HPV and Covid-19 Era: effects of nonpharmaceutical interventions on HPV transmission

Human papillomavirus (HPV) is considered the commonest viral cause of sexually transmitted infections. The impact of social distance measures due to Covid-19 pandemic on HPV spread is unknown. Therefore, this study has analyzed the seven-year trend of HPV prevalence in all patients tested for HPV DNA at the Microbiology and Virology Unit at Bari Policlinico. Moreover, the HPV prevalence in 2020 has been compared with the previous year ones in order to evaluate the consequences of lockdown and social distancing measures on transmission risks. From 2013 to 2020, we retrospectively analyzed 64 anal swabs, 418 biopsies, 5925 cervical-vaginal swabs, 512 cervical swabs, 104 gland swabs, 154 oral swabs, 21 seminal fluids and 503 urethral swabs. HPV DNA detection was initially performed using nested-polymerase chain reaction (PCR) and subsequently multiplex real-time PCR assay. All statistical tests were carried out by the open-source environment R 4.0.3 (R Core Team). The data were analyzed according to yearly positivity rates, temporal trend and prevalence of HPV genotypes (HPV-6, HPV-11, HPV-16, HPV-18, high risk and low risk) by age category and sex. The number of patients increased steadily from 2016 to 2019 and then decreased in 2020. There were significant differences in prevalence between females and males for HPV-6 (6.16% in females Vs 30.80% in males), HPV-11 (0.82% Vs 7.16%) and HPV-16 (7.77% Vs 5.01%). The prevalence of HPV-6 and HPV-11 significantly increased in 2020 compared to 2013-2019 (15.72% Vs 8.52 and 3.18% Vs 1.44%). On the contrary, the overall prevalence of HPV DNA remained constant in 2020 (52.84% Vs 48.44%). Over time, the prevalence of HPV DNA (Coefficient=-0.020, p-value = 0.036) and particularly high-risk genotypes (Coefficient=-0.030, p-value = 0.005) decreased in females, while low-risk genotypes (Coefficient = 0.141, p-value= < 0.001) and the prevalence of HPV DNA increased in males (Coefficient = 0.068, p-value = 0.008). During the pandemic, the number of screened patients declined, although HPV prevalence compared to 2013-2019 remained constant or increased as in the case of low-risk genotypes. It can be assumed that the reduction of the screening coverage favored the emerging of the more symptomatic low-risk infections. In conclusion, nonpharmaceutical interventions due to Covid-19 pandemic did not reduce the risk of HPV infection but it likely caused a decrease in access to health services resulting in an increased risk of undiagnosed HPV.

Autologous tooth graft: a histological comparison between dentin mixed with xenograft and dentin alone grafts in socket preservation

The aim of this study is to compare the histological results after socket preservation between dentin mixed with xenograft and dentin alone in tooth graft procedure. Six patients were included in this prospective case series study and treated in three clinical centers using standardized clinical procedures. This clinical trial enrolled patients with three walls post-extractive defects requiring the restoration of bone dimension and shape in mandibular zone. The patients were divided in two groups: extracted teeth alone (first group) and extracted teeth mixed with equal quantity of xenograft (second group). The extracted tooth was cleaned and processed by a recently introduced automated device, that allows fragmentation and partial demineralization of the tooth matrix and used as graft material. The graft obtained in this way, was inserted at the time of the extraction. A covering membrane was used to protect the graft. Implants were placed after 4 months of healing. Bone biopsies of the all grafted sites were taken at the time of implant surgery, for histological analysis. Descriptive statistics was used to synthesize the results, using mean values and standard deviations. Six patients (5 women, mean age at surgery 50.3±12.1 years) were treated and after 4 months of healing both groups, grafts height appeared stable. No signs of infection were present. Bone biopsy were taken in all grafted sites (3 with group one and 3 with group two). The histologic analysis revealed no inflammatory or infective reaction against both groups. The histomorphometry results between the two groups are different. The first group show an amount of new bone greater than the second group (+85.29%) and minor quantity of residual graft (-83.59%). The dentin alone shows a larger amount of new bone.