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de Morais ACCD, Ferreira ADS, Barbosa CDT, Lima MFB, Fook KD, de Carvalho MM, Muniz ACDS, de Araújo DR, Monteiro PDM, Araújo MJAM, Monteiro SCM, Lopes FF. Human papillomavirus in women infected with human immunodeficiency virus: association with viral load and lymphocyte count. Rev Inst Med Trop Sao Paulo 2024; 66:e36. [PMID: 38865574 PMCID: PMC11164047 DOI: 10.1590/s1678-9946202466036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/15/2024] [Indexed: 06/14/2024] Open
Abstract
Women living with human immunodeficiency virus are at an increased risk of developing cancers related to human papillomavirus (HPV). Thus, it is important to combine clinical assessments, serological screening, and HPV data for planning prevention policies. This study aimed to identify HPV and its specific types in the cervical, anal, and oral mucosa of HIV-seropositive women, associating it with viral load and lymphocyte count. Sociodemographic characteristics, health data (CD4+ and CD8+ T cell counts and viral load), and biological samples (cervical, anal, and oral) were collected from 86 HIV-positive women undergoing antiretroviral therapy. Data were classified according to the presence or absence of HPV-DNA, HPV-DNA presence at one or more anatomic sites, and level of oncogenic risk, considering low- and high-risk oncogenic HPV-DNA groups. The presence of HPV in the cervicovaginal site was 65.9%, 63.8% in anal canal, and 4.2% in oral mucosa. A viral load ≥75 HIV copies/mL was associated with the presence of HPV-DNA. There was an association between viral load and the low-risk HPV or high-risk HPV groups. We found a high prevalence of HPV infection in HIV-seropositive women, particularly in the cervical and anal mucosa, with viral load ≥75 HIV copies/mL being associated with HPV-DNA presence.
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Affiliation(s)
- Ana Cléa Cutrim Diniz de Morais
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | - Alice de Sá Ferreira
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
| | - Carla Déa Trindade Barbosa
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | - Maria Fernanda Bezerra Lima
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | - Karina Donato Fook
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | - Mônika Machado de Carvalho
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | - Alessandra Costa de Sales Muniz
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | - Deborah Rocha de Araújo
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | - Pablo de Matos Monteiro
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
| | - Maria José Abigail Mendes Araújo
- Universidade Federal do Maranhão, Hospital Universitário, Laboratório de Análises Clinicas e Histocompatibilidade, São Luís, Maranhão, Brazil
| | | | - Fernanda Ferreira Lopes
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde do Adulto, São Luís, Maranhão, Brazil
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Murahwa AT, Mudzviti T, Mandishora RSD, Chatindo T, Chanetsa P, Pascoe M, Shamu T, Basera W, Luethy R, Williamson AL. Vaccine and Non-Vaccine HPV Types Presence in Adolescents with Vertically Acquired HIV Five Years Post Gardasil Quadrivalent Vaccination: The ZIMGARD Cohort. Viruses 2024; 16:162. [PMID: 38275972 PMCID: PMC10818519 DOI: 10.3390/v16010162] [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: 12/13/2023] [Revised: 12/26/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination programs are a key intervention in protecting individuals against HPV-related disease. HIV1-infected individuals are at increased risk of HPV-associated cancers. This study was conducted to evaluate the potential role of prophylactic HPV vaccines in preventing new HPV infections among participants with perinatally acquired HIV who received the quadrivalent HPV vaccine at least five years before this study. METHODS This cross-sectional study was conducted at Newlands Clinic, Harare, Zimbabwe. The clinic provided the Gardasil quadrivalent HPV vaccine (4vHPV) to 624 adolescents living with HIV starting in December 2015. Vaginal and penile swabs were collected and tested for HPV types from the study participants who had received the 4vHPV vaccine 5-6 years before enrolment. RESULTS We present the results of 98 participants (44.6% female) vaccinated at a median age of 15 years (IQR 12-16). The mean amount of time since vaccination was 6 years (SD: ±0.4). The HPV-positive rate amongst the analyzed swabs was 69% (68/98). Among 30/98 (31%) HPV-positive participants, 13/98 (13%) had low-risk HPV types, and 17/98 (17%) had high-risk HPV types. Twelve participants tested positive for HPV18, only one participant tested positive for HPV16, and an additional four (4.3%) tested positive for either type 6 or 11, with respect to vaccine-preventable low-risk HPV types. CONCLUSION The Gardasil quadrivalent HPV vaccine (4vHPV) was expected to protect against infection with HPV types 16, 18, 6, and 11. We demonstrated a possible waning of immunity to HPV18 in 17% of the participants, and an associated loss in cross-protection against HPV45. We observed a relatively high prevalence of 'opportunistic non-vaccine HPV types' or 'ecological niche occupiers' in this cohort, and suggest further research on the involvement of these types in cervical and other genital cancers. Our study is one of the few, if not the first, to report on HPV vaccine immunoprotection among people living with HIV (PLWH), thereby setting a baseline for further studies on HPV vaccine effectiveness among PLWH.
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Affiliation(s)
- Alltalents T. Murahwa
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town 7925, South Africa;
- Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Tinashe Mudzviti
- Newlands Clinic, Harare P.O. Box A178, Zimbabwe (T.C.); (P.C.); (M.P.); (T.S.); (R.L.)
- Department of Pharmacy and Pharmaceutical Sciences, University of Zimbabwe, Harare P.O. Box AI78, Zimbabwe
| | - Racheal S. Dube Mandishora
- Medical Microbiology Unit, Department of Laboratory Diagnostic and Investigative Sciences, University of Zimbabwe, Harare P.O. Box AI78, Zimbabwe;
- Center for Immunization and Infection Research in Cancer, Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, 33612 FL, USA
| | - Takudzwa Chatindo
- Newlands Clinic, Harare P.O. Box A178, Zimbabwe (T.C.); (P.C.); (M.P.); (T.S.); (R.L.)
| | - Peace Chanetsa
- Newlands Clinic, Harare P.O. Box A178, Zimbabwe (T.C.); (P.C.); (M.P.); (T.S.); (R.L.)
| | - Margaret Pascoe
- Newlands Clinic, Harare P.O. Box A178, Zimbabwe (T.C.); (P.C.); (M.P.); (T.S.); (R.L.)
| | - Tinei Shamu
- Newlands Clinic, Harare P.O. Box A178, Zimbabwe (T.C.); (P.C.); (M.P.); (T.S.); (R.L.)
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, 3012 Bern, Switzerland
| | - Wisdom Basera
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7925, South Africa;
| | - Ruedi Luethy
- Newlands Clinic, Harare P.O. Box A178, Zimbabwe (T.C.); (P.C.); (M.P.); (T.S.); (R.L.)
| | - Anna-Lise Williamson
- Institute of Infectious Disease and Molecular Medicine, Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town 7925, South Africa;
- SAMRC Gynaecological Cancer Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
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da Silveira MF, Buffarini R, Gaspar PC, Machado HDM, Bazzo ML, Scherer A, Colusso ÁL, Travassos AGÁ, Arakaki-Sanchez D, Baia-da-Silva DC, de Oliveira EC, Zago IR, Moura MDA, de Lacerda MVG, Martins SM, Reuter T, Pinto VM, Perini W, Pereira GFM, Miranda AE. Detection of HPV DNA in vaginal samples self-collected by women living with HIV treated through the Brazilian public health system: Prevalence and analysis of risk factors. Rev Soc Bras Med Trop 2023; 56:e02772023. [PMID: 37820103 PMCID: PMC10561897 DOI: 10.1590/0037-8682-0277-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/05/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Women living with human immunodeficiency virus (HIV) (WLWH) are more likely to be infected with the oncogenic human papillomavirus (HPV). We assessed the prevalence of high-risk (HR) (16/18/31/33/35/39/45/51/52/56/58/59/68/73/82), probable high-risk (pHR) (26/53/66), and low-risk (LR) (6/11/40/42/43/44/54/61/70) HPV types and their associated risk factors. METHODS This cross-sectional study of WLWH aged 18-64 years included one laboratory and eight HIV-specialty healthcare facilities in the pilot network. Descriptive statistics were used to assess sociodemographic and behavioral characteristics. Adjusted analyses were conducted to evaluate risk factors associated with HR and/or pHR HPV infection in WLWH. RESULTS From May/2021 to May/2022, 1,914 (92.5%) WLWH participated in the pilot study and had valid HPV-DNA results of self-collected vaginal samples. The median age of the participants was 45 years, 60.1% had ≥ 9 years of schooling, 80.5% were ≤ 18 years at first sexual intercourse, and 51.7% had > 4 sexual partners throughout life. The prevalence of any HPV type, HR HPV, pHR HPV, and LR HPV was 65.8%, 49.6%, 16.7%, and 40.0%, respectively. Age was inversely associated with pHR and/or HR-HPV (p < 0.001), and education level was inversely associated with HR-HPV (p = 0.003) types. Any HR or pHR was associated with being single (p = 0.029) and exchanging sex for drugs (p = 0.037). CONCLUSIONS The prevalence of HPV, especially HR HPV, among WLWH is high in Brazil, highlighting the need for HPV screening in this population. Self-collection of vaginal samples is an important strategy for increasing testing access.
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Affiliation(s)
| | - Romina Buffarini
- Universidade Federal de Pelotas, Departamento de Medicina Social, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | - Pâmela Cristina Gaspar
- Ministério da Saúde, Departamento de HIV/aids, tuberculose, hepatites virais e infecções sexualmente transmissíveis, Brasília, DF, Brasil
- Universidade de Brasília, Programa de Pós-Graduação em Saúde Coletiva, Brasília, DF, Brasil
| | - Hanalydia de Melo Machado
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Farmácia, Laboratório de Biologia Molecular, Microbiologia e Sorologia, Florianópolis, SC, Brasil
| | - Maria Luiza Bazzo
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Farmácia, Laboratório de Biologia Molecular, Microbiologia e Sorologia, Florianópolis, SC, Brasil
| | - Aline Scherer
- Universidade Federal de Pelotas, Hospital Escola, Empresa Brasileira de Serviços Hospitalares, Pelotas, RS, Brasil
| | - Álvaro Luis Colusso
- Secretaria do Estado de Saúde do Distrito Federal, Centro Especializado em Doenças Infecciosas do Distrito Federal, Brasília, DF, Brasil
| | | | - Denise Arakaki-Sanchez
- Secretaria do Estado de Saúde do Distrito Federal, Centro Especializado em Doenças Infecciosas do Distrito Federal, Brasília, DF, Brasil
| | | | | | | | | | | | - Simone Murta Martins
- Centro Especializado em Diagnóstico, Assistência e Pesquisa, Salvador, BA, Brasil
| | - Tânia Reuter
- Universidade Federal do Espírito Santo, Hospital Universitário Cassiano Antônio Moraes, Vitória, ES, Brasil
| | | | - Waltesia Perini
- Universidade Federal do Espírito Santo, Hospital Universitário Cassiano Antônio Moraes, Vitória, ES, Brasil
| | - Gerson Fernando Mendes Pereira
- Ministério da Saúde, Departamento de HIV/aids, tuberculose, hepatites virais e infecções sexualmente transmissíveis, Brasília, DF, Brasil
| | - Angélica Espinosa Miranda
- Ministério da Saúde, Departamento de HIV/aids, tuberculose, hepatites virais e infecções sexualmente transmissíveis, Brasília, DF, Brasil
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Doenças Infecciosas, Vitória, ES, Brasil
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Roman C, Andrade D, Hernández Y, Salazar ZK, Espinosa L, Campoverde E, Guallaizaca L, Merchán M, Sarmiento M, Brenner J. Biological, demographic, and health factors associated with HPV infection in Ecuadorian women. Front Public Health 2023; 11:1158270. [PMID: 37397749 PMCID: PMC10311495 DOI: 10.3389/fpubh.2023.1158270] [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: 02/06/2023] [Accepted: 05/11/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives The study aims to identify the correlation between human papillomavirus (HPV) infection and sociodemographic and sexual reproductive health factors in Ecuadorian women from March to August 2019. Methods 120 women were randomly selected from two gynecological clinics to complete a questionnaire and provide a biospecimen. PCR-Hybridization was used to genotype 37 HPV serotypes in samples obtained by endo-cervical brushing for liquid-based cytology. Sociodemographic and sexual health data were collected through a validated questionnaire during a medical consultation. Mathematical modeling of HPV infection was done using bivariate logistic regression. Results 65.0% of the women sampled had an HPV infection; 74.3% of these women had co-infections with other HPV genotypes. Out of the women who were HPV positive, 75.6% were diagnosed with high-risk genotypes from HPV strains 18, 35, 52, and 66. Parity, immunosuppression, and use of oral contraception/intrauterine devices (IUDs) were identified as associated variables. The explanatory model had a sensitivity of 89.5% and a specificity of 73.8%. Conclusion The predominant strains of HPV among Ecuadorian women are diverse. The risk of HPV infection is a complex phenomenon where biological and psychosocial variables are integrated into a model. In populations with limited access to health services, low socioeconomic status, and negative sociocultural beliefs about sexually transmitted infections (STIs), surveys can be used as a pre-screening step for HPV infections. The diagnostic value of the model should be tested in multicenter studies that include women from all over the country.
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Affiliation(s)
- Carlos Roman
- Diagnostic Department, MEDsan, Inc., Saint Petersburg, FL, United States
| | - Diego Andrade
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Yenima Hernández
- Department of Mental Health, The Angels Mental Health Community, Tampa, FL, United States
| | - Zoila K. Salazar
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
- Medical Center Association for the Well-being of the Ecuadorian Family (APROFE), Cuenca, Ecuador
| | - Lizette Espinosa
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Erika Campoverde
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Lourdes Guallaizaca
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - María Merchán
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Miriam Sarmiento
- Obstetrics Department, San Juan de Dios Hospital, Cuenca, Ecuador
| | - Jonathan Brenner
- Diagnostic Department, MEDsan, Inc., Saint Petersburg, FL, United States
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Prevalence and Genotyping of HPV in Oral Squamous Cell Carcinoma in Northern Brazil. Pathogens 2022; 11:pathogens11101106. [DOI: 10.3390/pathogens11101106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Highly oncogenic human papillomavirus (HPV) is well known to be associated with and a risk factor for various types of oral carcinomas such as oral squamous cell carcinoma (OSCC). The aim of this study was to evaluate and describe the HPV-induced OSCC prevalence and genotyping in the city of Belém, northern Brazil. This cross-sectional study features 101 participants who attended an oral pathology referral center in a dental college looking for diagnoses of oral lesions (OL). After signing the consent term and meeting the inclusion criteria, all participants went through a sociodemographic and epidemiological questionnaire. Then, OL were collected by excisional or incisional biopsy depending on OL size; after that, OL tissues were preserved in paraffin blocks to histopathological diagnoses. Afterwards, paraffin blocks were divided into benign and malignant/premalignant lesions based on the classification of potentially malignant disorders of the oral and oropharyngeal mucosa. Then, the paraffin blocks had DNA extraction performed by the ReliaPrep FFPE gDNA Miniprep method in order to identify HPV DNA of high oncogenic risk and low oncogenic risk. Then, the viral DNA was amplified and typed using the Inno-Lipa genotyping Extra II method, and the collected data were analyzed by Chi-square and G-tests. In total, 59/101 (58.4%) OL were malignant/premalignant lesions, of which OSCC was the most prevalent with 40/59 (67.7%) and 42/101 (41.6%) benign lesions. The most common area of OL incidence was upper gingiva 46/101 (45.5%). Regarding HPV DNA detection, approximately 27/101 (26.7%) had positive results; of these, 17/59 (28.8%) were malignant/premalignant lesions, and the most prevalent genotypes detected were 16, 18, 52 and 58, while among benign lesions, 10/42 (66.6%) had HPV-positive results, and the most prevalent genotypes detected were 6, 11 and 42. Age range was the only risk factor with a significant association between HPV and OSCC presence (p-value: 0.0004). A correlation between OSCC and oral HPV among analyzed samples could not be demonstrated in our small cohort.
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Prevalence, Diversity, and Risk Factors for Cervical HPV Infection in Women Screened for Cervical Cancer in Belém, Pará, Northern Brazil. Pathogens 2022; 11:pathogens11090960. [PMID: 36145392 PMCID: PMC9506000 DOI: 10.3390/pathogens11090960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most common viral sexually transmitted infection of the reproductive tract, and cervical cancer is the most common HPV-related disease. This study estimated the prevalence, diversity of HPV genotypes, and associated risk factors in women screened for cervical cancer in northern Brazil. Methods: The cross-sectional study was conducted in Belém, Pará, in the Amazon region of Brazil, and it included 162 women who were spontaneously undergoing a Pap-smear routine. Epidemiological, sexual, and health-related information was collected by interviews, and cervical samples were collected for cytological examination and HPV-DNA detection. HPV genotypes were classified as low risk (LR) and high risk (HR) by nucleotide sequencing. Results: In total, 17.3% (28/162) of the participants had HPV-DNA, and LR-HPV was the most prevalent (71.4%). Among the 13 different types of HPV detected, HPV-11 was found most frequently (12/28; 42.9%), followed by HPV-31 (3/28; 10.7%). Of the participants with cytological alterations, HPV infection was detected in only four: two were diagnosed with low-grade squamous intraepithelial lesions (15.4%), one with atypical squamous cells of undetermined significance (7.7%), and one with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (7.7%). Of the 61 women who presented a normal cytology, 13 (21.3%) had positive tests for HPV infection, 4 (8.2%) of which were positive for a high-risk genotype. Conclusion: The prevalence of HPV was high in Belém, Pará, and especially in women who had normal cytology results, which suggests the need for greater screening for HPV infection in women’s primary health care.
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Li SL, Wang W, Zhao J, Zhang FZ, Zhang J, Ni X. A review of the risk factors associated with juvenile-onset recurrent respiratory papillomatosis: genetic, immune and clinical aspects. World J Pediatr 2022; 18:75-82. [PMID: 35072893 DOI: 10.1007/s12519-021-00496-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Juvenile-onset recurrent respiratory papillomatosis (JoRRP) is one of the most common benign lesions of hyperplastic respiratory epithelial tissue in children and is predominantly caused by human papillomaviruses (HPVs) 6 and 11. The clinical course of the disease is variable, and some patients even develop a malignancy. The purpose of this review was to summarize the related factors affecting the disease course in patients with JoRRP. DATA SOURCES We used databases, including PubMed and Google Scholar, to search for publications on factors associated with the genetic, immune, and clinical aspects of JoRRP. The most relevant articles to the scope of this review were chosen for analysis. RESULTS Mother-to-child transmission is the most important mode of disease transmission; other factors, such as immune condition or genetic susceptibility, may be important determinants of JoRRP occurrence. Genetically, the presence of DRB1*0301 and HPV 6/11 E6/E7 is associated with a more severe disease. Immunewise, patients have an enhanced T helper 2-like response. In addition, regulatory T cells are enriched in tumors and may become one of the effective prognostic indicators. For clinical characteristics, patients infected with HPV-11 have more aggressive disease. However, compared with HPV type, age at first onset is a more important factor related to the aggressiveness of JoRRP. Furthermore, socioeconomic status may also affect the course. CONCLUSIONS Genetic, immune, and some clinical factors have been noted to play an important role in the course of JoRRP. Exploring definite influencing factors will be an important direction of research in the future.
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Affiliation(s)
- Shi-Lan Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
| | - Wei Wang
- Laboratory of Tumor Immunology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
| | - Jing Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
| | - Feng-Zhen Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China
| | - Jie Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China.
| | - Xin Ni
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 10045, China.
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