Human papillomavirus infection inhealthy men from Rio de Janeiro, Brazil / Infecções por papilomavírus humanos em homens saudáveis do Rio de Janeiro, Brasil

Genital infections by human papillomavirus (HPV) are the most prevalent sexually transmitted viral diseases worldwide. Although the naturalhistory of cervical cancer is better understood, there are still scarce information regarding the etiology of penile cancer, and the natural history of HPV infection in men is not yet fully elucidated. Objective: This study aimed to determine the prevalence of HPV infection in penile samples, from a clinicall yasymptomatic male population. Methods: A total of 550 samples were collected between January 2011 and July 2014 in different institutions in the Stateof Rio de Janeiro, including a dermatology clinic and a metallurgical company. The samples were collected from the anatomical regions of the glans andbalanopreputial sulcus. HPV identification was made through the generic and type-specific Polymerase Chain Reaction (PCR), and Restriction FragmentLength Polymorphism (RFLP) techniques. Results: An overall prevalence of HPV infection was observed in 21.8% (120 subjects). The most prevalent HPV type was HPV 6 (35%), followed by HPV 16 (20.8%), HPV 11 (19.1%), HPV 31 (6.7%), HPV 33 (6.7%), HPV 45 (8.3%) and HPV 58 (3.3%). Hence,infection was associated with low-risk oncogenic types in 54.1% of the studied individuals, while high-risk oncogenic types were detected in 45.9% ofthem. The age of the studied subjects ranged from 18 to 65 years with a mean age of 28.4 years. Conclusion: According to our findings, we can infer thatthe prevalence of HPV infection among asymptomatic male population was considerably lower than the described in the literature, although in agreementwith results reported in some recently published studies. We believe that the results may contribute to understand the features of circulation of HPV in malepopulation, in order to evaluate risk-benefits and strategies of disease prevention.

As infecções genitais pelo Papilomavírus humano (HPV) são hoje as mais prevalentes viroses de transmissão sexual em todo o mundo. Embora a história natural do câncer cervical seja melhor compreendida, pouco se sabe sobre a etiologia do câncer de pênis e a história natural do HPV no homem não está completamente elucidada. Objetivo: Este estudo teve como objetivo, determinar a prevalência do HPV em amostras penianas de uma população masculina assintomática. Métodos: Foram coletadas 550 amostras entre janeiro de 2011 e julho de 2014 em diferentes instituições do Estado do Rio de Janeiro, dentre elas:uma clínica de dermatologia e uma indústria metalúrgica. As amostras foram coletadas de sítios anatômicos como sulco balanoprepucional. A identificação do HPV foi feita pela Reação em Cadeia da Polimerase (PCR) genérica e tipo-específica, bem como pelo Polimorfismo do padrão de comprimento de fragmentos de restrição (RFLP). Resultados: A prevalência total da infecção pelo HPV foi de 21,8% (120 indivíduos). O tipo viral de maior prevalência foi o HPV 6 (35%),seguido pelo HPV 16 (20,8%), HPV 11 (19,1%), HPV 31 (6,7%), HPV 33 (6,7%), HPV 45 (8,3%) e HPV 58 (3,3%). A infecção foi majoritariamente associada a tipos de baixo risco oncogênico (54,1%), enquanto os genótipos oncogênicos foram detectados em 45,9% dos pacientes. A idade dos pacientes variou de 18 a 65 anos com média de 28,4. Conclusão: De acordo com nossos achados, podemos sugerir que a prevalência do HPV na população masculina assintomática foi consideravelmente menor do que a descrita em alguns estudos da literatura, mas em acordo com o reportado recentemente por vários autores. Acreditamos que estes resultados podem contribuir para a compreensão dos aspectos epidemiológicos associados à infecção no trato genital masculino, a fim de avaliar estratégias de prevenção de doenças associadas e avaliar o risco-benefício das diferentes abordagens aplicadas em Saúde-Pública.

An evaluation of p16INK4a expression in cervical intraepithelial neoplasia specimens, including women with HIV-1

Although several studies have evaluated the role of p16INK4a as a diagnostic marker of cervical intraepithelial neoplasia (CIN) and its association with disease progression, studies regarding the role of p16INK4a in human immunodeficiency virus (HIV)-infected patients remain scarce. The present study was designed to determine the potential utility of p16INK4a as a diagnostic marker for CIN and invasive cervical cancer in HIV-positive and negative cervical specimens. An immunohistochemical analysis of p16INK4a was performed in 326 cervical tissue microarray specimens. Performance indicators were calculated and compared using receiving operating characteristics curve (ROC)/area under the curve. In HIV-1-negative women, the percentage of cells that was positive for p16INK4a expression was significantly correlated with the severity of CIN (p < 0.0001). A ROC curve with a cut-off value of 55.28% resulted in a sensitivity of 89%, a specificity of 81%, a positive predictive value of 91% and a negative predictive value of 78%. HIV-seropositive women exhibited decreased expression of p16INK4a in CIN2-3 specimens compared with HIV-negative specimens (p = 0.031). The ROC data underscore the potential utility of p16INK4a under defined conditions as a diagnostic marker for CIN 2-3 staging and invasive cervical cancer. HIV-1 infection, however, is associated with relatively reduced p16INK4a expression in CIN 2-3.