1
|
Del Pino M, Vorsters A, Joura EA, Doorbar J, Haniszewski M, Gudina IA, Kodjamanova P, Velicer C, Drury R. Risk factors for human papillomavirus infection and disease: A targeted literature summary. J Med Virol 2024; 96:e29420. [PMID: 38377121 DOI: 10.1002/jmv.29420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/10/2024] [Indexed: 02/22/2024]
Abstract
Adolescents are the primary cohort for routine human papillomavirus (HPV) vaccination, but unvaccinated adults may also benefit. A lack of consensus on which adults to target and the presence of reimbursement barriers likely contribute to the lag in adult vaccinations, highlighting missed prevention opportunities. Understanding factors contributing to risk of HPV infection and disease could help in decision making on vaccination. This review summarizes existing literature on risk factors for HPV infection and disease and includes 153 studies reporting relative risks or odds ratios for factors associated with HPV infection or disease in adults, published between 2009 and 2020. Despite inconsistent design and reporting of risk factors across studies, this review confirmed several risk factors associated with adult infection, including human immunodeficiency virus positivity, number of sex partners, and smoking. These findings can support policymaking, guideline development, and clinical decision making for HPV vaccination and screening of high-risk adult groups.
Collapse
Affiliation(s)
- Marta Del Pino
- Department of Obstetrics and Gynecology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Alex Vorsters
- Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | - Elmar A Joura
- Department of Gynaecology and Obstetrics, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - John Doorbar
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, UK
| | | | | | | | - Christine Velicer
- Global Medical and Scientific Affairs, Merck & Co., Inc., Rahway, New Jersey, USA
| | - Rosybel Drury
- Global Medical and Scientific Affairs, MSD, Lyon, France
| |
Collapse
|
2
|
Maina D, Chung MH, Temmerman M, Moloo Z, Wawire J, Greene SA, Unger ER, Mugo N, Sakr S, Sayed S, McGrath CJ. P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV. Front Med (Lausanne) 2023; 10:1277480. [PMID: 37881629 PMCID: PMC10597651 DOI: 10.3389/fmed.2023.1277480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
Background The expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepithelial lesions grade 2 or higher (CIN2+) following cryotherapy among women with HIV. Methods This is a subgroup analysis of women with HIV in Kenya with baseline cervical biopsy-confirmed CIN2+ who were randomized to receive cryotherapy and followed every six-months for two-years for biopsy-confirmed recurrence of CIN2+. P16 immunohistochemistry was performed on the baseline cervical biopsy with a positive result defined as strong abnormal nuclear expression in a continuous block segment of cells (at least 10-20 cells). Results Among the 200 women with CIN2+ randomized to cryotherapy, 160 (80%) had a baseline cervical biopsy specimen available, of whom 94 (59%) were p16-positive. p16 expression at baseline was associated with presence of any one of 14 hrHPV genotypes [Odds Ratio (OR) = 3.2; 95% Confidence Interval (CI), 1.03-9.78], multiple lifetime sexual partners (OR = 1.6; 95% CI, 1.03-2.54) and detectable plasma HIV viral load (>1,000 copies/mL; OR = 1.43; 95% CI, 1.01-2.03). Longer antiretroviral therapy duration (≥2 years) at baseline had lower odds of p16 expression (OR = 0.46; 95% CI, 0.24-0.87) than <2 years of antiretroviral therapy. Fifty-one women had CIN2+ recurrence over 2-years, of whom 33 (65%) were p16-positive at baseline. p16 was not associated with CIN2+ recurrence (Hazard Ratio = 1.35; 95% CI, 0.76-2.40). Conclusion In this population of women with HIV and CIN2+, 41% of lesions were p16 negative and baseline p16 expression did not predict recurrence of cervical neoplasia during two-year follow up.
Collapse
Affiliation(s)
- Daniel Maina
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Michael H. Chung
- Division of Infectious Diseases, Department of Medicine Emory University, Atlanta, GA, United States
| | - Marleen Temmerman
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Zahir Moloo
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Jonathan Wawire
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Sharon A. Greene
- Department of Global Health, University of Washington, Seattle, WA, United States
| | | | - Nelly Mugo
- Sexual Reproductive and Adolescent Child Health Research Program, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Shahin Sayed
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Christine J. McGrath
- Department of Global Health, University of Washington, Seattle, WA, United States
| |
Collapse
|
3
|
Geremew H, Tesfa H, Mengstie MA, Gashu C, Kassa Y, Negash A, Dessie AM, Geremew D. The association between HIV infection and precancerous cervical lesion. A systematic review and meta-analysis of case-control studies. Health Sci Rep 2023; 6:e1485. [PMID: 37547356 PMCID: PMC10397473 DOI: 10.1002/hsr2.1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023] Open
Abstract
Background The effect of human immunodeficiency virus (HIV) on precancerous cervical lesion is not consistent across studies. Besides to the variability in the presence of a significant association between HIV and precancerous cervical lesion, the reported strengths are inconsistent among studies that report a significant association. Therefore, we sought to determine the impact of HIV on women's risk of precancerous cervical lesion by conducting a systematic review and meta-analysis of case-control studies in Ethiopia. Methods Relevant articles were systematically searched on African Journals Online, Cochrane Library, Science Direct, Google Scholar, and PubMed from January 1, 2023, to February 20, 2023. After critical appraisal, pertinent data were extracted into an Excel spreadsheet and then exported to STATA 14 for further statistical analysis. The pooled effect size was estimated using the random-effect model. The Egger's regression test and I 2 statistics were employed to assess publication bias and heterogeneity among included studies, respectively. Results Ten case-control studies with a total of 3035 participants (992 cases and 2043 controls) were involved in this meta-analysis. According to our analysis, HIV-infected women were 2.86 times more likely to develop precancerous cervical lesion as compared with their counterparts (odds ratio: 2.86, 95% confidence interval: 1.79, 4.58). Conclusion We found that HIV-infected women have a higher risk of precancerous cervical lesion. Thus, targeted screening programs should be considered to reduce the burden of cervical cancer among HIV-infected women in Ethiopia.
Collapse
Affiliation(s)
| | - Hiwot Tesfa
- Department of Public Health, College of Medicine and Health SciencesInjibara UniversityInjibaraEthiopia
| | - Misganaw A. Mengstie
- Department of Biochemistry, College of Medicine and Health SciencesDebre Tabor UniversityDebre TaborEthiopia
| | - Chalachew Gashu
- Department of Statistics, College of Natural and Computational ScienceOda Bultum UniversityChiroEthiopia
| | - Yoseph Kassa
- Department of Statistics, College of Natural and Computational ScienceOda Bultum UniversityChiroEthiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical SciencesHaramaya UniversityHararEthiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, College of Health SciencesDebre Tabor UniversityDebre TaborEthiopia
| | - Demeke Geremew
- Department of Medical Laboratory Science, Immunology and Molecular Biology Unit, College of Medicine and Health SciencesBahir Dar UniversityBahir DarEthiopia
| |
Collapse
|
4
|
Onohuean H, Aigbogun EO, Igere BE. Meta-synthesis and science mapping analysis of HIV/HPV co-infection: a global perspective with emphasis on Africa. Global Health 2022; 18:36. [PMID: 35331267 PMCID: PMC8943940 DOI: 10.1186/s12992-022-00812-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background Viral infections are emerging with diverse clinical relevance both in endemic environments and non-endemic regions of the world. Some of the viruses cause co-infections that are of public health importance. The progress of studies on human immunodeficiency virus / Human papillomavirus (HIV/HPV) co-infection is not well documented especially in Africa where cases are endemic. Method Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a global three-decade meta-synthesis and science mapping analysis on HIV/HPV co-infections. Assessment of progress, Author/Country productivity/trends, topic conceptual framework, and international collaborative networks were analyzed. Results We recovered 196 documents of 115 sources from the web of science database. The meta-synthesis revealed 1203 prolific authors containing nine solo authors, an annual growth rate of 8.09%, a significant average citation per article of 20.7%, and an average citation per year per document of 2.1. A significant high correlation between the mean/TC per article and the mean total citation (TC) per year showed 80.98% of the articles produced between 2005 and 2007 on HPV/HIV co-infection. The co-author per document index were 7.0 and the collaboration index was 6.4. The meta-analysis also revealed inadequate funding from individual or governmental organizations; among the 196 documents dataset, 114 (58.2%) were funded, and only 31 (15.8%) were funded in Africa where HIV/HPV co-infection cases are endemic. Conclusions Authors’ collaboration network, countries’ collaboration, authors’ citations and implementation of research-based finding in previous studies are yet to receive the relevant outcome, especially as various countries in the African continent have received poor funding with a repeated reporting of co-infection associated with HIV/HPV. African needs to re-awaken and stir up research-based interest in HPV/HIV co-infection studies to resolve indigenous public health concerns associated with the viral endemicity.
Collapse
Affiliation(s)
- Hope Onohuean
- Biopharmaceutics Unit, Pharmacology and Toxicology, School of Pharmacy, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda. .,Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.
| | - Eric O Aigbogun
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Department of Human Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda
| | - Bright E Igere
- Department of Microbiology and Biotechnology, Western Delta University Oghara, Oghara, Delta State, Nigeria
| |
Collapse
|
5
|
Gupta R, Kaur A, Sandeep, Singh S, Gupta S. Anal cytological abnormalities and human papillomavirus infection in women living with HIV: A systematic review and meta-analysis. HIV Med 2022; 23:378-389. [PMID: 35150185 DOI: 10.1111/hiv.13227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/11/2021] [Accepted: 12/15/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To provide a summary estimate of the prevalence of anal cytological abnormalities and human papillomavirus (HPV) infection as well as their covariates in women living with HIV (WLHIV). METHODS Four databases - PubMed, Cochrane Library, ProQuest and Web of Science - were searched up to 31 May 2021 for studies reporting on the prevalence and/or covariates of abnormal anal cytology and/or anal HPV infection in WLHIV. The data were extracted independently by two authors using standardized extraction forms. Random effect models were used to estimate the summary effect sizes. RESULTS A total of 29 studies were included in the analysis. The overall prevalence of anal cytological abnormalities in WLHIV was 28.5% [95% confidence interval (CI): 22.8-35.5]. High-grade cytological lesions were seen in 12.1% (95% CI: 8.5-17.2) of the abnormal smears. HPV infection (any type) in the anal samples was detected in 60.7% (95% CI: 54.1-68.0) of the samples while high-risk HPV was found in 44.0% (95% CI: 37.6-51.5). A positive association was seen between anal cytological abnormality and factors such as receptive anal intercourse [meta-risk ratio (meta-RR) = 1.6, 95% CI: 1.3-1.8], having multiple sexual partners (1.6, 95% CI: 1.0-2.5), CD4 count < 200 cells/µL (4.6, 95% CI: 3.0-6.9), anal HPV (4.6, 95% CI: 2.4-8.8), abnormal cervical cytology (2.3, 95% CI: 2.0-2.8), and cervical HPV (meta-RR 4.6, 95% CI: 2.2-9.8). Anal HPV infection was significantly associated with cervical HPV positivity (2.5, 95% CI: 1.2-5.3). CONCLUSIONS Our results highlight the high prevalence of abnormal anal cytology and HPV infection in WLHIV. The positive association of anal cytological abnormality with parameters such as abnormal cervical cytology, cervical HPV infection and low CD4 count suggests that anal sex history and examination may be considered in WLHIV undergoing screening for sexually transmitted infection and possessing any of these risk factors.
Collapse
Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Avineet Kaur
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Sandeep
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Sompal Singh
- Department of Pathology, Hindu Rao Hospital, Delhi, India
| | - Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| |
Collapse
|
6
|
The Preventive Effect of Dietary Antioxidants Against Cervical Cancer Versus the Promotive Effect of Tobacco Smoking. Healthcare (Basel) 2019; 7:healthcare7040162. [PMID: 31847279 PMCID: PMC6955726 DOI: 10.3390/healthcare7040162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 01/11/2023] Open
Abstract
Uterine cervical cancer is the fourth most common cancer in women, and its etiology has been recognized. High-risk human papilloma virus (HR-HPV) infection induces an opportunity for malignant transformation. This paper discusses the current issues based on a review of the literature and compares the impact of the dietary and nutrient intake to the impact of tobacco smoking on cervical cancer development. The important roles of diet/nutrition in cervical cancer are as prophylaxis against HR-HPV infection. Antioxidant vitamins can inhibit the proliferation of cancer cells, stabilize the p53 protein, prevent DNA damage, and reduce immunosuppression. In contrast, tobacco smoking not only causes DNA adducts and strand breaks, but it independently causes an increased viral load in HR-HPV-infected cells. Tobacco smoking induces the heightened expression of E6 and E7 and can inhibit the immune system response to HPV. What happens when two materials, which have opposite effects on cervical cells, are taken in at the same time? The negative effects of tobacco smoking may be stronger than the positive effects of vitamins, vegetables, and fruits on the regression of cervical disease such as cervical intraepithelial neoplasia (CIN). A relatively low intake of vitamins, vegetables, and fruits in combination with tobacco smoking was most associated with a high incidence of cervical neoplasia.
Collapse
|
7
|
Rodrigues LL, Pilotto JH, Lima LR, Gaydos CA, Hardick J, Morgado MG, Martinelli KG, de Paula VS, Nicol AF. Self-collected versus clinician-collected samples for HSV-2 and HSV-2/HPV screening in HIV-infected and -uninfected women in the Tapajós region, Amazon, Brazil. Int J STD AIDS 2019; 30:1055-1062. [PMID: 31451076 DOI: 10.1177/0956462419842007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the prevalence of herpes simplex virus 2 (HSV-2) and HSV-2/human papillomavirus (HPV) co-infection by self-collected samples compared to clinician-collected samples in human immunodeficiency virus 1 (HIV-1)-infected and -uninfected women from the Tapajós region, Amazon, Brazil. A cross-sectional study was conducted with 439 anal and cervical scrapings and cervico-vaginal self-collected samples obtained from 153 eligible HIV-infected and -uninfected women. Real-time PCR for HSV-2 and nested PCR for HPV detection were performed. A multivariate analysis identified risk factors for HSV-2/HPV co-infection. The anogenital prevalence of HSV-2 was 9.2% (14/153), HPV was 67.3% (103/153) and HSV-2/HPV co-infection was 6.5% (10/153). There was a significant overall agreement (95.5%, 11/133, kappa 0.64, 95% CI 0.38–0.90, p < 0.0001) for HSV-2 detection by the self-collected and clinician-collected samples. HSV-2 genital infection was more prevalent than anal infection in all participants. HIV-infected women had a higher prevalence of HSV-2 and HSV-2/HPV. No woman with a cervical squamous intraepithelial lesion had HSV-2/HPV co-infection. Risk factors for HSV-2/HPV were age ≤25 years (aOR = 10.07) and being single (aOR = 3.79). In general, young and single women are at greater risk for HSV-2/HPV infection. Self-collection can be a useful strategy for the screening of HSV-2 and HPV in limited-resource settings.
Collapse
Affiliation(s)
- Luana Ls Rodrigues
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Instituto de Saúde Coletiva, Universidade Federal do Oeste do Pará, Santarém, Brazil
| | - José H Pilotto
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Lyana Rp Lima
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Justin Hardick
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mariza G Morgado
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Katrini G Martinelli
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Vanessa S de Paula
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Alcina F Nicol
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| |
Collapse
|
8
|
Yakub MM, Fowotade A, Anaedobe CG, Manga MM, Bakare RA, Abimiku BA. Human papillomavirus correlates of high grade cervical dysplasia among HIV-Infected women at a major treatment centre in Nigeria: a cross-sectional study. Pan Afr Med J 2019; 33:125. [PMID: 31558924 PMCID: PMC6754827 DOI: 10.11604/pamj.2019.33.125.17589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 01/28/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction Persistent high-risk HPV (hrHPV) infection is higher among women living with HIV/AIDS thus increasing their risk for cervical cancer. We evaluated the virological and immunological correlates of cervical dysplasia in HIV-infected women. Methods A cohort of 220 consenting women attending the antiretroviral clinic of the Federal Medical Centre, Keffi, Nigeria was tested for cervical human papilloma virus (HPV) infection using PCR. The prevalent HPV genotypes were determined by DNA sequencing. CD4+T count and type specific HPV was correlated with cervical cytology. Descriptive and inferential statistical analysis of the data was done using the statistical package for social sciences (SPSS) version 20 (SPSS Inc, Illinois, USA) for analysis after validation. Results Overall HPV prevalence was 54.1% while the hrHPV prevalence was 35.9%. Premalignant and malignant lesions were observed among participants with CD4+T counts between 200-300/mm3. A statistically significant association was observed between cervical premalignant lesions and CD4+ count (X2=24.747, P value=0.001) as well as hrHPV infections (X2=46.800, P<0.001). Conclusion Risk stratification with HPV screening among HIV-infected women will help in early case management of cervical precancerous lesions.
Collapse
Affiliation(s)
- Martin Maimako Yakub
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology, Federal Medical Centre, Nassarawa, Keffi, Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chinenye Gloria Anaedobe
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology, Gwagwalada Teaching Hospital, Abuja, Nigeria
| | - Mohammed Mohammed Manga
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology and Immunology, Federal Teaching Hospital Gombe, Gombe State, Nigeria
| | - Rasheed Ajani Bakare
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.,Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bawa Ahmed Abimiku
- Department of Histopathology and Forensic Medicine, Gwagwalada Teaching Hospital, Abuja, Nigeria
| |
Collapse
|
9
|
HIV-positive women have higher risk of human papilloma virus infection, precancerous lesions, and cervical cancer. AIDS 2018; 32:795-808. [PMID: 29369827 DOI: 10.1097/qad.0000000000001765] [Citation(s) in RCA: 217] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE HIV-positive women have higher human papillomavirus (HPV) prevalence and cervical cancer incidence than HIV-negative women, partly because of HIV's modifying effect on HPV pathogenesis. We synthesized the literature on the impact of HIV on HPV natural history. DESIGN Systematic review and meta-analysis. METHODS We searched the literature for studies evaluating HPV acquisition and persistence or precancer progression by HIV status. Data on HPV natural history by HIV status, CD4 cell counts, viral load, and antiretroviral therapy (ART) were summarized using fixed effect models. RESULTS Overall, 38 of 1845 abstracts identified met inclusion criteria. HIV-positive women had higher HPV acquisition [relative risk (RRpooled) 2.64, 95% confidence interval (CI) 2.04-3.42] and lower HPV clearance (hazard ratiopooled 0.72, 95% CI 0.62-0.84) than HIV-negative women. HPV acquisition was higher with declining CD4 cell count and was lower in those virally suppressed on ART. HIV was associated with higher incidence of low-grade squamous intraepithelial lesions (LSIL; RRpooled 3.73, 95% CI 2.62-5.32) and high-grade squamous intraepithelial lesions (HSIL; hazard ratiopooled 1.32, 95% CI 1.10-1.58), largely because of increased HPV persistence. ART lowered progression from normal cytology to LSIL (hazard ratiopooled 0.65, 95% CI 0.52-0.82), but not HSIL. Cervical cancer incidence was associated with HIV positivity (RR 4.1, 95% CI 2.3-6.6), but not with ART. CONCLUSION HIV-positive women have higher risk of acquiring HPV, with risk inversely associated with CD4 cell count. ART lowered HPV acquisition, increased clearance, and reduced precancer progression, likely via immune reconstitution. Although some of our results are limited by small number of studies, our study can inform screening guidelines and mathematical modeling for cervical cancer prevention.
Collapse
|
10
|
Braundmeier AG, Lenz KM, Inman KS, Chia N, Jeraldo P, Walther-António MRS, Berg Miller ME, Yang F, Creedon DJ, Nelson H, White BA. Individualized medicine and the microbiome in reproductive tract. Front Physiol 2015; 6:97. [PMID: 25883569 PMCID: PMC4381647 DOI: 10.3389/fphys.2015.00097] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/12/2015] [Indexed: 01/02/2023] Open
Abstract
Humans have evolved along with the millions of microorganisms that populate their bodies. These microbes (10(14)) outnumber human cells by 10 to 1 and account for 3 × 10(6) genes, more than ten times the 25,000 human genes. This microbial metagenome acts as our "other genome" and like our own genes, is unique to the individual. Recent international efforts such as the Human Microbiome Project (HMP) and the MetaHIT Project have helped catalog these microbial genomes using culture-independent, high-throughput, next-generation sequencing. This manuscript will describe recent efforts to define microbial diversity in the female reproductive tract because of the impact that microbial function has on reproductive efficiency. In this review, we will discuss current evidence that microbial communities are critical for maintaining reproductive health and how perturbations of microbial community structures can impact reproductive health from the aspect of infection, reproductive cyclicity, pregnancy, and disease states. Investigations of the human microbiome are propelling interventional strategies from treating medical populations to treating individual patients. In particular, we highlight how understanding and defining microbial community structures in different disease and physiological states have lead to the discovery of biomarkers and, more importantly, the development and implementation of microbial intervention strategies (probiotics) into modern day medicine. Finally this review will conclude with a literature summary of the effectiveness of microbial intervention strategies that have been implemented in animal and human models of disease and the potential for integrating these microbial intervention strategies into standard clinical practice.
Collapse
Affiliation(s)
- Andrea G Braundmeier
- Department of Medical Microbiology, Immunology and Cell Biology, Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine Springfield, IL, USA
| | - Katherine M Lenz
- Department of Medical Microbiology, Immunology and Cell Biology, Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine Springfield, IL, USA
| | - Kristin S Inman
- Department of Cancer Biology, Mayo Clinic College of Medicine Jacksonville, FL, USA
| | - Nicholas Chia
- The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Division of Nutritional Sciences, University of Illinois Urbana, IL, USA ; Biomedical Engineering and Physiology, Mayo College Rochester, MN, USA
| | - Patricio Jeraldo
- The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana, IL, USA ; Department of Surgery, Mayo Clinic Rochester, MN, USA
| | - Marina R S Walther-António
- The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Department of Surgery, Mayo Clinic Rochester, MN, USA
| | | | - Fang Yang
- Division of Nutritional Sciences, University of Illinois Urbana, IL, USA ; Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana, IL, USA
| | - Douglas J Creedon
- Department of Obstetrics and Gynecology, Mayo Clinic Rochester, MN, USA
| | - Heidi Nelson
- The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Department of Surgery, Mayo Clinic Rochester, MN, USA
| | - Bryan A White
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana, IL, USA
| |
Collapse
|
11
|
Mucosal immunity in the female genital tract, HIV/AIDS. BIOMED RESEARCH INTERNATIONAL 2014; 2014:350195. [PMID: 25313360 PMCID: PMC4181941 DOI: 10.1155/2014/350195] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/27/2014] [Accepted: 08/28/2014] [Indexed: 01/15/2023]
Abstract
Mucosal immunity consists of innate and adaptive immune responses which can be influenced by systemic immunity. Despite having been the subject of intensive studies, it is not fully elucidated what exactly occurs after HIV contact with the female genital tract mucosa. The sexual route is the main route of HIV transmission, with an increased risk of infection in women compared to men. Several characteristics of the female genital tract make it suitable for inoculation, establishment of infection, and systemic spread of the virus, which causes local changes that may favor the development of infections by other pathogens, often called sexually transmitted diseases (STDs). The relationship of these STDs with HIV infection has been widely studied. Here we review the characteristics of mucosal immunity of the female genital tract, its alterations due to HIV/AIDS, and the characteristics of coinfections between HIV/AIDS and the most prevalent STDs.
Collapse
|
12
|
Denslow SA, Rositch AF, Firnhaber C, Ting J, Smith JS. Incidence and progression of cervical lesions in women with HIV: a systematic global review. Int J STD AIDS 2013; 25:163-77. [PMID: 24216030 DOI: 10.1177/0956462413491735] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Global data on cervical lesion incidence and progression in HIV-positive women are essential for understanding the natural history of cervical neoplasia and informing screening policy. A systematic review was performed summarizing the incidence and progression of cervical lesions in HIV-positive women. Of 5882 HIV-positive women from 15 studies, incidence ranged from 4.9 to 21.1 cases per 100 woman-years for any cervical lesion and 0.4 to 8.8 cases per 100 woman-years for high-grade cervical lesions. HIV-positive women showed a median three-fold higher incidence of cervical lesions compared to HIV-negative women. Of 1099 HIV-positive women from 11 studies, progression from low- to high-grade lesions ranged from 1.2 to 26.2 cases per 100 woman-years. Both incidence and progression rates increased with lower CD4 counts. The effect of antiretroviral therapy on the natural history of cervical neoplasia remains unclear. HIV-positive women have higher incidence and progression of cervical neoplasia. Cervical cancer screening should be integrated into HIV treatment programmes.
Collapse
Affiliation(s)
- Sheri A Denslow
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | | | | | | | | |
Collapse
|
13
|
Ali KS, Ali HYM, Jubrael JMS. Concentration levels of IL-10 and TNFα cytokines in patients with human papilloma virus (HPV) DNA⁺ and DNA⁻ cervical lesions. J Immunotoxicol 2012; 9:168-72. [PMID: 22471745 DOI: 10.3109/1547691x.2011.642419] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The present study was performed to assess the immune response in women with human papilloma virus (HPV) DNA⁺ and DNA⁻ cervical lesions. Eighty women with cervical lesions (age range = 25-70 years) and 20 healthy individuals (control group) were enrolled in the study. Lesions were cytologically classified into four groups: ASC-US (20), CINI (30), CINII-III (16), and cervical carcinoma (14) prior to HPV DNA detection. Estimation of interleukin (IL)-10 and tumor necrosis factor (TNF)-α levels in cervical secretions and serum of the studied patients was performed utilizing ELISA. PCR screening kits were used to detect HPV DNA in cervical smears obtained from the studied cases with the different lesions. IL-10 levels in cervical secretions of HPV DNA⁺ were significantly greater than those from DNA⁻ patients (i.e., 88.73 vs 24.00 pg/ml) and from controls (i.e., 88.73 vs 8.27 pg/ml) and the levels were higher in DNA⁻ patients than in controls (i.e., 24.00 vs 8.27 pg/ml). In comparison, serum IL-10 levels in these patients did not significantly differ from control values (i.e., 13.69 vs 12.16 vs 9.99 pg/ml, respectively). TNFα levels in cervical secretions of the HPV DNA⁺ and DNA⁻ cases did not significantly differ from values for the controls (i.e., 12.18 vs 9.90 vs 7.90 pg/ml, respectively). Serum TNFα of these patients also did not differ significantly from controls (i.e., 11.59 vs 11.90 vs 10.83 pg/ml, respectively). The detected levels of IL-10 in cervical secretions of patients with HPV DNA⁺ lesions was significantly higher than in their sera, while secretion TNFα levels were nominally greater than sera values. Lastly, higher levels of IL-10 were observed in secretions of 10-14 (71.4%) patients who had progressive cervical lesions (HSIL and cervical cancer stages) who were HPV DNA⁺ than observed in 20 of 66 (30.0%) of DNA⁻ patients with similar progressive lesions. In general, the higher levels of IL-10 than of TNFα suggested a potential down-modulation of tumor-specific immune responses to HPV-infected lesions. This phenomenon appears to provide a tumor 'progressive' microenvironment in these particular patients.
Collapse
|
14
|
de Freitas LB, de Mattos AT, Lima BMC, Miranda AE, Spano LC. Adeno-associated virus may play a protective role against human papillomavirus-induced cervical lesions independent of HIV serostatus. Int J STD AIDS 2012; 23:258-61. [DOI: 10.1258/ijsa.2009.009150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated the prevalence of adeno-associated virus (AAV) and human papillomavirus (HPV) DNA in cervical samples of HIV-seropositive and -seronegative women attending a clinic in south-eastern Brazil. Both viruses were investigated by polymerase chain reaction (PCR) and cytological exams were performed. AAV was typed by PCR and restriction fragment length polymorphism analysis. AAV prevalence was 19.7% (56/284), with 18.7% (21/112) and 20.3% (35/172) in HIV-positive and -negative women, respectively. AAV type 2 was the single virus type detected. AAV was detected with higher frequency in HPV-infected women ( P < 0.05) as was HPV in HIV-positive women ( P < 0.05). The AAV–HPV co-infected women showed a lower rate of atypical squamous cells of undetermined significance or cervical intraepithelial neoplasia development compared with those infected only with HPV. The prevalence of AAV2 confirms this type as the most common in human samples. This is the first report examining AAV in cervical samples of HIV-infected women and indicates that HIV infection does not appear to influence AAV prevalence or AAV–HPV co-infection.
Collapse
Affiliation(s)
| | | | | | | | - L C Spano
- Núcleo de Doenças Infecciosas
- Department of Pathology, Health Science Center, Federal University of Espírito Santo, Vitória-ES, Brazil
| |
Collapse
|
15
|
Denslow SA, Westreich DJ, Firnhaber C, Michelow P, Williams S, Smith JS. Bacterial vaginosis as a risk factor for high-grade cervical lesions and cancer in HIV-seropositive women. Int J Gynaecol Obstet 2011; 114:273-7. [PMID: 21683359 DOI: 10.1016/j.ijgo.2011.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/24/2011] [Accepted: 05/17/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the effect of bacterial vaginosis (BV) on the risk of high-grade squamous intraepithelial lesions (HSIL) among HIV-seropositive women. METHODS A hospital-based prospective cohort study of HIV-seropositive women was conducted in Johannesburg, South Africa from January 2005 to September 2009. Multivariate log-binomial and Poisson regressions were used to estimate prevalence and rate ratios, respectively. RESULTS Among 1954 HIV-seropositive women, the baseline prevalence of HSIL was 17%. BV prevalence was high (54%) and showed no association with prevalence of HSIL (adjusted prevalence ratio, 1.12; 95% confidence intervals (CI), 0.92-1.35) nor with cervical lesion progression at follow-up visit (n=503) (adjusted rate ratio: 1.00; 95% CI, 0.65-1.53). CONCLUSION Among HIV-seropositive women, BV was not associated with an increased risk of HSIL or cervical lesion progression.
Collapse
Affiliation(s)
- Sheri A Denslow
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | | | | | | | | | | |
Collapse
|
16
|
Amaro Filho SM, Nicol AF. The utility of in situ detection, including RT in situ PCR, of viral nucleic acid and the co-localization of the cytokine response to the study of viral pathogenesis. Methods 2010; 52:332-42. [DOI: 10.1016/j.ymeth.2010.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 07/27/2010] [Accepted: 07/29/2010] [Indexed: 10/19/2022] Open
|
17
|
Brandão VDCRAB, Lacerda HR, Lucena-Silva N, Ximenes RADA. Frequency and types of human papillomavirus among pregnant and non-pregnant women with human immunodeficiency virus infection in Recife determined by genotyping. Mem Inst Oswaldo Cruz 2010; 104:755-63. [PMID: 19820838 DOI: 10.1590/s0074-02762009000500016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Accepted: 06/26/2009] [Indexed: 11/22/2022] Open
Abstract
Women with human immunodeficiency virus (HIV) infection present a higher risk of infection by the human papillomavirus (HPV) and cervical cancer. To determine HPV genotypes and frequencies among HIV-positive women, an analytical cross-sectional study was carried out on 147 women (51 were pregnant and HIV-positive, 45 pregnant and HIV-negative and 51 HIV-positive and not pregnant), who were attended at a maternity hospital in Recife between April 2006-May 2007. They answered a questionnaire and underwent a gynaecological examination, with samples collected for HPV investigation by PCR, hybrid capture II, oncotic colpocytology (Papanicolau) and colposcopy. The frequency of HPV DNA was 85.3% (122/143), with a high proportion of HPV types that have been identified as high risk for cervical cancer. Among HIV-positive pregnant women, there was an HPV prevalence of 96% (48/50), of whom 60.4% (29/48) were high-risk. HPV 16, 58, 18, 66 and 31 were the most frequent types. Colpocytological abnormalities were observed in 35.3% (18/51) of HIV-positive non-pregnant women, 21.6% (11/51) of HIV-positive pregnant women and 13.3% (6/45) of HIV-negative pregnant women with a predominance of low-level lesions. A high prevalence of HPV infection was identified, especially with the high-risk types 16, 58, 18 and 66. This study identified high-risk HPV types in all three groups examined (HIV-positive pregnant women, HIV-negative pregnant women and HIV-positive not pregnant), characterising its distribution in this setting.
Collapse
|
18
|
Mogtomo MLK, Malieugoue LCG, Djiepgang C, Wankam M, Moune A, Ngane AN. Incidence of cervical disease associated to HPV in human immunodeficiency infected women under highly active antiretroviral therapy. Infect Agent Cancer 2009; 4:9. [PMID: 19493339 PMCID: PMC2701409 DOI: 10.1186/1750-9378-4-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 06/03/2009] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Women infected with human immunodeficiency virus (HIV) may be at higher risk of developing cervical cancer than non infected women. In a pilot study, we assessed the relationships among cervical cytology abnormalities associated to Human Papillomavirus (HPV), HIV infection and Highly Active Antiretroviral Therapy (HAART) on the development of Squamous Intraepithelial lesions (SILs). Out of the 70 HIV infected women from Douala -Cameroon (Central Africa) that we included in the study, half (35) were under HAART. After obtaining information related to their lifestyle and sexual behaviour, cervicovaginal samples for Pap smears and venous blood for CD4 count were collected and further divided into two groups based upon the presence or absence of cervical cytology abnormalities i.e. those with normal cervical cytology and those with low and high Squamous Intraepithelial lesions (LSIL, HSIL). RESULTS Assessment was done according to current antiretroviral regimens available nationwide and CD4 count. It was revealed that 44.3% of HIV-infected women had normal cytology. The overall prevalence of LSIL and HSIL associated to HPV in the studied groups was 24.3% (17/70) and 31.4% (22/70) respectively. Among the 22 HSIL-positive women, 63.6% (14/22) were not on antiretroviral therapy, while 36.4% (8/22) were under HAART. HIV infected women under HAART with positive HSIL, showed a median CD4+ T cell count of 253.7 +/- 31.7 higher than those without therapy (164.7 +/- 26.1). The incidence of HSIL related to HPV infection within the study group independently of HAART initiation was high. CONCLUSION These results suggest the need for extension and expansion of the current study in order to evaluate the incidence of HPV infection and cervical cancer among HIV-infected and non HIV- infected women in Cameroon.
Collapse
Affiliation(s)
| | | | - Carolle Djiepgang
- Laboratory of Viral Oncology, Department of Biochemistry, Faculty of Sciences, University of Douala, Cameroon
| | - Michel Wankam
- Aids Care Unit and Gynaecology, Bonassama Hospital Douala, Cameroon
| | - Andre Moune
- Pathology Unit, Douala General Hospital, Cameroon
| | - Annie Ngono Ngane
- Laboratory of Viral Oncology, Department of Biochemistry, Faculty of Sciences, University of Douala, Cameroon
| |
Collapse
|
19
|
Epidemiological data of different human papillomavirus genotypes in cervical specimens of HIV-1-infected women without history of cervical pathology. J Acquir Immune Defic Syndr 2009; 50:168-75. [PMID: 19131892 DOI: 10.1097/qai.0b013e3181938e63] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
AIM To study the epidemiology of different human papillomavirus (HPV) genotypes in cervical samples of HIV-1-infected women with normal Papanicolau smears. DESIGN : Retrospective analysis of a prospective cohort. PATIENTS AND METHODS We selected HIV-1-infected women with 2 consecutive normal Papanicolau smears at baseline and at least 1 baseline and 1 follow-up cervical sample. HPV infection was assessed by second-generation hybrid capture (HC-2) and multiplex polymerase chain reaction (mPCR). HPV genotypes were determined by mPCR. RESULTS From a cohort of 139 women followed up to 4 years, 93 women meeting the inclusion criteria were analyzed. The mean period between samples was 20 months (range, 6-44 months). HPV baseline prevalence was 63% [59/93; 95% confidence interval (CI), 53% to 73%] using polymerase chain reaction and 41% (38/93; 95% CI, 31% to 51%) using HC-2, P = 0.007 (kappa, 0.45; P = 0.001). The most prevalent high oncogenic risk genotypes (HR-HPV) were HPV-16 (28%), HPV-33 (18%), HPV-52 (12%), HPV-58 (11%), and HPV-39 (11%). Infection with multiple HPV genotypes was detected in >40% of women. HPV infection persisted at follow-up in 86% (51/59; 95% CI, 77% to 95%) by polymerase chain reaction and 76% (29/38; 95% CI, 62% to 90%) by HC-2. HPV infection persisted in 55% of women with samples available beyond 3 years. The actuarial probabilities of clearance and incidence of HPV infection at 36 months were 16% and 45%, respectively. CONCLUSIONS HPV infection is highly prevalent and persistent among HIV-1-infected women with normal Papanicolau smears. HR-HPV genotypes other than HPV-16 (HPV-33, HPV-52) are frequently detected in HIV-infected women. mPCR provides better surveillance of HPV infection than HC-2 methods.
Collapse
|
20
|
Guha D, Chatterjee R. Cytokine levels in HIV infected and uninfected Indian women: Correlation with other STAs. Exp Mol Pathol 2009; 86:65-8. [DOI: 10.1016/j.yexmp.2008.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Revised: 10/15/2008] [Accepted: 10/16/2008] [Indexed: 11/16/2022]
|
21
|
Hacker MA, Kaida A, Hogg RS, Bastos FI. The first ten years: achievements and challenges of the Brazilian program of universal access to HIV/AIDS comprehensive management and care, 1996-2006. CAD SAUDE PUBLICA 2008; 23 Suppl 3:S345-59. [PMID: 17992341 DOI: 10.1590/s0102-311x2007001500003] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2006] [Accepted: 04/16/2007] [Indexed: 12/18/2022] Open
Abstract
A review was carried out of papers published between 1996 and 2006, documenting the introduction of highly active anti-retroviral therapy (HAART) in Brazil. Papers indexed in the MEDLINE and SciELO databases were retrieved using different combinations of keywords related to the management and care of AIDS in the post-HAART era: opportunistic diseases and co-infections, adherence to therapy, survival in the pre- and post-HAART eras, adverse events and side-effects, emergence and possible transmission of resistant viral strains, metabolic and cardiovascular disorders, and issues related to access to care and equity. The review documents the dramatic changes in HIV/AIDS disease progression in the post-HAART era, including an increase in survival and quality of life and a pronounced decrease in the episodes of opportunistic diseases. Notwithstanding such major achievements, new challenges have emerged, including slow evolving co-infections (such as hepatitis C, metabolic and cardiovascular disorders), the emergence of viral resistance, with consequences at the individual level (virological failure) and the community level (primary/secondary resistance at the population level), and impacts on the cost of new therapeutic regimens.
Collapse
Affiliation(s)
| | - Angela Kaida
- University of British Columbia, Canada; BC Centre for Excellence in HIV/AIDS, Canada
| | - Robert S. Hogg
- BC Centre for Excellence in HIV/AIDS, Canada; Simon Fraser University, Canada
| | | |
Collapse
|
22
|
Shackelford J, Pagano JS. Role of the ubiquitin system and tumor viruses in AIDS-related cancer. BMC BIOCHEMISTRY 2007; 8 Suppl 1:S8. [PMID: 18047745 PMCID: PMC2106372 DOI: 10.1186/1471-2091-8-s1-s8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Tumor viruses are linked to approximately 20% of human malignancies worldwide. This review focuses on examples of human oncogenic viruses that manipulate the ubiquitin system in a subset of viral malignancies; those associated with AIDS. The viruses include Kaposi's sarcoma herpesvirus, Epstein-Barr virus and human papilloma virus, which are causally linked to Kaposi's sarcoma, certain B-cell lymphomas and cervical cancer, respectively. We discuss the molecular mechanisms by which these viruses subvert the ubiquitin system and potential viral targets for anti-cancer therapy from the perspective of this system. Publication history: Republished from Current BioData's Targeted Proteins database (TPdb; ).
Collapse
Affiliation(s)
- Julia Shackelford
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7295, USA.
| | | |
Collapse
|
23
|
Tavares-Murta BM, de Resende AD, Cunha FQ, Murta EFC. Local profile of cytokines and nitric oxide in patients with bacterial vaginosis and cervical intraepithelial neoplasia. Eur J Obstet Gynecol Reprod Biol 2007; 138:93-9. [PMID: 17683845 DOI: 10.1016/j.ejogrb.2007.06.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2005] [Revised: 03/26/2007] [Accepted: 06/19/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the local immune response in patients with bacterial vaginosis (BV) and cervical intraepithelial neoplasia (CIN), as assessed by cytokine and nitric oxide (NO) concentrations. STUDY DESIGN Patients attending for routine gynaecological examination were prospectively enrolled in groups: BV (n=25) diagnosed by clinical criteria, CIN graded I to III (n=35, 6 CIN I, 8 CIN II and 21 CIN III) by histological analysis, and controls (n=15) without clinical and cytological findings. Randomly selected patients within CIN group at grades II or III (n=15) were re-evaluated at 60 days after surgical treatment. Endocervical (EC) and vaginal secretion samples were collected by cytobrush and the levels of cytokines (ELISA) and NO metabolite (Griess reaction) were assayed. RESULTS NO was assessed in all subjects, and cytokines in all controls, 15 BV and 30 CIN patients. Interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and nitrite levels were higher in EC than in vaginal secretions in BV and CIN groups. In CIN group, IL-8, IL-10 and nitrite concentrations were greater in EC and/or vaginal secretions than in BV or controls. Surgical treatment reduced IL-8 levels in EC and vaginal secretions. CONCLUSION A similar local immune profile was found in BV and CIN groups. The increased local production of IL-8, IL-10 and NO in CIN suggests a role for these mediators in the immune response against tumour or tumour development.
Collapse
Affiliation(s)
- Beatriz M Tavares-Murta
- Department of Biological Sciences, Discipline of Pharmacology, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil.
| | | | | | | |
Collapse
|
24
|
Abstract
There is overwhelming evidence that the human immune system can keep in check the growth of autologous tumors. Yet, this phenomenon is rare and most often tumors survive striking a balance with the host's immune system. The well-documented coexistence of immune cells that can recognize cancer and their targets within the same host is reminiscent of chronic allograft rejection well-controlled by immune suppression or of a lingering tissue-specific autoimmune reaction. In this review, we argue that autologous tumor rejection represents a distinct form of tissue-specific rejection similar to acute allograft rejection or to flares of autoimmunity. Here we discuss similarities within the biology of these phenomena that may converge into a common immunological constant of rejection. The purpose is to simplify the basis of immune rejection to its bare bones critically dissecting the significance of those components proposed by experimental models as harbingers of this final outcome.
Collapse
Affiliation(s)
- Ena Wang
- Immunogenetics Section, The Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | | | | |
Collapse
|