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Luigi R, Stefania S, Francesca I, Federica R, Fiore BD, Annalisa S, Francesco DG, Eugenio M, Mandorino M, Adriana M, Eleonora S, Carmela DC, Lucia N, Enrica R, Michele M, Maria Teresa M, Raffaele DP. HPV and Covid-19 Era: effects of nonpharmaceutical interventions on HPV transmission. Pathog Glob Health 2023; 117:735-743. [PMID: 37533358 PMCID: PMC10614711 DOI: 10.1080/20477724.2023.2239052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
Human papillomavirus (HPV) is considered the commonest viral cause of sexually transmitted infections. The impact of social distance measures due to Covid-19 pandemic on HPV spread is unknown. Therefore, this study has analyzed the seven-year trend of HPV prevalence in all patients tested for HPV DNA at the Microbiology and Virology Unit at Bari Policlinico. Moreover, the HPV prevalence in 2020 has been compared with the previous year ones in order to evaluate the consequences of lockdown and social distancing measures on transmission risks. From 2013 to 2020, we retrospectively analyzed 64 anal swabs, 418 biopsies, 5925 cervical-vaginal swabs, 512 cervical swabs, 104 gland swabs, 154 oral swabs, 21 seminal fluids and 503 urethral swabs. HPV DNA detection was initially performed using nested-polymerase chain reaction (PCR) and subsequently multiplex real-time PCR assay. All statistical tests were carried out by the open-source environment R 4.0.3 (R Core Team). The data were analyzed according to yearly positivity rates, temporal trend and prevalence of HPV genotypes (HPV-6, HPV-11, HPV-16, HPV-18, high risk and low risk) by age category and sex. The number of patients increased steadily from 2016 to 2019 and then decreased in 2020. There were significant differences in prevalence between females and males for HPV-6 (6.16% in females Vs 30.80% in males), HPV-11 (0.82% Vs 7.16%) and HPV-16 (7.77% Vs 5.01%). The prevalence of HPV-6 and HPV-11 significantly increased in 2020 compared to 2013-2019 (15.72% Vs 8.52 and 3.18% Vs 1.44%). On the contrary, the overall prevalence of HPV DNA remained constant in 2020 (52.84% Vs 48.44%). Over time, the prevalence of HPV DNA (Coefficient=-0.020, p-value = 0.036) and particularly high-risk genotypes (Coefficient=-0.030, p-value = 0.005) decreased in females, while low-risk genotypes (Coefficient = 0.141, p-value= < 0.001) and the prevalence of HPV DNA increased in males (Coefficient = 0.068, p-value = 0.008). During the pandemic, the number of screened patients declined, although HPV prevalence compared to 2013-2019 remained constant or increased as in the case of low-risk genotypes. It can be assumed that the reduction of the screening coverage favored the emerging of the more symptomatic low-risk infections. In conclusion, nonpharmaceutical interventions due to Covid-19 pandemic did not reduce the risk of HPV infection but it likely caused a decrease in access to health services resulting in an increased risk of undiagnosed HPV.
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Affiliation(s)
- Ronga Luigi
- Microbiology and Virology, UOC, Azienda Ospedaliero-Universitaria Policlinico, Bari, Italy
| | - Stolfa Stefania
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Indraccolo Francesca
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Romanelli Federica
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Bavaro Davide Fiore
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, Bari “Aldo Moro” University, Bari, Italy
| | - Saracino Annalisa
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, Bari “Aldo Moro” University, Bari, Italy
| | - Di Gennaro Francesco
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, Bari “Aldo Moro” University, Bari, Italy
| | - Milano Eugenio
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, Bari “Aldo Moro” University, Bari, Italy
| | - Manuela Mandorino
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Mosca Adriana
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Sparapano Eleonora
- Microbiology and Virology, UOC, Azienda Ospedaliero-Universitaria Policlinico, Bari, Italy
| | - De Carlo Carmela
- Microbiology and Virology, UOC, Azienda Ospedaliero-Universitaria Policlinico, Bari, Italy
| | - Nisi Lucia
- Microbiology and Virology, UOC, Azienda Ospedaliero-Universitaria Policlinico, Bari, Italy
| | - Ranieri Enrica
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Mastria Michele
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Montagna Maria Teresa
- Hygiene Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
| | - Del Prete Raffaele
- Microbiology Section, Medicine Interdisciplinary Department, Medicine School, Bari “Aldo Moro” University, Bari, Italy
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