High incidence of herpes simplex virus-1 in cord blood and placenta infection of women in southern Brazil / Alta incidência do vírus herpes simplex 1 em sangue de cordão e infecção na placenta de mulheres no sul do Brasil

Abstract Objective Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. Methods Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencingwere used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. Results The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. Conclusion The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.

Resumo Objetivo Estimar a prevalência do DNA do vírus herpes humano 1 (HSV-1) em amostras de placenta, sua incidência no sangue do cordão umbilical de recém-nascidos e fatores de risco associados. Métodos Biópsias de placenta e de sangue de cordão umbilical foram analisadas, totalizando 480 amostras de parturientes assintomáticas e seus recém-nascidos emum hospital universitário. Reação de cadeia de polimerase (RCP) nested e sequenciamento gênico foram usados para identificar o vírus; odds ratio (OR) e risco relativo (RR) foram realizados para comparar os fatores de risco associados à essa condição. Resultados A prevalência do DNA do HSV-1 em amostras de placenta foi de 37,5%, e a incidência no sangue do cordão foi de 27,5%. A via transplacentária hematogênica foi identificada em 61,4% das amostras de HSV-1+do sangue do cordão umbilical, pareadas com o tecido placentário. Nenhuma evidência do vírus foi observada nos restantes 38,6% dos tecidos placentários, sugerindo uma infecção ascendente do trato genital. A falta de uso do preservativo aumentou o risco de encontrar o HSV-1 na placenta e no sangue do cordão umbilical. Conclusão A ocorrência de DNA do HSV-1 na placenta e no sangue do cordão umbilical sugere uma transmissão vertical de gestantes assintomáticas para o feto.

Characterisation of complete high- and low-risk human papillomavirus genomes isolated from cervical specimens in southern Brazil

The classification of human papillomavirus (HPV) intratypic lineages by complete genome sequencing is a determinant in understanding biological differences in association with this disease. In this work, we have characterised complete HPV genomes from southern Brazil. Fifteen cervicovaginal Pap smear negative samples previously categorised as HPV-positive were sequenced using ultradeep sequencing, and 18 complete genomes from 13 different HPV types were assembled. Phylogenetic and genetic distance analyses were performed to classify the HPV genomes into lineages and sublineages. This is the first report describing the distribution of HPV intratype lineages of high and low oncogenic risk in asymptomatic women from southern Brazil.

Human papillomavirus type distribution and HPV16 intratype diversity in southern Brazil in women with and without cervical lesions

BACKGROUND Increasing evidence suggests that human papillomavirus (HPV) intratype variants (specific lineages and sublineages) are associated with pathogenesis and progression from HPV infection to persistence and the development of cervical cancer. OBJECTIVES This study aimed to verify the prevalence of HPV infection and distribution of HPV types and HPV16 variants in southern Brazil in women with normal cytology or intraepithelial lesions. METHODS HPV typing was determined by L1 gene sequencing. To identify HPV16 variants, the LCR and E6 regions were sequenced, and characteristic single nucleotide variants were identified. FINDINGS A total of 445 samples were studied, with 355 from cervical scrapes and 90 from cervical biopsies. HPV was detected in 24% and 91% of these samples, respectively. The most prevalent HPV types observed were 16 (cervical, 24%; biopsies, 57%) and 58 (cervical, 12%; biopsies, 12%). Seventy-five percent of the HPV16-positive samples were classified into lineages, with 88% defined as lineage A, 10% as lineage D, and 2% as lineage B. MAIN CONCLUSIONS This study identified a high frequency of European and North American HPV16 lineages, consistent with the genetic background of the human population in southern Brazil.

Frequência do Papilomavírus Humano na placenta, no colostro e no sangue do cordão umbilical / Frequency of Human Papillomavirus in the placenta, in the colostrum and in the umbilical cord blood

OBJETIVO: Determinar a frequência do Papilomavírus Humano (HPV) na placenta, no colostro e no sangue do cordão umbilical de parturientes e seus neonatos atendidos no Ambulatório de Ginecologia e Obstetrícia do Hospital Universitário de Rio Grande (RS), Brasil. MÉTODOS: Foram coletadas biópsias de 150 placentas do lado materno, 150 do lado fetal, 138 amostras do sangue do cordão umbilical e 118 amostras de colostro. As biópsias de placenta foram coletadas da porção central e periférica. O DNA foi extraído segundo protocolo do fabricante e conforme referência encontrada na literatura. O HPV foi detectado pela técnica da reação em cadeia da polimerase aninhada (PCR-Nested) com os primers MY09/11 e GP5/GP6. A genotipagem foi por sequenciamento direto. As participantes responderam a um questionário autoaplicado com dados demográficos e clínicos, a fim de caracterizar a amostra. RESULTADOS: O HPV foi detectado em 4% (6/150) do lado materno das placentas, 3,3% (5/150) do lado fetal; 2,2% (3/138) no sangue do cordão e 0,8% (1/118) no colostro. A taxa de transmissão vertical foi de 50%. O genótipo de baixo risco oncogênico encontrado foi o HPV-6 (60%) e de alto risco, os HPV-16 e HPV-18 (20% cada). CONCLUSÕES: Esses resultados sugerem que o HPV pode infectar a placenta, o colostro e o sangue do cordão umbilical. .

PURPOSE: To determine the frequency of Human Papillomavirus (HPV) in the placenta, in the colostrum and in the umbilical cord blood of parturient women and their newborns assisted at the Clinic of Gynecology and Obstetrics of the University Hospital of Rio Grande (RS), Brazil. METHODS: Biopsies were collected from 150 placentas on the maternal side, 150 on the fetal side, 138 samples of umbilical cord blood and 118 of the colostrum. The placenta biopsies were collected from the central and peripheral portions. DNA was extracted according to the manufacturer's protocol and to a reference found in the literature. HPV was detected by the nested polymerase chain reaction (PCR-Nested) using primers MY09/11 and GP5/GP6. Genotyping was performed by direct sequencing. The participants responded to a self-applied questionnaire with demographic and clinical data, in order to characterize the sample. RESULTS: HPV was detected in 4% (6/150) of cases on the mother's side of the placentas, in 3.3% (5/150) on the fetal side, in 2.2% (3/138) in umbilical cord blood and in 0.84% (1/118) in colostrum samples. The vertical transmission rate was 50%. HPV-6 was the low-risk genotype found (60%) and the high-risk genotypes were HPV-16 and HPV-18 (20% each). CONCLUSIONS: These results suggest that HPV can infect the placenta, the colostrum and the umbilical cord blood. .