical viral infections in asymptomatic women. METHODS The study group included 52 randomly selected asymptomatic female volunteers from Bulgarian border town Kardzhali. Cervical specimens were tested by real-time PCR for human papillomaviruses (HPV), herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human immunodeficiency virus (HIV). RESULTS The investigation demonstrated a high rate (61.5%) of infection with one or more viruses of uterine cervix of participating women considered at low risk. The most prevalent was HPV, found in 32.7% of all women. The genotyping of high-risk (HR) HPV positive specimens showed that HPV16 was the most prevalent HR type. HSV prevalence (30.8%) was almost as high as that of HPV and most women were HSV1 infected. 9.6% and 5.8% of all specimens were positive for EBV and CMV, respectively. CONCLUSIONS Our results indicate that women from Kardzhali region, involved in this study, might be at risk for development of genital tract pathology, including cervical cancer, and for transmission of virus infection sexually and perinatally.
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Affiliation(s)
- Jeni Staykova
- Regional Health Inspectorate, Kardzhali, Bulgaria.,Faculty of Public Health, Medical University, Sofia, Bulgaria
| | | | - Ayla Murad
- Regional Health Inspectorate, Kardzhali, Bulgaria
| | | | | | - Evelina Shikova
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
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7
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Jia H, Wang X, Long Z, Li L. Human papillomavirus infection and cervical dysplasia in female sex workers in Northeast China: an observational study. BMC Public Health 2015. [PMID: 26202513 PMCID: PMC4512111 DOI: 10.1186/s12889-015-2066-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Women having multiple sex partners are reportedly at an increased risk of HPV infection. However, the prevalence and risk factors of HPV infection in female sex workers (FSWs) vary considerably across racial/ethnic, socioeconomic, and geographic groups. This study aimed to determine the prevalence and risk factors of HPV infection in FSWs in Northeast China. Methods A total of 309 FSWs identified and approached through a local police office and 1000 healthy subjects from a single factor undergoing annual gynecological examinations in Shenyang were recruited. A liquid-based ThinPrep Pap test and the Hybrid Capture II-based high-risk HPV DNA test, with or without a colposcopic examination, were performed on both FSWs and control subjects. Data on HPV infection and histological and cytological lesions of the cervix were obtained and analyzed. A questionnaire survey was administered to all 309 FSWs with their socio-demographic and behavioral information collected. The association of various socio-demographic and behavioral variables with HPV infection was assessed. Results HPV was significantly more prevalent in FSWs (61.90 %) than in healthy control subjects (21.00 %) (P < 0.01), so were cervical lesions (P < 0.01). HPV prevalence in our sample of FSWs fell in the upper range of reported values in FSWs across different countries, and was similar to that for FSWs in the southeast Chinese city of Huzhou but higher than that for FSWs in southwest China, Guangxi, as compared with data from other studies within China. HPV infection in FSWs was significantly associated with the age at first sexual intercourse (OR 0.699, 95 % CI 0.492–0.992) and post-menopause (OR 2.928, 95 % CI 1.099–7.800) (P < 0.05). Conclusions FSWs are at a substantially high risk of HPV infection and cervical dysplasia development as compared with healthy control subjects in Shenyang, China. Age of first sexual intercourse and post-menopause are two independent risk factors for HPV infection in this special group of population. Intensified and coordinated efforts from government, public health sector, communities and families are needed to reduce the risk of HPV infection in this specific group of population.
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Affiliation(s)
- Haiqing Jia
- Department of Gynecological Oncology, Liaoning Provincial Cancer Hospital, 44 Xiaoheyan Road, Shenyang, Liaoning, 110042, China.
| | - Xiaobin Wang
- Department of Gynecological Oncology, Liaoning Provincial Cancer Hospital, 44 Xiaoheyan Road, Shenyang, Liaoning, 110042, China.
| | - Zaiqiu Long
- Department of Gynecological Oncology, Liaoning Provincial Cancer Hospital, 44 Xiaoheyan Road, Shenyang, Liaoning, 110042, China.
| | - Liankun Li
- Department of Gynecological Oncology, Liaoning Provincial Cancer Hospital, 44 Xiaoheyan Road, Shenyang, Liaoning, 110042, China.
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8
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Ersan G, Kose S, Senger SS, Gunes H, Sehirali S, Gurbuz I. The prevalence and risk factors of human papillomavirus in female sex workers. Eurasian J Med 2015; 45:16-20. [PMID: 25610243 DOI: 10.5152/eajm.2013.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 11/12/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Human papillomavirus virus (HPV) is the major causative factor for cervical cancer, and sex workers are at high risk for HPV infection. In this study, we aimed to estimate the prevalence and risk factors of HPV infection among female sex workers (FSWs). MATERIALS AND METHODS The study included 239 brothel-based FSWs who work in Izmir, Turkey. A self-administered questionnaire for risk factors was completed, and cervical brush samples were taken for HPV detection and typing. HPV detection and typing were performed by multiplex polymerase chain reaction (PCR) and reverse hybridization methods. The risk factors related to HPV infection were determined by multivariate analysis. RESULTS The prevalence of HPV among FSWs was 20.1%. HPV18 was the most common type (40%), followed by HPV16 (17%) and HPV50 (15%). Logistic regression analysis revealed that being less than 30 years of age, having a high frequency of sexual contacts, smoking, and lack of condom use were significantly associated with HPV infection. CONCLUSION FSWs have a high prevalence of HPV infection and are at increased risk for cervical cancer. As they are a priority group for active follow-up, national strategies for reducing HPV among FSWs and regular cervical cancer screening programs should be implemented for this population.
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Affiliation(s)
- Gursel Ersan
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Suheyla Serin Senger
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Research and Training Hospital, Izmir, Turkey
| | | | - Salim Sehirali
- Ege Obstetrics and Gynecology Education and Research Hospital, İzmir, Turkey
| | - Ilhan Gurbuz
- Izmir Branch of Ministry of Health, Izmir, Turkey
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Kaderli R, Schnüriger B, Brügger LE. The impact of smoking on HPV infection and the development of anogenital warts. Int J Colorectal Dis 2014; 29:899-908. [PMID: 24935346 DOI: 10.1007/s00384-014-1922-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2014] [Indexed: 02/04/2023]
Abstract
PURPOSE The worldwide prevalence of human papillomavirus (HPV) infection is estimated at 9-13 %. Persistent infection can lead to the development of malignant and nonmalignant diseases. Low-risk HPV types are mostly associated with benign lesions such as anogenital warts. In the present systematic review, we examined the impact of smoking on HPV infection and the development of anogenital warts, respectively. METHODS A systematic literature search was performed using MEDLINE database for peer-reviewed articles published from January 01, 1985 to November 30, 2013. Pooled rates of HPV prevalence were compared using the χ (2) test. RESULTS In both genders, smoking is associated with higher incidence and prevalence rates for HPV infection, whereas the latter responds to a dose-effect relationship. The overall HPV prevalence for smoking patients was 48.2 versus 37. 5 % for nonsmoking patients (p < 0.001) (odds ratio (OR) = 1.5, 95 % confidence interval (CI) 1.4-1.7). Smoking does also increase persistence rates for high-risk HPV infection, while this correlation is debatable for low-risk HPV. The incidence and recurrence rates of anogenital warts are significantly increased in smokers. CONCLUSIONS Most current data demonstrate an association between smoking, increased anogenital HPV infection, and development of anogenital warts. These data add to the long list of reasons for making smoking cessation a keystone of patient health.
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Affiliation(s)
- Reto Kaderli
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, 3010, Bern, Switzerland,
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10
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Soohoo M, Blas M, Byraiah G, Carcamo C, Brown B. Cervical HPV Infection in Female Sex Workers: A Global Perspective. Open AIDS J 2013; 7:58-66. [PMID: 24511334 PMCID: PMC3915319 DOI: 10.2174/1874613601307010058] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 12/18/2013] [Accepted: 12/18/2013] [Indexed: 11/22/2022] Open
Abstract
Introduction: Approximately 291 million women worldwide are HPV DNA carriers. Studies have indicated
that having multiple sexual partners may lead to higher HPV transmission. Thus female sex workers (FSWs) may be at
greater risk of infection compared to the general population. Herein we review publications with data on FSW cervical
HPV test results. We also examine variations of HPV prevalence and risk behaviors by region. Knowledge of prevalent
HPV types in FSWs may lead to improved prevention measures and assist in understanding vaccination in high-risk
groups. Methods: We conducted a review of the literature by searching PUBMED using the terms “prostitution” or “female sex
workers”, “human papillomavirus” or “HPV”, and “prevalence” or “PCR” to find articles. We excluded studies without
HPV testing or HPV type specific results, or unconventional HPV testing. Results: A total of 35 peer-reviewed publications were included in our review. High risk HPV types 16 and 18 ranged
from 1.1-38.9‰ in prevalence. In addition to high-risk HPV types, newer studies reported non-carcinogenic HPV types
also of high prevalence. The most prevalent HPV types reported among FSWs included HPV 6 (11.5%), 16 (38.9%), 18
(23.1%), 31 (28.4%), 52 (32.7%), and 58 (26.0%). Conclusions: Female sex workers have an overall high prevalence of HPV infection of high-risk types as evident through
various testing methods. FSWs are thought to be at increased risk of cervical cancer because of high HPV exposure. This
highlights the need for HPV and cervical prevention campaigns tailored to FSWs.
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Affiliation(s)
- Melissa Soohoo
- Program in Public Health, University of California, Irvine, USA
| | - Magaly Blas
- Unit of Epidemiology, HIV and STD, Universidad Peruana Cayetano Heredia, Perú
| | - Gita Byraiah
- Cooper Medical School, Rowan University, New Jersey, USA
| | - Cesar Carcamo
- Unit of Epidemiology, HIV and STD, Universidad Peruana Cayetano Heredia, Perú
| | - Brandon Brown
- Program in Public Health, University of California, Irvine, USA
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Marek E, Dergez T, D'cruz G, Bozsa S, Cseh A, Szilard I, Benczik M, Kiss I, Varszegi D, Vilagi S, Ember I, Gocze P. Human papillomavirus infections among Hungarian female sex workers. Eur J Cancer Care (Engl) 2013; 23:65-75. [PMID: 23957436 DOI: 10.1111/ecc.12110] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 12/22/2022]
Abstract
The purpose of this study was to assess the human papillomavirus (HPV) prevalence in cervical, oropharyngeal and anal samples of the high-risk population of Hungarian female sex workers (FSWs). HPV testing of swab specimens from FSWs (n = 34) using polymerase chain reaction (PCR) methodology was performed. Results were compared with control group (n = 52) matched for age. Questionnaires were used to obtain data regarding participants' sexual behaviour. Data were analysed using SPSS. HPV DNA was detected in at least one location in a great majority of FSWs (82.4%), compared with 46.2% of the general female population (P < 0.05). Both the cervical and the anal samples of sex workers showed higher infection rates than those of controls (64.7% vs. 34.6% and 50.0% vs. 15.4%, respectively, P < 0.05). High-risk HPV prevalence was also significantly higher in sex workers (55.9% vs. 25.0%, P < 0.05). A significantly higher proportion of FSWs had a history of genital warts (26.5% vs. 3.8%, P < 0.05). The results suggest that condom use may not result in adequate protection from HPV infection. The high infection rates among FSWs should be viewed as a priority group for HPV and cervical cancer prevention programmes since they are sources of HPV infection for the general population.
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Affiliation(s)
- E Marek
- Medical School, University of Pecs, Pecs, Hungary
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12
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Ersan G, Köse S, Gunes H, Ozkan M. Knowledge and awareness of female sex workers towards human papillomavirus infection in Turkey. Cent Eur J Public Health 2013; 20:219-22. [PMID: 23285524 DOI: 10.21101/cejph.a3738] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to determine the knowledge and awareness of female sex workers (FSWs) about human papillomavirus (HPV) infection in Turkey. METHODS 239 brothel-based FSWs were recruited for an interview. A questionnaire was completed by face to face interview. The demographic features, the level of knowledge, and awareness about HPV infection of the participants were recorded. RESULTS A total of 152 (63.6%) were over 30 years of age, and 210 (87.9%) completed primary education. 122 FSWs (50.9%) were using condom, and about one third had high frequency of sexual contacts. Knowledge scores were < OR =4 in 181 (75.7%) FSWs. Low education and higher age group were not significant predictors of low knowledge scores. Low education was not an independent risk factor for awareness but higher age group participants were significantly less aware of risks associated with HPV infection (p = 0.019) although overall score was very poor (0.60 +/- 0.68). CONCLUSIONS The knowledge and awareness about HPV infection and its possible consequences (cervical cancer) as well as the utility of screening methods among FSWs in Turkey are extremely poor. HPV-focused educational programmes for targeted populations, e.g. FSWs and young adults prior to their sexual activity, should be launched urgently to increase awareness of the risks associated with HPV infection and thus reducing the incidence of cervical cancer in Turkey in the future.
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Affiliation(s)
- Gürsel Ersan
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Research and Training Hospital, Izmir, Turkey.
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Couture MC, Page K, Stein ES, Sansothy N, Sichan K, Kaldor J, Evans JL, Maher L, Palefsky J. Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection. BMC Infect Dis 2012; 12:166. [PMID: 22839728 PMCID: PMC3436768 DOI: 10.1186/1471-2334-12-166] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 06/29/2012] [Indexed: 01/09/2023] Open
Abstract
Background Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia. Methods We conducted a cross-sectional study among 220 young women (15–29 years) engaged in sex work in different venues including brothels or entertainment establishments, and on a freelance basis in streets, parks and private apartments. Cervical specimens were collected using standard cytobrush technique. HPV DNA was tested for by polymerase chain reaction (PCR) and genotyping using type-specific probes for 29 individual HPV types, as well as for a mixture of 10 less common HPV types. All participants were also screened for HIV status using blood samples. Multivariate logistic regression analyses were conducted to assess risk factors for any or multiple HPV infection. Results The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection. Conclusions This is the first Cambodian study on cervical HPV prevalence and genotypes. We found that HPV infection was common among young FSW, especially among women infected with HIV. These results underscore the urgent need for accessible cervical cancer screening and treatment, as well as for a prophylactic vaccine that covers the HPV subtypes present in Cambodia.
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Affiliation(s)
- Marie-Claude Couture
- University of California San Francisco, Global Health Sciences, 50 Beale street, Suite 1200, San Francisco, CA 94105, USA.
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