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Gonçalves MG, Ferreira MT, Lopéz RVM, Ferreira S, Sirak B, Baggio ML, Lazcano-Ponce E, Nyitray AG, Giuliano AR, Villa LL, Sichero L. Prevalence and persistence of HPV-16 molecular variants in the anal canal of men: The HIM Study. J Clin Virol 2022; 149:105128. [DOI: 10.1016/j.jcv.2022.105128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
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2
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Sudenga SL, Lotspeich SC, Nyitray AG, Sirak B, Shepherd BE, Messina J, Sereday KA, Silva RC, Abrahamsen M, Baggio ML, Quiterio M, Lazcano-Ponce E, Villa L, Giuliano AR. The Role of External Genital Lesions in Human Immunodeficiency Virus Seroconversion Among Men Participating in a Multinational Study. Sex Transm Dis 2022; 49:55-58. [PMID: 34282740 PMCID: PMC8722569 DOI: 10.1097/olq.0000000000001516] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Studies in women have shown an increased risk of human immunodeficiency virus (HIV) acquisition with prior human papilloma virus (HPV) infection; however, few studies have been conducted among men. Our objective was to assess whether HPV-related external genital lesions (EGLs) increase risk of HIV seroconversion among men. METHODS A total of 1379 HIV-negative men aged 18 to 70 years from the United States, Mexico, and Brazil were followed for up to 7 years and underwent clinical examination for EGLs and blood draws every 6 months. Human immunodeficiency virus seroconversion was assessed in archived serum. Cox proportional hazards and marginal structural models assessed the association between EGL status and time to HIV seroconversion. RESULTS Twenty-nine participants HIV seroconverted during follow-up. Older age was associated with a lower hazard of HIV seroconversion. We found no significant difference in the risk of HIV seroconversion between men with and without EGLs (adjusted hazard ratio, 0.94; 95% confidence interval, 0.32-2.74). Stratified analyses focusing on men that have sex with men found no association between EGLs and HIV seroconversion risk (hazards ratio, 0.63; 95% confidence interval, 0.00-1.86). CONCLUSIONS External genital lesions were not associated with higher risk for HIV seroconversion in this multinational population, although statistical power was limited as there were few HIV seroconversions. Results may differ in populations at higher risk for HIV.
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Affiliation(s)
- Staci L. Sudenga
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah C. Lotspeich
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alan G. Nyitray
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Bradley Sirak
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Bryan E. Shepherd
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jane Messina
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Karen A. Sereday
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Roberto Carvalho Silva
- Centro de Referência e Treinamento DST/AIDS and Centro Universitário FAM, São Paulo, Brazil
| | - Martha Abrahamsen
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Maria Luiza Baggio
- Instituto do Cancer do Estado de São Paulo, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Luisa Villa
- Instituto do Cancer do Estado de São Paulo, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center & Research Institute, Tampa, FL, USA
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Dickey BL, Fan W, Bettampadi D, Reich RR, Sirak B, Abrahamsen M, Baggio ML, Galan L, Silva RC, Salmerón J, Villa LL, Lazcano-Ponce E, Giuliano AR. Sequential acquisition of human papillomavirus infection between genital and oral anatomic sites in males. Int J Cancer 2021; 149:1483-1494. [PMID: 34224588 DOI: 10.1002/ijc.33732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/11/2021] [Indexed: 11/12/2022]
Abstract
Oral human papillomavirus (HPV) is associated with increasing rates of HPV-associated oropharyngeal cancer (OPC) in men. Sequential infection from one site to another has been demonstrated at the cervix and anus. Thus, risk of an oral HPV infection after a genital infection of the same type in the HPV infection in men study was investigated. Samples from 3140 men enrolled in a longitudinal cohort were assessed for sequential genital to oral infection with one of nine HPV types (HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58); and then also sequential, same-type oral to genital infection. Incidence rate ratios (IRRs) compared rates of oral HPV among men with and without prior genital infection of the same type. Risk of sequential HPV infections were assessed using Cox proportional hazards model. Incidence of an oral HPV infection was significantly higher among men with a prior genital infection of the same type for any of the 9 HPV types (IRR: 2.3; 95% CI: 1.7-3.0). Hazard ratio of a sequential genital to oral HPV infection was 2.3 (95% CI: 1.7-3.1) and 3.5 (95% CI: 1.9-6.4) for oral to genital infection. Both changed minimally after adjustment for age, country, circumcision, alcohol use, lifetime sexual partners and recent oral sex partners. HPV infections at one site could elevate risk of a subsequent genital or oral HPV infection of the same type in men, emphasizing the importance of vaccination to prevent all HPV infections.
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Affiliation(s)
- Brittney L Dickey
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Wenyi Fan
- Biostatistics and Bioinformatics Shared Resource, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, USA
| | - Deepti Bettampadi
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Richard R Reich
- Biostatistics and Bioinformatics Shared Resource, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, USA
| | - Bradley Sirak
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Martha Abrahamsen
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Lenice Galan
- Centro de Referencia e Treinamento em DST/Aids, São Paulo, Brazil
| | | | - Jorge Salmerón
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Luisa L Villa
- Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil.,Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Bettampadi D, Dickey B, Abrahamsen M, Sirak B, Baggio ML, Galan L, Silva RC, Villa L, Ponce EL, Giuliano AR. Differences in Factors Associated With High- and Low-Risk Oral Human Papillomavirus Genotypes in Men. J Infect Dis 2021; 223:2099-2107. [PMID: 33151300 DOI: 10.1093/infdis/jiaa693] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) causes oral warts and oropharyngeal cancer (OPC). Human papillomavirus-attributable OPC incidence among men is significantly increasing worldwide, yet few studies have reported oral HPV across multiple countries or examined factors associated with low- and high-risk HPV separately. METHODS Oral gargles from 3095 men in the multinational HPV Infection in Men (HIM) Study were HPV genotyped. Multivariable models assessed factors independently associated with high-risk and low-risk HPV prevalence. RESULTS The prevalence of high-risk and low-risk HPV was 6.0% and 2.8%, respectively. Greater number of sexual partners was only associated with high-risk HPV (1.88; 95% confidence interval [CI], 1.22-2.90) prevalence. In multivariable models, residing in Mexico (1.66; 95% CI, 1.15-2.40) and smoking (1.66; 95% CI, 1.13-2.44) were significantly associated with high-risk HPV, and history of consistent gum bleeding (2.16; 95% CI, 1.35-3.45) was significantly associated with low-risk HPV. Gender of the sexual partner did not alter the results for either high- or low-risk HPV endpoints. CONCLUSIONS Different factors were independently associated with high- and low-risk oral HPV. Oral sexual behaviors were associated with high-risk HPV, and oral health was associated with low-risk HPV. High-risk HPV prevalence differed by country of residence, highlighting the need for additional studies in multiple countries.
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Affiliation(s)
- Deepti Bettampadi
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Brittney Dickey
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Martha Abrahamsen
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Bradley Sirak
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Lenice Galan
- Centro de Referencia e Treinamento em DST/AIDS, São Paulo, Brazil
| | | | - Luisa Villa
- Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil.,Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano Ponce
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Nyitray AG, Peng F, Day RS, Carvalho Da Silva RJ, Baggio ML, Salmerón J, Quiterio M, Abrahamsen M, Lazcano-Ponce E, Villa LL, Giuliano AR. The association between body mass index and anal canal human papillomavirus prevalence and persistence: the HIM study. Hum Vaccin Immunother 2019; 15:1911-1919. [PMID: 30897017 DOI: 10.1080/21645515.2019.1593083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: While receptive anal sex is an established risk factor for anal human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA), people with anal HPV infection and SCCA commonly report no lifetime receptive anal sex suggesting other factors may also increase risk for anal HPV infection and persistence. Given potential associations between obesity and conditions that may cause perianal or anal canal lesions, we hypothesized that body mass index (BMI) was associated with HPV infection. Methods: Genotyping for 36 HPV types was conducted on anal canal specimens from men, ages 18-70, from Brazil, Mexico, and the USA. Eligibility included no history of genital warts or HIV. Evaluable specimens were collected from 328 men having sex with men (MSM) and 1348 men having sex with women (MSW) who reported no lifetime receptive anal sex. Prevalence of anal HPV infection and six-month persistence by BMI were estimated in addition to adjusted prevalence ratios for the association between BMI and HPV infection. Results: Among MSW, obese men had a higher prevalence of HPV-16 in the anal canal (3.1%), compared to normal weight men (1.3%) although 95% CI overlapped. Among MSM, prevalence of HPV decreased with increasing BMI. A similar pattern was observed for persistence. After adjustment for confounders, obese MSW had 2.4 times higher odds of HPV-16 compared to normal weight men. Conclusions: BMI may be positively associated with anal HPV (especially HPV-16) among MSW and negatively associated with anal HPV among MSM which supports continued universal HPV vaccination programs.
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Affiliation(s)
- Alan G Nyitray
- a Clinical Cancer Center and Center for AIDS Intervention Research, Medical College of Wisconsin , Milwaukee , WI , USA
| | - Fen Peng
- b Department of Clinical Research, Medtronic, Inc , Northridge , CA , USA
| | - Rena S Day
- c Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center School of Public Health at Houston , Houston , TX , USA
| | | | - Maria Luiza Baggio
- e Centro de Investigação Translacional em Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil
| | - Jorge Salmerón
- f Research Center on Policies, Population, and Health, Faculty of Medicine, National Autonomous University of Mexico , Mexico City , Mexico.,g Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos , Mexico
| | - Manuel Quiterio
- g Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos , Mexico
| | - Martha Abrahamsen
- h Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute , Tampa , FL , USA
| | - Eduardo Lazcano-Ponce
- g Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos , Mexico
| | - Luisa L Villa
- i Faculdade de Medicina, Universidade de São Paulo Department of Radiology and Oncology, Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo , Brazil
| | - Anna R Giuliano
- h Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute , Tampa , FL , USA
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Flores-Díaz E, Sereday KA, Ferreira S, Sirak B, Sobrinho JS, Baggio ML, Galan L, Silva RC, Lazcano-Ponce E, Giuliano AR, Villa LL, Sichero L, The Him Study Group. HPV-11 variability, persistence and progression to genital warts in men: the HIM study. J Gen Virol 2017; 98:2339-2342. [PMID: 28809141 DOI: 10.1099/jgv.0.000896] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
HPV-11 and HPV-6 are the etiological agents of about 90 % of genital warts (GWs). The intra-typic variability of HPV-11 and its association with infection persistence and GW development remains undetermined. Here, HPV infection in men (HIM) participants who had an HPV-11 genital swab and/or GW, preceded or not by a normal skin genital swab were analysed. Genomic variants were characterized by PCR-sequencing and classified within lineages (A, B) and sublineages (A1, A2, A3, A4). HPV-11 A2 variants were the most frequently detected in the genital swab samples from controls and in both genital swabs and GW samples from cases. The same HPV-11 variant was detected in the GW sample and its preceding genital swab. There was a lack of association between any particular HPV-11 variant and the increased risk for GW development.
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Affiliation(s)
- Ema Flores-Díaz
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Present address: Institute for Research in Immunology and Cancer-IRIC; Molecular Biology Program, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Karen A Sereday
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Silvaneide Ferreira
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Bradley Sirak
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - João Simão Sobrinho
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maria Luiza Baggio
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Lenice Galan
- Ludwig Institute for Cancer Research, São Paulo branch, São Paulo, Brazil
| | - Roberto C Silva
- Centro de Referência e Treinamento DST/Aids, São Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Anna R Giuliano
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Luisa L Villa
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology and Oncology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Laura Sichero
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Sudenga SL, Torres BN, Silva R, Villa LL, Lazcano-Ponce E, Abrahamsen M, Baggio ML, Salmeron J, Quiterio M, Giuliano AR. Comparison of the Natural History of Genital HPV Infection among Men by Country: Brazil, Mexico, and the United States. Cancer Epidemiol Biomarkers Prev 2017; 26:1043-1052. [PMID: 28446543 PMCID: PMC5556383 DOI: 10.1158/1055-9965.epi-17-0040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/10/2017] [Accepted: 04/06/2017] [Indexed: 01/21/2023] Open
Abstract
Background: Male genital human papillomavirus (HPV) prevalence and incidence has been reported to vary by geographical location. Our objective was to assess the natural history of genital HPV by country among men with a median of 48 months of follow-up.Methods: Men ages 18-70 years were recruited from United States (n = 1,326), Mexico (n = 1,349), and Brazil (n = 1,410). Genital specimens were collected every 6 months and HPV genotyping identified 37 HPV genotypes. Prevalence of HPV was compared between the three countries using the Fisher exact test. Incidence rates and 95% confidence intervals were calculated. The median time to HPV clearance among men with an incident infection was estimated using the Kaplan-Meier method.Results: The prevalence and incidence of the genital HPV types known to cause disease in males (HPV 16 and 6) was significantly higher among men from Brazil than men from Mexico. Prevalence and incidence of those genital HPV types in the United States varied between being comparable with those of Mexico or Brazil. Although genital HPV16 duration was significantly longer in Brazil (P = 0.04) compared with Mexico and the United States, HPV6 duration was shortest in Brazil (P = 0.03) compared with Mexico and the United States.Conclusions: Men in Brazil and Mexico often have similar, if not higher prevalence of HPV compared with men from the United States.Impact: Currently, there is no routine screening for genital HPV among males and while HPV is common in men, and most naturally clear the infection, a proportion of men do develop HPV-related diseases. Men may benefit from gender-neutral vaccine policies. Cancer Epidemiol Biomarkers Prev; 26(7); 1043-52. ©2017 AACR.
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Affiliation(s)
- Staci L Sudenga
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - B Nelson Torres
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Roberto Silva
- Centro de Referência e Treinamento em DST/AIDS, São Paulo, Brazil
| | - Luisa L Villa
- School of Medicine, Universidade de São Paulo and Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | - Martha Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Maria Luiza Baggio
- School of Medicine, Universidade de São Paulo and Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | | | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
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Sudenga SL, Nyitray AG, Torres BN, Silva R, Villa L, Lazcano-Ponce E, Abrahamsen M, Baggio ML, Salmeron J, Quiterio M, Giuliano AR. Comparison of anal HPV natural history among men by country of residence: Brazil, Mexico, and the United States. J Infect 2017; 75:35-47. [PMID: 28363585 PMCID: PMC6640845 DOI: 10.1016/j.jinf.2017.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/16/2017] [Accepted: 03/22/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Globally, anal cancer incidence is rare, but is increasing in some world regions. Our objective was to assess differences in anal HPV natural history in three countries. METHODS Men aged 18-70 years were recruited from the US (n = 634), Mexico (n = 665), and Brazil (n = 731). Anal specimens were collected every six-months. HPV genotyping was assessed by Linear Array. Anal HPV prevalence was compared using the Fisher's exact test. HPV infection incidence rates (IR) and 95% confidence intervals (CI) were calculated. RESULTS Any anal HPV prevalence was highest among men from Brazil (24%) compared to Mexico (15%) and the US (15%). When stratified by sexual history, the prevalence of any HPV among MSM/MSMW was 43%, 37%, and 45% and 9%, 12%, and 10% for MSW from Brazil, Mexico, and US, respectively. Any HPV incidence was significantly higher among men from Brazil compared to US men (IRR = 2.4, 95% CI = 1.7-3.4) and comparable between men from Mexico and the US (IRR = 1.2, 95% CI = 0.8-1.8). CONCLUSION Men in Brazil and Mexico often have similar, if not higher incidence of anal HPV compared to men from the U.S., and may benefit from gender neutral HPV vaccine policies.
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Affiliation(s)
- Staci L Sudenga
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA; Division of Epidemiology, Vanderbilt University, Nashville, TN, USA
| | - Alan G Nyitray
- Center for Infectious Disease, The University of Texas School of Public Health at Houston, TX, USA
| | - B Nelson Torres
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Roberto Silva
- Centro de Referência e Treinamento em DST/AIDS, São Paulo, Brazil
| | - Luisa Villa
- School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Maria Luiza Baggio
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA.
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Lopes RDVC, Teixeira JA, Marchioni D, Villa LL, Giuliano AR, Luiza Baggio M, Fisberg RM. Dietary intake of selected nutrients and persistence of HPV infection in men. Int J Cancer 2017; 141:757-765. [PMID: 28486774 DOI: 10.1002/ijc.30772] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 03/22/2017] [Accepted: 04/26/2017] [Indexed: 01/18/2023]
Abstract
Human papillomavirus (HPV) infection is a common sexually transmitted disease. Although often transitory, persistent oncogenic HPV infection may progress to a precursor lesion and, if not treated, can further increase the risk of cancer. The purpose of this study was to investigate the relation between dietary intake and HPV persistent infection in men of a Brazilian cohort. The study population consisted of 1,248 men from the Brazilian cohort of the HIM (HPV in Men) Study, ages 18 to 70 years, who completed a quantitative food frequency questionnaire. U Mann-Whitney test was used to assess differences in median nutrient intake of selected nutrients. The association of dietary intake and persistent HPV infection was assessed in multivariate logistic models. The prevalence of any HPV infection at baseline was 66.6%. Of 1,248 participants analyzed, 1,211 (97.0%) were HPV positive at one or more times during the 4 years of follow-up and 781 (62.6%) were persistently HPV positive. Men with nonpersistent oncogenic HPV infections had higher median intake of retinol (p = 0.008), vitamin A (p < 0.001) and folate (DFE; p = 0.003) and lower median intake of energy (p = 0.005) and lycopene (p = 0.008) in comparison to men with persistent oncogenic infections. No significant association was found between selected nutrients and persistent oncogenic HPV infection. For nononcogenic persistent infections, only vitamin B12 intake was significantly associated (p = 0.003, test for trend). No association was observed between dietary intake and persistent oncogenic-type HPV infection; however, vitamin B12 intake was inversely associated with nononcogenic HPV persistence.
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Affiliation(s)
| | - Juliana A Teixeira
- Department of Nutrition, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil
| | - Dirce Marchioni
- Department of Nutrition, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil
| | - Luisa L Villa
- Department of Radiology and Oncology, Faculdade de Medicina, Universidade de São Paulo and Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo - ICESP, Brazil
| | - Anna R Giuliano
- Center for Infection Research in Cancer (CIRC) H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Maria Luiza Baggio
- Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Brazil
| | - Regina M Fisberg
- Department of Nutrition, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil
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Flores-Díaz E, Sereday KA, Ferreira S, Sirak B, Sobrinho JS, Baggio ML, Galan L, Silva RC, Lazcano-Ponce E, Giuliano AR, Villa LL, Sichero L. HPV-6 Molecular Variants Association With the Development of Genital Warts in Men: The HIM Study. J Infect Dis 2017; 215:559-565. [PMID: 28011919 PMCID: PMC5388291 DOI: 10.1093/infdis/jiw600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/01/2016] [Indexed: 11/14/2022] Open
Abstract
Background Human papillomavirus type 6 (HPV-6) and HPV-11 are the etiological agents of approximately 90% of genital warts (GWs). The impact of HPV-6 genetic heterogeneity on persistence and progression to GWs remains undetermined. Methods HPV Infection in Men (HIM) Study participants who had HPV-6 genital swabs and/or GWs preceded by a viable normal genital swab were analyzed. Variants characterization was performed by polymerase chain reaction sequencing and samples classified within lineages (A, B) and sublineages (B1, B2, B3, B4, B5). Country- and age-specific analyses were conducted for individual variants; odds ratios and 95% confidence intervals for the risk of GWs according to HPV-6 variants were calculated. Results B3 variants were most prevalent. HPV-6 variants distribution differed between countries and case status. HPV-6 B1 variants prevalence was increased in GWs and genital swabs of cases compared to controls. There was difference in B1 and B3 variants detection in GW and the preceding genital swab. We observed significant association of HPV-6 B1 variants detection with GW development. Conclusions HPV-6 B1 variants are more prevalent in genital swabs that precede GW development, and confer an increased risk for GW. Further research is warranted to understand the possible involvement of B1 variants in the progression to clinically relevant lesions.
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Affiliation(s)
- Ema Flores-Díaz
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Karen A Sereday
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Silvaneide Ferreira
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Bradley Sirak
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - João Simão Sobrinho
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Maria Luiza Baggio
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Lenice Galan
- Ludwig Institute for Cancer Research, São Paulo Branch, São Paulo, Brazil
| | - Roberto C Silva
- Centro de Referência e Treinamento DST/Aids, São Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Anna R Giuliano
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Luisa L Villa
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.,Department of Radiology and Oncology, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Laura Sichero
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
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da Silva RJC, Sudenga SL, Sichero L, Baggio ML, Galan L, Cintra R, Torres BN, Stoler M, Giuliano AR, Villa LL. HPV-related external genital lesions among men residing in Brazil. Braz J Infect Dis 2017; 21:376-385. [PMID: 28399426 PMCID: PMC6561086 DOI: 10.1016/j.bjid.2017.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 03/21/2017] [Indexed: 02/07/2023] Open
Abstract
The aims of this study were to determine the incidence of external genital lesions (EGLs), specifically histologically confirmed condyloma (genital warts) and Penile Intraepithelial Neoplasia (PeIN), and genital HPV infection progression to EGLs among healthy men aged 18-73 residing in Brazil. Subjects included 1118 men enrolled in the HPV Infection in Men (HIM) study between July 2005 and June 2009. At each visit, EGLs were biopsied and subjected to pathological evaluation. HPV status in genital swabs and biopsies was determined by Linear Array and INNO-LiPA, respectively. Age-specific EGLs incidence and the proportion and median time to EGL development were estimated. Kaplan-Meier cumulative incidence rates at 6, 12, and 24 months were determined. During follow-up, 73 men developed an incident EGL. Men could develop multiple EGLs and there were 36 men with condyloma, 27 men with lesions suggestive of condyloma, six men with PeIN, and 20 men with non-HPV lesions. HPV-positive men who developed EGLs were younger (p=0.002) than men that did not develop lesions. Among the 815 men with HPV infection, 4% progressed to EGL with the same HPV detected in the swab. During follow up, 15.7% of genital HPV-6 and HPV-11 infections progressed to condyloma (median progression time of nine months for HPV-6 versus 6.8 months for HPV-11). Approximately 1% of HPV-16 infections progressed to PeIN with a median progression time of 25 months. HPV types covered by the 4-valent HPV vaccine were detected in 82.3% and 83.3% of condyloma and PeIN, respectively. The high burden of HPV and high frequency of progression to disease underscores the need to offer HPV prophylactic vaccination to men to reduce the overall burden of infection and diseases caused by HPV.
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Affiliation(s)
| | - Staci Lynn Sudenga
- H Lee Moffitt Cancer Center and Research Institute, Department of Cancer Epidemiology, Tampa, FL, USA
| | - Laura Sichero
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer do Estado de São Paulo, Centro de Investigação Translacional em Oncologia, São Paulo, SP, Brazil
| | - Maria Luiza Baggio
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer do Estado de São Paulo, Centro de Investigação Translacional em Oncologia, São Paulo, SP, Brazil
| | - Lenice Galan
- Instituto Ludwig de Pesquisa Sobre o Câncer, São Paulo, SP, Brazil
| | - Ricardo Cintra
- Universidade de São Paulo, Instituto de Química, Departamento de Bioquímica, São Paulo, SP, Brazil
| | - Benji Nelson Torres
- H Lee Moffitt Cancer Center and Research Institute, Department of Cancer Epidemiology, Tampa, FL, USA
| | - Mark Stoler
- University of Virginia Health System, Charlottesville, VA, USA
| | - Anna Regina Giuliano
- H Lee Moffitt Cancer Center and Research Institute, Department of Cancer Epidemiology, Tampa, FL, USA
| | - Luisa Lina Villa
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer do Estado de São Paulo, Centro de Investigação Translacional em Oncologia, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Departamento de Radiologia e Oncologia, São Paulo, SP, Brazil.
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12
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Sudenga SL, Torres BN, Fulp WJ, Silva R, Villa LL, Lazcano-Ponce E, Ingles DJ, Stoler M, Messina JL, Abrahamsen M, Luiza Baggio M, Salmeron J, Quiterio M, Giuliano AR. Country-specific HPV-related genital disease among men residing in Brazil, Mexico and The United States: The HIM study. Int J Cancer 2017; 140:337-345. [PMID: 27681815 PMCID: PMC5687823 DOI: 10.1002/ijc.30452] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/07/2016] [Indexed: 01/08/2023]
Abstract
The purpose of this study was to assess whether the incidence of histopathologically confirmed condyloma and penile intraepithelial neoplasia (PeIN) and rates of genital HPV infection progression to these lesions differs by country (Brazil, Mexico and the U.S.). At each visit, lesions were biopsied and were categorized by pathologic diagnoses. The Linear Array genotyping method was used to identify HPV genotypes from genital swabs, while the INNO-LiPA HPV Genotyping Extra method was used for tissue specimens. Age-specific analyses were conducted for lesion incidence by country, with Kaplan-Meier estimation of cumulative incidence. The proportion of HPV infections that progressed to condyloma and PeIN, the median time to lesion development and the incidence rates were estimated by country. When comparing demographic and sexual characteristics across the three countries, sexual orientation (p = 0.008) and lifetime number of female sexual partners (p < 0.0001) were differentially associated with lesion incidence in the three countries. Condyloma incidence in Brazil and the U.S. decreased with age, while incidence remained constant across the lifespan in Mexico. There were no differences by country and age for PeIN incidence. HPV types 6 and 11 were the most common types to progress to condyloma and HPV types 16, 6 and 11 were the most common types to progress to PeIN in all three countries. The continuous risk of condyloma and PeIN across all age groups and countries in this study emphasizes the need to ensure that strong HPV immunity, such as that obtained through vaccination, is maintained across the lifespan of men.
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Affiliation(s)
| | | | | | - Roberto Silva
- Centro de Referencia de Treinamento em DST e Aids, São Paulo, Brazil
| | | | | | | | - Mark Stoler
- University of Virginia Health System, Charlottesville, VA, USA
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13
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Figueroa-Downing D, Baggio ML, Baker ML, Dias De Oliveira Chiang E, Villa LL, Eluf Neto J, Evans DP, Bednarczyk RA. Factors influencing HPV vaccine delivery by healthcare professionals at public health posts in São Paulo, Brazil. Int J Gynaecol Obstet 2016; 136:33-39. [PMID: 28099706 DOI: 10.1002/ijgo.12004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/06/2016] [Accepted: 09/30/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the association between Brazilian healthcare providers' characteristics and their knowledge, perceptions, and practices regarding the HPV vaccine. METHODS An observational cross-sectional study was conducted at five public health posts in São Paulo between July 28 and August 8, 2014. Healthcare professionals directly involved in patient care were asked to complete a written survey. Factors associated with routine verification of HPV vaccination status were evaluated using Poisson regression. RESULTS Among 200 participants included, 74 (38.5%) reported never and 70 (36.5%) reported always asking about HPV immunization status. Doctors were significantly less likely to report always asking than were community health agents (5/39 [12.8%] vs 32/60 [53.3%]; adjusted prevalence ratio [aPR] 0.25 [95% confidence interval (CI) 0.07-0.91]). Knowledge about the correct dosing schedule was associated with always rather than never verifying vaccination status (aPR 2.46 [95% CI 1.06-5.70]). CONCLUSION Knowledge and attitude played secondary roles in influencing HPV vaccine verification. Community health agents were crucial for vaccine promotion; continued education and support of this group is essential for the sustained success of HPV immunization efforts in Brazil.
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Affiliation(s)
- Daniella Figueroa-Downing
- Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Misha L Baker
- Department of Behavioral Science and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Luisa L Villa
- The Cancer Institute of the State of São Paulo, São Paulo, Brazil.,Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jose Eluf Neto
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.,Oncology Foundation of São Paulo, São Paulo, Brazil
| | - Dabney P Evans
- Departments of Behavioral Science and Health Education and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert A Bednarczyk
- Departments of Behavioral Science and Health Education and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Cancer Prevention and Control Program, Winship Cancer Institute, Atlanta, GA, USA.,Emory Vaccine Center, Atlanta, GA, USA
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14
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Liu Z, Nyitray AG, Hwang LY, Swartz MD, Abrahamsen M, Lazcano-Ponce E, Salmerón J, Quiterio M, Villa LL, Baggio ML, Silva RJC, Giuliano AR. Human Papillomavirus Prevalence Among 88 Male Virgins Residing in Brazil, Mexico, and the United States. J Infect Dis 2016; 214:1188-91. [PMID: 27489299 DOI: 10.1093/infdis/jiw353] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/29/2016] [Indexed: 01/10/2023] Open
Abstract
This study determined the prevalence and risk factors for genital human papillomavirus (HPV) detection among men who deny ever engaging in penetrative sex. A questionnaire was administered to 4123 men from a cohort study of HPV natural history. Genital exfoliated cells were collected and genotyped for 36 HPV types. Eighty-eight men were classified as virgins. Log-binomial regression models identified factors associated with genital HPV detection. The prevalence of any and high-risk HPV types among 88 male virgins was 25.0% and 18.2%, respectively. Age and smoking status were associated with HPV detection. Further studies are needed to better understand the risk for HPV infection among male virgins.
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Affiliation(s)
- Zhiyue Liu
- Department of Epidemiology, Human Genetics and Environmental Sciences
| | - Alan G Nyitray
- Department of Epidemiology, Human Genetics and Environmental Sciences Center for Infectious Diseases
| | - Lu-Yu Hwang
- Department of Epidemiology, Human Genetics and Environmental Sciences Center for Infectious Diseases
| | - Michael D Swartz
- Department of Biostatistics, School of Public Health, The University of Texas Health Science Center at Houston
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - Jorge Salmerón
- Instituto Nacional de Salud Pública Instituto Mexicano del Seguro Social, Cuernavaca, México
| | | | - Luisa L Villa
- Faculdade de Medicina, Universidade de São Paulo Department of Radiology and Oncology, Centro de Investigação Translacional em Oncologia
| | - Maria Luiza Baggio
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
| | - Roberto J C Silva
- Centro de Referência e Treinamento em Doenças Sexualmente Transmissíveis/AIDS, São Paulo, Brazil
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, Florida
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15
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Nunes EM, Sudenga SL, Gheit T, Tommasino M, Baggio ML, Ferreira S, Galan L, Silva RC, Pierce Campbell CM, Lazcano-Ponce E, Giuliano AR, Villa LL, Sichero L. Diversity of beta-papillomavirus at anogenital and oral anatomic sites of men: The HIM Study. Virology 2016; 495:33-41. [PMID: 27161202 PMCID: PMC4949595 DOI: 10.1016/j.virol.2016.04.031] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 04/28/2016] [Accepted: 04/29/2016] [Indexed: 11/22/2022]
Abstract
Our goal was to describe prevalence of β-HPVs at three anatomic sites among 717 men from Brazil, Mexico and US enrolled in the HPV Infection in Men (HIM) Study. β-HPVs were genotyped using Luminex technology. Overall, 77.7%, 54.3% and 29.3% men were positive for any β-HPV at the genitals, anal canal, and oral cavity, respectively. Men from US and Brazil were significantly less likely to have β-HPV at the anal canal than men from Mexico. Older men were more likely to have β-HPV at the anal canal compared to younger men. Prevalence of β-HPV at the oral cavity was significantly associated with country of origin and age. Current smokers were significantly less likely to have β-HPV in the oral cavity than men who never smoked. Lack of associations between β-HPV and sexual behaviors may suggest other routes of contact such as autoinoculation which need to be explored further.
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Affiliation(s)
- Emily Montosa Nunes
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Staci L Sudenga
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Cancer Research (IARC), Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Cancer Research (IARC), Lyon, France
| | - Maria Luiza Baggio
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Silvaneide Ferreira
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Lenice Galan
- Ludwig Institute for Cancer Research, São Paulo branch, São Paulo, Brazil
| | - Roberto C Silva
- Centro de Referência e Treinamento DST/Aids, São Paulo, Brazil
| | | | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Anna R Giuliano
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Luisa L Villa
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Laura Sichero
- Molecular Biology Laboratory, Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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16
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Nyitray AG, Carvalho da Silva RJ, Chang M, Baggio ML, Ingles DJ, Abrahamsen M, Papenfuss M, Lin HY, Salmerón J, Quiterio M, Lazcano-Ponce E, Villa LL, Giuliano AR. Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study. Clin Infect Dis 2016; 62:1367-1374. [PMID: 26962079 DOI: 10.1093/cid/ciw140] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/26/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Given high rates of anal disease, we investigated the natural history of high-risk anal human papillomavirus (HPV) among a multinational group of men who have sex with men (MSM) aged 18-64 years. METHODS Anal specimens from human immunodeficiency virus-negative men from Brazil, Mexico, and the United States were genotyped. Over 2 years, 406 MSM provided evaluable specimens every 6 months for ≥2 visits. These men were stratified into men who have sex only with men (MSOM, n = 70) and men who have sex with women and men (MSWM, n = 336). Persistence was defined as ≥12 months' type-specific duration and could begin with either a prevalent or incident infection. Prevalence ratios and 95% confidence intervals were calculated by Poisson regression. RESULTS Median follow-up time was 2.1 years. Retention was 82%. Annual cumulative incidence of 9-valent vaccine types was 19% and 8% among MSOM and MSWM, respectively (log-rank P = .02). Duration of anal HPV did not differ for MSOM and MSWM and was a median of 6.9 months for HPV-16 after combining men from the 2 groups. Among men with prevalent high-risk infection (n = 106), a total of 36.8%, retained the infection for at least 24 months. For those with prevalent HPV-16 (n = 27), 29.6% were persistent for at least 24 months. Persistence of high-risk HPV was associated with number of male anal sex partners and inversely associated with number of female sex partners. CONCLUSIONS MSM with prevalent high-risk HPV infection should be considered at increased risk for nontransient infection.
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Affiliation(s)
- Alan G Nyitray
- Center for Infectious Diseases, University of Texas School of Public Health at Houston
| | | | - Mihyun Chang
- Division of Biostatistics, University of Texas School of Public Health at Houston
| | - Maria Luiza Baggio
- Center of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Brazil
| | - Donna J Ingles
- Vanderbilt Institute for Global Health, Nashville, Tennessee
| | - Martha Abrahamsen
- Center for Infection Research in Cancer,Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Mary Papenfuss
- Center for Infection Research in Cancer,Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Hui-Yi Lin
- Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Jorge Salmerón
- Instituto Nacional de Salud Pública.,Instituto Mexicano del Seguro Social, and
| | - Manuel Quiterio
- Instituto Nacional de Salud Pública, Cuernavaca, México; and
| | | | - Luisa L Villa
- Faculdade de Medicina, Universidade de São Paulo Department of Radiology and Oncology, Centro de Investigação Translacional em Oncologia, ICESP, Brazil
| | - Anna R Giuliano
- Center for Infection Research in Cancer,Moffitt Cancer Center and Research Institute, Tampa, Florida
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17
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Giuliano AR, Viscidi R, Torres BN, Ingles DJ, Sudenga SL, Villa LL, Baggio ML, Abrahamsen M, Quiterio M, Salmeron J, Lazcano-Ponce E. Seroconversion Following Anal and Genital HPV Infection in Men: The HIM Study. Papillomavirus Res 2015; 1:109-115. [PMID: 26688833 PMCID: PMC4680989 DOI: 10.1016/j.pvr.2015.06.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Protection from naturally acquired human papillomavirus (HPV) antibodies may influence HPV infection across the lifespan. This study describes seroconversion rates following genital, anal, and oral HPV 6/11/16/18 infections in men and examines differences by HPV type and anatomic site. Methods Men with HPV 6/11/16/18 infections who were seronegative for those genotypes at the time of DNA detection were selected from the HPV Infection in Men (HIM) Study. Sera specimens collected ≤36 months after detection were analyzed for HPV 6/11/16/18 antibodies using a virus-like particle-based ELISA. Time to seroconversion was separately assessed for each anatomic site, stratified by HPV type. Results Seroconversion to ≥1 HPV type (6/11/16/18) in this sub-cohort (N=384) varied by anatomic site, with 6.3%, 18.9%, and 0.0% seroconverting following anal, genital, and oral HPV infection, respectively. Regardless of anatomic site, seroconversion was highest for HPV 6 (19.3%). Overall, seroconversion was highest following anal HPV 6 infection (69.2%). HPV persistence was the only factor found to influence seroconversion. Conclusions Low seroconversion rates following HPV infection leave men susceptible to recurrent infections that can progress to HPV-related cancers. This emphasizes the need for HPV vaccination in men to ensure immune protection against new HPV infections and subsequent disease.
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Affiliation(s)
- Anna R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Raphael Viscidi
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - B Nelson Torres
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Donna J Ingles
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Staci L Sudenga
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Luisa L Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Martha Abrahamsen
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Jorge Salmeron
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico ; Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
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18
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Trottier H, Mayrand MH, Baggio ML, Galan L, Ferenczy A, Villa LL, Franco EL. Risk of Human Papillomavirus (HPV) Infection and Cervical Neoplasia after Pregnancy. BMC Pregnancy Childbirth 2015; 15:244. [PMID: 26446835 PMCID: PMC4597450 DOI: 10.1186/s12884-015-0675-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 10/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parity is well established as a risk factor for cervical cancer. It is not clear, however, how pregnancy influences the natural history of HPV infection and cervical neoplasia. Our objective was to study the risk of HPV infection and cervical squamous intraepithelial lesions (SIL) after pregnancy. METHODS We used the Ludwig-McGill cohort study which includes 2462 women recruited in Sao Paulo, Brazil in 1993-97 and followed for up to 10 years. Cellular specimens were collected every 4-6 months for Pap cytology and HPV detection and genotyping by a polymerase chain reaction protocol. Study nurses recorded pregnancy occurrence during follow-up. HPV and Pap results from pregnant women were available before and after, but not during pregnancy. The associations between pregnancy and post-partum HPV infection/SIL were studied using generalized estimating equation models with logistic link. Adjusted odds ratios (OR) were estimated with empirical adjustment for confounding. RESULTS We recorded 122 women with a history of pregnancy during follow-up. Of these, 29 reintegrated the cohort study after delivery. No association between HPV and pregnancy was found. A single SIL case (high grade SIL) occurred post-partum. Likewise, there was no association between pregnancy and risk of low grade SIL or any-grade SIL at the next visit (adjusted OR = 0.84, 95 % CI: 0.46-15.33) after controlling for confounders. CONCLUSIONS No associations were found between pregnancy and HPV or LSIL. The single observed case of HSIL post-partum was more than would be expected based on the rate of these abnormalities among non-pregnant women. As this association was found with only one case, caution is required in the interpretation of these results.
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Affiliation(s)
- Helen Trottier
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, Canada. .,Department of Social and Preventive Medicine, Université de Montréal, Montreal, Canada. .,Sainte-Justine Hospital Research Center, Department of Social and Preventive Medicine, Université de Montréal, 3175 Côte Sainte-Catherine, Room A-830, Montreal, QC, H3T 1C5, Canada.
| | - Marie-Hélène Mayrand
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Canada. .,Department of Obstetrics and Gynecology, Université de Montréal and CRCHUM, Montreal, Canada.
| | | | - Lenice Galan
- Ludwig Institute for Cancer Research, São Paulo, Brazil.
| | - Alex Ferenczy
- Department of Pathology, McGill University and Jewish General Hospital, Montreal, Canada.
| | - Luisa L Villa
- Ludwig Institute for Cancer Research, São Paulo, Brazil. .,Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Eduardo L Franco
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, Canada.
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Baker ML, Figueroa-Downing D, Chiang EDDO, Villa L, Baggio ML, Eluf-Neto J, Bednarczyk RA, Evans DP. Paving pathways: Brazil's implementation of a national human papillomavirus immunization campaign. Rev Panam Salud Publica 2015; 38:163-166. [PMID: 26581058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 04/13/2015] [Indexed: 06/05/2023] Open
Abstract
In 2014, Brazil introduced an HPV immunization program for girls 9-13 years of age as part of the Unified Health System's (SUS) National Immunization Program. The first doses were administered in March 2014; the second ones, in September 2014. In less than 3 months more than 3 million girls received the first dose of quadrivalent HPV vaccine, surpassing the target rate of 80%. This paper examines three elements that may influence the program's long-term success in Brazil: sustaining effective outreach, managing a large technology-transfer collaboration, and developing an electronic immunization registry, with a focus on the State of São Paulo. If these three factors are managed, the Government of Brazil is primed to serve as a model of success for other countries interested in implementing a national HPV vaccination program to decrease HPV-related morbidity and mortality.
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Affiliation(s)
- Misha L Baker
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | | | | | - Luisa Villa
- Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | - José Eluf-Neto
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Robert A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Dabney P Evans
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Nyitray AG, Chang M, Villa LL, Carvalho da Silva RJ, Baggio ML, Abrahamsen M, Papenfuss M, Quiterio M, Salmerón J, Lazcano-Ponce E, Giuliano AR. The natural history of genital human papillomavirus among HIV-negative men having sex with men and men having sex with women. J Infect Dis 2015; 212:202-12. [PMID: 25649172 DOI: 10.1093/infdis/jiv061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 01/26/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Although human immunodeficiency virus (HIV)-negative men having sex with men (MSM) bear a substantial burden of human papillomavirus (HPV)-associated disease, prospective studies of genital HPV infection in this population are scarce. METHODS HPV genotyping was conducted on genital samples from men (aged 18-70 years) from Brazil, Mexico, or the United States who provided specimens at 6-month intervals for up to 4 years. Eligibility criteria included no history of genital warts or HIV infection. Evaluable specimens were collected from 564 MSM and 3029 men having sex with women (MSW). Incidence and clearance estimates with 95% confidence intervals were calculated. RESULTS The 12-month cumulative incidence of genital HPV was high in both MSM (25%; 95% confidence interval, 21%-30%) and MSW (21%; 20%-23%). After stratifying by city, MSM and MSW incidence rates were comparable, with 3 exceptions where MSM had higher incidence in ≥1 city: the group of quadrivalent vaccine types, HPV-45, and HPV-11. Median times to HPV-16 clearance were also comparable, with point estimates of >6 months for both MSM and MSW. CONCLUSIONS Unlike with many other sexually transmitted infections, genital HPV natural history may be similar in HIV-negative MSM and MSW. Study periods of ≤6 months, however, may not be long enough to accurately measure the persistence of these infections in men.
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Affiliation(s)
- Alan G Nyitray
- The University of Texas School of Public Health at Houston, Texas
| | - Mihyun Chang
- The University of Texas School of Public Health at Houston, Texas
| | - Luisa L Villa
- School of Medicine, University of São Paulo, School of Medical Sciences, Santa Casa de São Paulo
| | | | - Maria Luiza Baggio
- Center of Translational Oncology, Instituto do Câncer do Estado de São Paulo-ICESP, Brazil
| | | | - Mary Papenfuss
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - Jorge Salmerón
- Instituto Nacional de Salud Pública Instituto Mexicano del Seguro Social
| | | | - Anna R Giuliano
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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21
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Sichero L, Nyitray AG, Nunes EM, Nepal B, Ferreira S, Sobrinho JS, Baggio ML, Galan L, Silva RC, Lazcano-Ponce E, Giuliano AR, Villa LL. Diversity of human papillomavirus in the anal canal of men: the HIM Study. Clin Microbiol Infect 2015; 21:502-9. [PMID: 25698660 DOI: 10.1016/j.cmi.2014.12.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/16/2014] [Accepted: 12/21/2014] [Indexed: 11/17/2022]
Abstract
Human papillomavirus (HPV) infections are associated with the development of anogenital lesions in men. There are no reports describing the distribution of non-α HPV types in the anal canal of a sexually diverse group of men. The HPV Infection in Men (HIM) Study is a multicentre study on the natural history of HPV infection in Brazil, Mexico, and the USA. At baseline, 12% of anal canal PCR HPV-positive specimens were not typed by the Roche Linear Array, and were considered to be unclassified. Our goals were to characterize HPVs among these unclassified specimens at baseline, and to assess associations with participant socio-demographic and behavioural characteristics. Unclassified HPVs were typed by sequencing of amplified PGMY09/11 products or cloning of PGMY/GP + nested amplicons followed by sequencing. Further analysis was conducted with FAP primers. Of men with unclassified HPV in the anal canal, most (89.1%) were men who have sex with women. Readable sequences were produced for 62.8% of unclassified specimens, of which 75.2% were characterized HPV types. Eighteen, 26 and three different α-HPV, β-HPV and γ-HPV types were detected, respectively. α-HPVs were more commonly detected among young men (18-30 years) than among older men (45-70 years), whereas β-HPVs were more frequent among mid-adult men (31-44 years). β-HPVs were more common among heterosexual men (85.0%) than among non-heterosexual men. All β-HPVs detected among non-heterosexual men were β2-HPV types. The high prevalence of β-HPV in the anal canal of men who do not report receptive anal sex is suggestive of other forms of transmission that do not involve penile-anal intercourse.
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Affiliation(s)
- L Sichero
- Molecular Biology Laboratory, Centre of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil.
| | - A G Nyitray
- Center for Infectious Diseases, The University of Texas School of Public Health, Houston, TX, USA
| | - E M Nunes
- Molecular Biology Laboratory, Centre of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - B Nepal
- Center for Infectious Diseases, The University of Texas School of Public Health, Houston, TX, USA
| | - S Ferreira
- Molecular Biology Laboratory, Centre of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - J S Sobrinho
- Molecular Biology Laboratory, Centre of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - M L Baggio
- Molecular Biology Laboratory, Centre of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - L Galan
- Ludwig Institute for Cancer Research, São Paulo, Brazil
| | - R C Silva
- Centro de Referência e Treinamento DST/Aids, São Paulo, Brazil
| | - E Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - A R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - L L Villa
- Molecular Biology Laboratory, Centre of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil; Department of Radiology and Oncology, School of Medicine of the University of São Paulo and HPV Institute, School of Medicine, Santa Casa de São Paulo, Brazil
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22
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Sichero L, Pierce Campbell CM, Ferreira S, Sobrinho JS, Luiza Baggio M, Galan L, Silva RC, Lazcano-Ponce E, Giuliano AR, Villa LL. Broad HPV distribution in the genital region of men from the HPV infection in men (HIM) study. Virology 2013; 443:214-7. [PMID: 23722104 DOI: 10.1016/j.virol.2013.04.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 04/10/2013] [Accepted: 04/25/2013] [Indexed: 10/26/2022]
Abstract
The HPV infection in men (HIM) study examines the natural history of genital HPV infection in men. Genotyping methods used in this study identify 37 α-HPV types; however, the viral type could not be identified in approximately 22% of male genital specimens that were HPV PCR positive. Our aim was to genotype HPV-unclassified specimens by sequencing PGMY09/11, GP5+/6+ or FAP59/64 PCR products. Using this approach we were able to detect 86 unique HPV types among 508 of 931 specimens analyzed. We report for the first time the presence of a broad range of α-, β- and γ-HPV at the male genitals.
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Affiliation(s)
- Laura Sichero
- Molecular Biology Laboratory, Center of Translational Oncology, Instituto do Câncer do Estado de São Paulo--ICESP, São Paulo 01246-000, Brazil.
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23
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Lu B, Viscidi RP, Wu Y, Nyitray AG, Villa LL, Lazcano-Ponce E, Carvalho da Silva RJ, Baggio ML, Quiterio M, Salmerón J, Smith DC, Abrahamsen M, Papenfuss M, Giuliano AR. Seroprevalence of human papillomavirus (HPV) type 6 and 16 vary by anatomic site of HPV infection in men. Cancer Epidemiol Biomarkers Prev 2012; 21:1542-6. [PMID: 22761306 DOI: 10.1158/1055-9965.epi-12-0483] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND It is largely unknown if antihuman papillomavirus (HPV) serum antibody responses vary by anatomic site of infection in men. METHODS This study assessed type-specific anti-HPV serum antibody prevalence associated with corresponding HPV DNA detection in the external genitalia and the anal canal of 1,587 heterosexual men and 199 men who have sex with men (MSM). RESULTS We observed that HPV 6 and 16 seroprevalence was higher in the presence of same HPV-type infection in the anal canal compared with same HPV-type infection in the external genitalia only, and among MSM compared with the heterosexual men. Seropositivity to HPV 6 was strongly associated with HPV 6 DNA detection in the anal canal but not in the external genitalia alone among both heterosexual men [adjusted prevalence ratio (APR), anal+/genital+ vs. anal-/genital-: 4.2, 95% confidence interval (CI), 11.7-10.5; anal+/genital- vs. anal-/genital-: 7.9 (95% CI, 3.7-17.0)] and MSM [APR, anal+/genital+ vs. anal-/genital-: 5.6 (95% CI, 2.7-11.9); anal+/genital- vs. anal-/genital-: 3.2 (95% CI, 2.1-4.9)]. Similar associations between seropositivity to HPV 16 and anal HPV 16 DNA detection were only observed in MSM [anal+/genital+ vs. anal-/genital-: 3.1 (95% CI, 2.0-5.0); anal+/genital- vs. anal-/genital-: 2.2 (95% CI, 1.3-3.5)]. CONCLUSION Our data showed that seroprevalence varied by anatomic site of HPV infection, suggesting differences in epithelium type present at these anatomic sites may be relevant. IMPACT Our finding is instrumental in advancing our understanding of immune mechanism involved in anatomic site-specific antibody response.
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Affiliation(s)
- Beibei Lu
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612-9416, USA
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Lu B, Viscidi RP, Wu Y, Lee JH, Nyitray AG, Villa LL, Lazcano-Ponce E, da Silva RJC, Baggio ML, Quiterio M, Salmeron J, Smith DC, Abrahamsen ME, Papenfuss MR, Stockwell HG, Giuliano AR. Prevalent serum antibody is not a marker of immune protection against acquisition of oncogenic HPV16 in men. Cancer Res 2011; 72:676-85. [PMID: 22123925 DOI: 10.1158/0008-5472.can-11-0751] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In women, naturally induced anti-human papilloma virus (HPV) serum antibodies are a likely marker of host immune protection against subsequent HPV acquisition and progression to precancerous lesions and cancers. However, it is unclear whether the same is the case in men. In this study, we assessed the risk of incident genital infection and 6-month persistent genital infection with HPV16 in relation to baseline serostatus in a cohort of 2,187 men over a 48-month period. Genital swabs were collected every 6 months and tested for HPV presence. Incidence proportions by serostatus were calculated at each study visit to examine whether potential immune protection attenuated over time. Overall, incidence proportions did not differ statistically between baseline seropositive and seronegative men at any study visit or over the follow-up period. The risk of incident and 6-month persistent infection was not associated with baseline serostatus or baseline serum antibody levels in the cohort. Our findings suggest that baseline HPV seropositivity in men is not associated with reduced risk of subsequent HPV16 acquisition. Thus, prevalent serum antibodies induced by prior infection may not be a suitable marker for subsequent immune protection against genital HPV16 acquisition in men.
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Affiliation(s)
- Beibei Lu
- H Lee Moffitt Cancer Center and Research Institute, College of Public Health, University of South Florida, Tampa, Florida 33612, USA
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25
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Nyitray AG, Carvalho da Silva RJ, Baggio ML, Smith D, Abrahamsen M, Papenfuss M, Lin HY, Quiterio M, Salmerón J, Lazcano-Ponce E, Villa LL, Giuliano AR. Six-month incidence, persistence, and factors associated with persistence of anal human papillomavirus in men: the HPV in men study. J Infect Dis 2011; 204:1711-22. [PMID: 21964400 DOI: 10.1093/infdis/jir637] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although there are limited numbers of incidence and persistence estimates for anal human papillomavirus (HPV) in women and in men who have sex with men (MSM), there are no such reports for men who have sex with women (MSW). METHODS Genotyping was performed on anal samples from men, aged 18-70, from São Paulo, Brazil; Cuernavaca, Mexico; and Tampa, Florida, who provided specimens at enrollment and the 6-month visit of a 4-year prospective study. Eligibility included no history of genital warts or human immunodeficiency virus. A total of 954 MSW and 156 MSM provided evaluable specimens at both visits. Persistence was defined as type-specific infection at each visit. RESULTS Incident anal infection was common among both MSM and MSW but generally higher for MSM for HPV groups and specific genotypes. A total of 5.1% of MSM and 0.0% of MSW had a persistent HPV-16 infection at the 6-month visit. Cigarette smoking among MSM and age among MSW were associated with persistent infection with any HPV genotype. CONCLUSIONS Although anal HPV infection is commonly acquired by both MSW and MSM, incident events and persistence occurred more often among MSM. Cigarette smoking is a modifiable risk factor that may contribute to HPV persistence among MSM.
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Affiliation(s)
- Alan G Nyitray
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
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26
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Teixeira JA, Baggio ML, Giuliano AR, Fisberg RM, Marchioni DML. Performance of the quantitative food frequency questionnaire used in the Brazilian center of the prospective study Natural History of Human Papillomavirus Infection in Men: The HIM Study. J Am Diet Assoc 2011; 111:1045-51. [PMID: 21703383 PMCID: PMC3471779 DOI: 10.1016/j.jada.2011.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Accepted: 01/05/2011] [Indexed: 11/25/2022]
Abstract
The Natural History of Human Papillomavirus (HPV) Infection in Men: The HIM Study is a prospective multicenter cohort study that, among other factors, analyzes participants' diet. A parallel cross-sectional study was designed to evaluate the validity and reproducibility of the quantitative food frequency questionnaire (QFFQ) used in the Brazilian center from the HIM Study. For this, a convenience subsample of 98 men aged 18 to 70 years from the HIM Study in Brazil answered three 54-item QFFQ and three 24-hour recall interviews, with 6-month intervals between them (data collection January to September 2007). A Bland-Altman analysis indicated that the difference between instruments was dependent on the magnitude of the intake for energy and most nutrients included in the validity analysis, with the exception of carbohydrates, fiber, polyunsaturated fat, vitamin C, and vitamin E. The correlation between the QFFQ and the 24-hour recall for the deattenuated and energy-adjusted data ranged from 0.05 (total fat) to 0.57 (calcium). For the energy and nutrients consumption included in the validity analysis, 33.5% of participants on average were correctly classified into quartiles, and the average value of 0.26 for weighted kappa shows a reasonable agreement. The intraclass correlation coefficients for all nutrients were greater than 0.40 in the reproducibility analysis. The QFFQ demonstrated good reproducibility and acceptable validity. The results support the use of this instrument in the HIM Study.
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Affiliation(s)
- Juliana Araujo Teixeira
- MSc, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo-SP, Brazil
| | - Maria Luiza Baggio
- Study coordinator, Ludwig Institute for Cancer Research, São Paulo-SP, Brazil
| | - Anna R. Giuliano
- PhD, H. Lee Moffitt Cancer Center and Research Institute, Tampa-Florida, USA
| | - Regina Mara Fisberg
- PhD, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo-SP, Brazil
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27
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Lu B, Viscidi RP, Lee JH, Wu Y, Villa LL, Lazcano-Ponce E, da Silva RJC, Baggio ML, Quiterio M, Salmerón J, Smith DC, Abrahamsen M, Papenfuss M, Stockwell HG, Giuliano AR. Human papillomavirus (HPV) 6, 11, 16, and 18 seroprevalence is associated with sexual practice and age: results from the multinational HPV Infection in Men Study (HIM Study). Cancer Epidemiol Biomarkers Prev 2011; 20:990-1002. [PMID: 21378268 DOI: 10.1158/1055-9965.epi-10-1160] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Few human papillomavirus (HPV) serology studies have evaluated type-specific seroprevalence of vaccine HPV types in men. This study investigates seroprevalence of HPV 6, 11, 16, and 18, and associated risk factors in men residing in three countries (United States, Mexico, and Brazil). METHODS Data from 1,477 men aged 18 to 70 enrolled in the HPV Infection in Men Study (HIM Study) were analyzed. Serum antibody testing was performed with virus-like particle-based ELISA. Potential risk factors were assessed for individual HPV types by the use of logistic regression. RESULTS Overall, HPV-6, 11, 16, and 18 seroprevalence was 14.8%, 17.3%, 11.2%, and 5.8%, respectively. Thirty-four percent of men were seropositive to one or more HPV types. When examined by sexual practice, 31.2% of men who had sex with women, 65.6% of men who had sex with men (MSM), and 59.4% of men who had sex with both men and women (MSMW) were seropositive to one or more HPV types. Seroprevalence increased with age among young-to-middle-aged men with significant upward age trends observed for HPV 11, 16, and 18. Men with multiple lifetime male anal sex partners were 2 to 4 times more likely to be HPV 6 or 11 seropositive and 3 to 11 times more likely to be HPV 16 or 18 seropositive. CONCLUSION Our data indicate that exposures to vaccine HPV types were common in men and highly prevalent among MSM and MSMW. IMPACT Our study provides strong evidence that the practice of same-sex anal intercourse is an independent risk factor for seroprevalence of individual vaccine HPV types. Examination of antibody responses to HPV infections at various anatomic sites in future studies is needed to elaborate on the mechanism.
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Affiliation(s)
- Beibei Lu
- H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612-9416, USA
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Nyitray AG, Carvalho da Silva RJ, Baggio ML, Lu B, Smith D, Abrahamsen M, Papenfuss M, Villa LL, Lazcano-Ponce E, Giuliano AR. Age-specific prevalence of and risk factors for anal human papillomavirus (HPV) among men who have sex with women and men who have sex with men: the HPV in men (HIM) study. J Infect Dis 2011; 203:49-57. [PMID: 21148496 DOI: 10.1093/infdis/jiq021] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND An increasing incidence of anal cancer among men suggests a need to better understand anal canal human papillomavirus (HPV) infection among human immunodeficiency virus-negative men. METHODS Genotyping for HPV was conducted on cells from the anal canal among men who have sex with women (MSW) and men who have sex with men (MSM), aged 18-70 years, from Brazil, Mexico, and the United States. Factors associated with anal HPV infection were assessed using multivariable logistic regression. RESULTS The prevalence of any HPV type and oncogenic HPV types did not differ by city. Anal canal HPV prevalence was 12.2% among 1305 MSW and 47.2% among 176 MSM. Among MSW, reporting a lifetime number of ≥ 10 female sex partners, a primary sexual relationship <1 year in duration, and a prior hepatitis B diagnosis were independently associated with detection of any anal HPV in multivariable analysis. Among MSM, a younger age, reporting ≥ 2 male anal sex partners in the past 3 months, and never using a condom for anal sex in the past 6 months were independently associated with detection of any anal HPV in multivariable analysis. CONCLUSIONS Number of sex partners was associated with anal HPV infection in both MSW and MSM. Anal HPV infection in men may be mediated by age, duration of sexual relationship, and condom use.
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Affiliation(s)
- Alan G Nyitray
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
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Teixeira JA, Baggio ML, Fisberg RM, Marchioni DML. Calibration of the dietary data obtained from the Brazilian center of the Natural History of HPV Infection in Men study: the HIM Study. CAD SAUDE PUBLICA 2010; 26:2323-33. [DOI: 10.1590/s0102-311x2010001200011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Accepted: 05/21/2010] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to estimate the regressions calibration for the dietary data that were measured using the quantitative food frequency questionnaire (QFFQ) in the Natural History of HPV Infection in Men: the HIM Study in Brazil. A sample of 98 individuals from the HIM study answered one QFFQ and three 24-hour recalls (24HR) at interviews. The calibration was performed using linear regression analysis in which the 24HR was the dependent variable and the QFFQ was the independent variable. Age, body mass index, physical activity, income and schooling were used as adjustment variables in the models. The geometric means between the 24HR and the calibration-corrected QFFQ were statistically equal. The dispersion graphs between the instruments demonstrate increased correlation after making the correction, although there is greater dispersion of the points with worse explanatory power of the models. Identification of the regressions calibration for the dietary data of the HIM study will make it possible to estimate the effect of the diet on HPV infection, corrected for the measurement error of the QFFQ.
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30
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Giuliano AR, Lazcano E, Villa LL, Flores R, Salmeron J, Lee JH, Papenfuss M, Abrahamsen M, Baggio ML, Silva R, Quiterio M. Circumcision and sexual behavior: factors independently associated with human papillomavirus detection among men in the HIM study. Int J Cancer 2009; 124:1251-7. [PMID: 19089913 DOI: 10.1002/ijc.24097] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is growing interest in understanding human papillomavirus (HPV) infection and related disease among men. To date there have been numerous studies reporting HPV DNA prevalence among men from several different countries, however, few have incorporated multivariable analyses to determine factors independently associated with male HPV detection. The purpose of this study was to assess the factors independently associated with HPV detection in men ages 18-70 years residing in Brazil (n = 343), Mexico (n = 312), and the United States (US) (n = 333). In samples combined from the coronal sulcus, glans penis, shaft, and scrotum, we evaluated factors associated with any, oncogenic, and nononcogenic HPV infections. In multivariable analyses, detection of any HPV infection was significantly associated with reported race of Asian/Pacific Islander, lifetime and recent number of sexual partners, and having sex in the past 3 months. Oncogenic HPV detection was independently associated with lifetime and recent number of sexual partners, and having sex in the past 3 months. NonOncogenic HPV infection was independently associated with lifetime number of sexual partners. Circumcision, assessed by clinical examination, was associated with reduced risk of HPV detection across all categories of HPV evaluated. HPV detection in men in the current study was strongly related to sexual behavior and circumcision status. Interventions such as circumcision may provide a low-cost method to reduce HPV infection.
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Affiliation(s)
- Anna R Giuliano
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
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31
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Schlecht NF, Trevisan A, Baggio ML, Galan L, Duarte-Franco E, Greenberg MD, Rohan TE, Ferenczy A, Villa LL, Franco EL. Lack of agreement between cervicography and cytology and the effect of human papillomavirus infection and viral load. J Low Genit Tract Dis 2006; 10:229-37. [PMID: 17012988 DOI: 10.1097/01.lgt.0000225892.03613.2c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cohort studies of the natural history of human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions with repeated screening allow the comparison of different macroscopic and microscopic diagnostic methods. MATERIALS AND METHODS Concurrent visual inspection using cervicography and conventional Pap cytology tests were performed during multiple visits in a cohort of women attending a maternal and child health clinic in São Paulo, Brazil. HPV infection status at the same visits was determined by polymerase chain reaction followed by typing with specific oligonucleotide probing and viral load quantification. Information on reproductive health and hygiene habits was also collected at each visit. RESULTS Overall agreement between cervicography and cytology was low (kappa = 0.046), which increased only slightly when high oncogenic-risk HPV types (kappa = 0.120) or high viral burden (>100 copies/cell) (kappa = 0.170) was present. Analysis of reproductive health and hygiene habits revealed somewhat different risk factors for cervical lesions detected by these tests. However, presence of oncogenic HPV DNA (odds ratio = 36.0, 95% CI = 16.6-77.8) and high viral burden (odds ratio = 67.34; 95% CI = 27.1-167.0) were strongly associated with lesions detected by cytology but not by cervicography. CONCLUSIONS Although changes in the cervix (because of age, gravidity, or hormonal effects) may influence the performance of morphology-based screening tests, the lack of agreement and the different degrees of association with HPV infection measures indicate that a visual inspection method such as cervicography may detect different cervical abnormalities relative to cytology.
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Affiliation(s)
- Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Giuliano AR, Siegel EM, Roe DJ, Ferreira S, Baggio ML, Galan L, Duarte-Franco E, Villa LL, Rohan TE, Marshall JR, Franco EL. Dietary Intake and Risk of Persistent Human Papillomavirus (HPV) Infection: The Ludwig‐McGill HPV Natural History Study. J Infect Dis 2003; 188:1508-16. [PMID: 14624376 DOI: 10.1086/379197] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2003] [Accepted: 06/03/2003] [Indexed: 11/03/2022] Open
Abstract
The association between dietary intake and persistence of type-specific human papillomavirus (HPV) infection, during a 12-month period, among 433 women participating in the Ludwig-McGill HPV Natural History Study was evaluated by use of a nested case-control design. Dietary intake was assessed by a food-frequency questionnaire at the month-4 visit. HPV status was assessed at months 0, 4, 8, and 12 by polymerase chain reaction (MY09/11). Only women who ever tested positive for HPV were included in the present study: 248 had transient HPV infections (1 of 4 positive tests or nonconsecutively positive), and 185 had persistent HPV infections (> or =2 consecutive tests positive for the same HPV type). Risk of type-specific, persistent HPV infection was lower among women reporting intake values of beta-cryptoxanthin and lutein/zeaxanthin in the upper 2 quartiles and intake values of vitamin C in the upper quartile, compared with those reporting intake in the lowest quartile. Consumption of papaya > or =1 time/week was inversely associated with persistent HPV infection.
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Affiliation(s)
- Anna R Giuliano
- University of Arizona Cancer Center and College of Public Health, Tucson, Arizona 85724-5024, USA.
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