Juvenile-onset recurrent respiratory papillomatosis with pulmonary involvement and carcinomatous transformation

Papilloma associated with recurrent respiratory papillomatosis (RRP), caused by human papilloma virus (HPV) infection types 6 and 11, is the most common benign neoplasm of the larynx. The clinical features of RRP vary widely from mild to aggressive forms. RRP in children is known as juvenile-onset recurrent respiratory papillomatosis (JORRP). Its outcome may be poor or even fatal due to the high rate of recurrence and eventual spread to the entire respiratory tract. Pulmonary invasion is reported to occur in 3.3% of patients with RRP, and malignant transformation in 0.5% of patients. We report the case of a 39-year-old female patient with a diagnosis of JORRP from the age of 3 years, with extensive bilateral pulmonary involvement and malignant transformation. Analysis of the papilloma and carcinomatous tissues revealed the presence of HPV type 11, which is associated with rapid and aggressive progression. We discussed the case on the basis of a literature review on pulmonary invasion, malignant transformation, and HPV 11 aggressiveness.

Multiple Human Papillomavirus Infection Is Associated with High-Risk Infection in Male Genital Warts in Ulsan, Korea

Further understanding of male human papillomavirus (HPV) infection is necessary to prevent infection in men, as well as transmission to women. In our current study, we investigated patterns of HPV infection and genotype distributions in male genital warts using the Anyplex II HPV28 Detection kit. We reviewed the medical records of 80 male patients who presented to 5 neighborhood clinics in Ulsan, Korea, for the treatment of genital warts between April 2014 and January 2015. All patients underwent HPV genotyping. The prevalence and characteristics of HPV infection were analyzed, and the patterns of HPV infection according to age were assessed. Among the study patients, 13 (16.3%) were negative for HPV infection, 46 (57.3%) were infected with low-risk HPV, and 21 (26.3%) were infected with high-risk HPV. Patients with multiple HPV infection were more likely to have high-risk HPV infection (P = 0.001). The prevalence of HPV infection was much higher in samples obtained by tissue excision due to a definite lesion (P = 0.001). There were no differences in high-risk HPV infection (P = 0.459), multiple HPV infection (P = 0.185), and recurrence at diagnosis (P = 0.178) according to age. HPV-6 and HPV-11 were the most common type overall (39.7% and 13.8%, respectively). HPV-16 and HPV-18 were the most common high-risk infections (both 3.4%). HPV infection is not only commonly encountered in male genital warts, but is also accompanied by high-risk HPV and multiple infections.

Electrocautery Resection, Shaving with a Scalpel, and Podophyllin: a Combination Therapy for Giant Condyloma Acuminatum

Giant condyloma acuminatum (also known as Buschke-Lowenstein tumor) is a rare disease, for which the treatment of choice is still controversial. In the case described in this report, we used a combination of electrocautery and a surgical scalpel to resect a huge genital wart, followed by long-term local treatment with podophyllin. This procedure was relatively fast, easy to perform, involved minimal bleeding, and did not result in any complications. Moreover, combination therapy enabled us to avoid deep resection of the lesion and consequently, sexual function was preserved completely.

Human papillomavirus infection is not related with prostatitis-related symptoms: results from a case-control study

PurposeTo investigate the relationship between human papillomavirus (HPV) infection and prostatitis-related symptoms.Materials and MethodsAll young heterosexual patients with prostatitis-related symptoms attending the same Center from January 2005 to December 2010 were eligible for this case-control study. Sexually active asymptomatic men were considered as the control group. All subjects underwent clinical examination, Meares-Stamey test and DNA-HPV test. Patients with prostatitis-related symptoms and asymptomatic men were compared in terms of HPV prevalence. Moreover, multivariable Cox proportional hazards regression analysis was performed to determine the association between HPV infection and prostatitis-related symptoms.ResultsOverall, 814 out of 2,938 patients (27.7%) and 292 out of 1,081 controls (27.0%) proved positive to HPV. The HPV genotype distribution was as follows: HR-HPV 478 (43.3%), PHR-HPV 77 (6.9%), LR-HPV 187 (16.9%) and PNG-HPV 364 (32.9%). The most common HPV genotypes were: 6, 11, 16, 26, 51, 53 and 81. No difference was found between the two groups in terms of HPV infection (OR 1.03; 95% CI 0.88-1.22; p = 0.66). We noted a statistically significant increase in HPV infection over the period 2005 to 2010 (p < 0.001) in both groups. Moreover, we found a statistically significant increase in HPV 16 frequency from 2005 to 2010 (p = 0.002).ConclusionsThis study highlights that prostatitis-like symptoms are unrelated to HPV infection. Secondary, we highlight the high prevalence of asymptomatic HPV infection among young heterosexual men.

Conhecimento e atitude de usuários do SUS sobre o HPV e as vacinas disponíveis no Brasil / SUS users? knowledge of and attitude to HPV virus and vaccines available in Brazil / SUS users? knowledge of and attitude to HPV virus and vaccines available in Brazil

OBJETIVO : Analisar o conhecimento de homens e mulheres acerca do HPV e das vacinas e sua intenção de serem vacinados e de vacinarem seus filhos adolescentes. MÉTODOS : Estudo descritivo, de corte transversal, com 286 mulheres (18 a 49 anos) e 252 homens (18 a 60 anos), usuários de cinco unidades básicas de saúde e duas policlínicas do Sistema Único de Saúde, em Campinas, SP, em 2011. Foi realizada entrevista estruturada. Realizou-se análise bivariada e regressão de Poisson para identificar variáveis associadas ao conhecimento sobre HPV e vacinas e à intenção de vacinação. RESULTADOS : Quase 40,0% dos entrevistados referiram ter ouvido falar do HPV e 28,9% mencionaram informações adequadas; a principal fonte de informação foi a mídia (41,7%); 8,6% tinham ouvido falar das vacinas. Depois de informados da existência das vacinas, cerca de 94,0% dos participantes disseram que se vacinariam e/ou vacinariam filhos adolescentes se as vacinas estivessem disponíveis na rede pública de saúde. Escolaridade > 8 anos e ser do sexo feminino estiveram independentemente associados a ter ouvido falar do HPV e das vacinas e a ter conhecimento adequado sobre o vírus. Maior idade associou-se a ter ouvido falar das vacinas. Não houve variáveis associadas à intenção de vacinação. CONCLUSÕES : Os resultados reforçam a necessidade de haver intervenções educativas na população para prover informação adequada sobre o HPV e sobre medidas de prevenção. .

Objetivo : Analizar el conocimiento de hombres y mujeres sobre el VPH y de las vacunas y su intención de ser vacunados y de vacunar sus hijos adolescentes. Métodos : Estudio descriptivo, de corte transversal, con 286 mujeres (18 a 49 años) y 252 hombres (18 a 60 años), usuarios de cinco unidades básicas de salud y dos policlínicas del Sistema Único de Salud, en Campinas, SP – Brasil, en 2011. Se realizó entrevista estructurada. Se utilizó el análisis bivariado y regresión de Poisson para identificar variables asociadas al conocimiento sobre VPH y vacunas y la intención de vacunación. Resultados : Casi el 40,0% de los entrevistados mencionaron haber oído hablar del VPH y 28,9% relataron informaciones adecuadas; la principal fuente de información fueron los medios de comunicación (41,7%); 8,6% habían oído hablar de las vacunas. Después de informados de la existencia de las vacunas, cerca de 94,0% de los participantes dijeron que se vacunarían y/o vacunarían hijos adolescentes si las vacunas estaban disponibles en la red pública de salud. Escolaridad > 8 años y ser del sexo femenino estuvieron independientemente asociados al haber oído hablar del VPH y de las vacunas y tener conocimiento adecuado sobre el virus Mayor edad se asoció al haber oído hablar de vacunas. No hubo variables asociadas a la intención de vacunación. Conclusiones : Los resultados refuerzan la necesidad de haber intenciones educativas en la población para proveer información adecuada sobre el VPH y sobre medidas de prevención .

OBJECTIVE : To investigate knowledge of HPV and HPV vaccines in men and women, users of the Brazilian Unified Health System, and the intention to get themselves and their teenage children vaccinated. METHODS : A descriptive, cross-sectional study with 286 women (18-49 years old) and 252 men (18-60 years old), users of five primary health units and two polyclinics in Campinas, SP, Southeastern Brazil, was carried out. Participants were interviewed in 2011 using a structured questionnaire. Bivariate and Poisson regression analysis were performed to identify variables associated with knowledge of HPV and HPV vaccines, and participants vaccination intentions. RESULTS : Almost 40.0% of the participants reported having heard of HPV and 28.9% mentioned adequate information. The main information source was the media (41.7%). Only 8.6% of the participants had heard of the HPV vaccines. Once the participants were informed of the existence of HPV vaccines about 94% of them said they would get vaccinated and/or vaccinate their teenage children, if the vaccines were available in the public health system. Schooling of over 8 years and being female were the variables independently associated with having heard of HPV, the vaccines and having adequate knowledge of the virus. Advanced age was associated with having heard of HPV vaccines. There were no variables associated with the vaccination intentions. CONCLUSIONS : These results reinforce the need for educational activities that provide the population with adequate information on HPV and preventive measures. .

Buschke -Loewenstein tumor: identification of HPV type 6 and 11 / Condiloma acuminado gigante de Buschke-Lowenstein: identificação dos HPV 6 e 11

The authors report a case of exuberant giant condyloma acuminatum of Buschke-Loewenstein in a male patient, slow-growing, progressive and with locally destructive behavior in the inguinal, body of the penis, scrotum, perineal and perianal regions. After surgery he showed no signs of recurrence in 20 months of follow-up. The identification of HPV types 6 and 11 was performed using in situ hybridization.

Os autores relatam um caso exuberante de condiloma acuminado gigante de Buschke-Lowenstein, em paciente do sexo masculino, de crescimento lento e progressivo e de comportamento destrutivo das regiões inguinal, corpo do pênis, escroto, perineal e perianal. Após tratamento cirúrgico, não apresentou sinais de recidiva em 20 meses de seguimento. A identificação dos HPVs, tipos 6 e 11, foi realizada através da técnica de hibridização in situ.

Tratamento do papiloma vírus humano na infância com creme de imiquimode a 5 por cento / Treatment of human papillomavirus in childhood with imiquimod 5 percent cream

Lesões decorrentes da infecção pelo papilomavírus humano na infância, em especial as verrugas anogenitais, são um importante problema epidemiológico e terapêutico. O tratamento das verrugas anogenitais na infância é um desafio terapêutico. Os tratamentos convencionais geralmente são dolorosos e necessitam de anestesia geral. O imiquimode, um imunomodulador tópico, constitui uma alternativa terapêutica. Serão descritos quatro casos tratados com sucesso utilizando creme de imiquimode a 5 por cento aplicado topicamente.

In children, lesions caused by the human papillomavirus (HPV) constitute a significant epidemiological issue and a therapeutic dilemma, particularly in the case of anogenital warts. The treatment of anogenital warts in children is a challenge, since standard treatments are generally painful and require the patient to be anesthetized. Imiquimod, a topical immune response modifier, constitutes an alternative therapeutic agent for the treatment of HPV. The present report describes four cases in which treatment with topically applied imiquimod 5 percent cream was implemented with successful results.

Phylogenetic classification of human papillomavirus genotypes in high-grade cervical intraepithelial neoplasia in women from a densely populated Brazilian urban region / Classificação filogenética dos genótipos de papilomavírus humano em neoplasia intraepitelial cervical de alto grau em mulheres de uma região urbana brasileira densamente povoada

CONTEXT AND OBJECTIVE: Differences in human papillomavirus (HPV) types may correlate with the biological potential and invasion risk of high-grade cervical intraepithelial neoplasia (CIN 2 and CIN 3). The objective of this study was to determine the relationship between different combinations of HPV types and CIN severity. DESIGN AND SETTING: Cross-sectional study, at Universidade Estadual de Campinas (Unicamp). METHODS: Cervical samples from 106 women treated due to CIN 2 (18) or CIN 3 (88) were examined for specific HPV genotypes using Roche Linear Array® (LA-HPV). The proportions of CIN 2 and CIN 3 in groups of women infected with the HPV phylogenetic groups A7 and A9 were compared. Three groups were formed: women with single infections; multiple infections; and the whole sample. RESULTS: Multiple infections were detected in 68 samples (64.7 percent). The most frequent high-risk genotypes detected (single/multiple) were HPV 16 (57.1 percent), HPV 58 (24.7 percent), HPV 33 (15.2 percent), HPV 52 (13.3 percent), HPV 31 (10.4 percent), HPV 51 (7.6 percent) and HPV 18 (6.6 percent). Women without infection with HPV species Alpha 9 were less likely to have CIN 3 than were their Alpha 9 HPV-infected counterparts. HPV 16 and/or HPV 18, with or without associations with other viral types, were more frequently found in women with CIN 3 than in those with CIN 2. CONCLUSIONS: The severity of high-grade CIN may be aggravated by the presence of HPV types included in the Alpha 9 phylogenetic classification and by infections including HPV 16 and 18, singly or in combination with other HPV genotypes.

CONTEXTO E OBJETIVO: Diferentes tipos de papilomavírus humano (human papillomavirus, HPV) podem ser correlacionados com a capacidade biológica e risco de invasão das neoplasias intra-epitelial de alto grau cervical (NIC 2 e NIC 3). O objetivo deste estudo foi determinar a relação de diferentes tipos de HPV com a gravidade da NIC. TIPO DE ESTUDO E LOCAL: Estudo transversal na Universidade Estadual de Campinas (Unicamp). MÉTODOS: Foram avaliados os genótipos específicos de HPV da amostra cervical de 106 mulheres com NIC 2 (18) ou NIC 3 (88), utilizando Roche Linear Array® (LA) HPV genotyping assay. Foram comparadas as proporções de NIC 2 e NIC 3 em grupos de mulheres infectadas com tipos de HPV dos grupos filogenéticos A7 e A9. Três grupos foram formados: mulheres com infecção simples; infecção múltipla; e infecção simples e múltipla. RESULTADOS: Infecções múltiplas foram detectadas em 68 (64,7 por cento) das amostras. Os genótipos de alto risco mais frequentemente detectados em infecção simples ou múltipla foram HPV 16 (57,1 por cento), HPV 58 (24,7 por cento), HPV 33 (15,2 por cento), HPV 52 (13,3 por cento), HPV 31 (10,4 por cento), HPV 51 (7,6 por cento) e HPV 18 (6,6 por cento). A probabilidade de mulheres com NIC 3 serem infectadas com HPV que não da espécie Alfa 9 era menor do que com os tipos de HPV da espécie Alfa 9. HPV 16 e ou 18, associado ou não com outros tipos virais eram mais frequentemente encontrados nas mulheres com NIC 3 do que naquelas com NIC 2. CONCLUSÃO: A gravidade da NIC de alto grau pode ser aumentada pela presença de tipos de HPV incluídos na classificação filogenética Alfa 9 e por infecções que incluem HPV 16 e 18 combinados ou não com outros genótipos de HPV.

Transfection of HPV11 genome DNA into human keratinocyte cell line HaCaT / 中华皮肤科杂志

Objective To explore if keratinocytes that stably maintain HPV11 genome can be obtained by transfection and selection methods. Methods Escherichia coil containing pBR322.HPV11 plasmid was cultured and amplified. Then the plasmid was extracted, purified and digested with BamH Ⅰ enzyme to release viral genome from the bacterial vector. After recovering from the low-melting point agarose gel by electrophoresis, the genome was self-circulated with T4 DNA ligase. The religated DNA was cotransfected with pTK-neo DNA into HaCaT keratinocytes using Lipofectamine reagent. After selection with G418 for 2 to 3 weeks, clonal and pooled cultures were expanded and analyzed. Fluorescent quantitative PCR (FQ-PCR) and nested reverse transcriptase PCR (nRT-PCR) were applied to detect HPV11 DNA and spliced HPV11 E1

Analysis of cervix HPV infection and its genotypes in women in Wuxi area / 国际检验医学杂志

Objective To detect the genotypes of human papillomaviral infection(HPV)in 970 women who were suspicious as HPV infection, and to investigate its clinical significance. Methods Cervical cast-off cells were acquired with the special cervix brush. DNA hybridization technique was applied to detecting HPV genotypes in 970 clinical specimens. Results Totally 390 case(40.2%) were HPV positive among 970 clinical specimens. A total of 12 subtypes were detected. In 390 cases of HPV infection,260 cases (26.8%) were infected with single HPV subtype, and while 130 cases(13.4%) were with infection of two or above HPV subtypes. HPV6 and 11 were the most frequent low-risk sub-types,and in the high-risk subtypes,HPV16,33,52,58 and 18 were dominant. Conclusion The cervix HPV infection rate is considerable in women in Wuxi area. HPV6 and 11 are the most frequent sub-types. The determination of HPV genotypes plays all important role in early discovery, prevention and treatment of gential tract and cervical cancer.

Effects of hyperthermia on the expression of E6 and E7 genes of human papillomavirus type 6 and 11 / 中华皮肤科杂志

Objective To investigate the effect of hyperthermia on the expression of E6 and E7 genes of human papillomavirus (HPV) type 6 and 11 in HPV-infected human skin. Methods Tissue samples were obtained from the lesions of condyloma accuminatum (CA) in 6 patients after informed consent. Each sample was divided into 4 parts: one was embedded and directly stored at -80 ℃; the other 3 parts were placed in culture medium and the surface of the samples was irradiated for 30 minutes with a thermotherapy apparatus at 37℃, 42 ℃, 45 ℃, respectively, then the samples were taken out and stored at -80 ℃. RNA was extracted from the specimens, real time quantitative PCR (qPCR) was performed to detect the expression of E6 and E7 genes of HPV-6 and -11. Results Of the 6 patients, 2 were infected with HPV-6 and -11 respectively, 4 with both HPV-6 and HPV-11. The expression of E6 and E7 mRNA decreased with the increase in irradiation temperature. The relative mRNA expression levels at 37 ℃, 42 ℃ and 45 ℃ were 1.00 ± 0.00, 0.61 ± 0.17, 0.27 ± 0.15, respectively, for HPV-6 E6 gene, 1.00 ± 0.00, 0.56 ± 0.21, 0.16 ± 0.11 respectively, for HPV-6 E7 gene, 1.00 ± 0.00, 0.60 ± 0.22, 0.16 ± 0.08, respectively, for HPV-I1 E6 gene, 1.00 ± 0.00, 0.55 ± 0.15, 0.24 ± 0.06, respectively, for HPV-11 E7 gene; statistical difference was noted among them between the specimens irradiated at different temperature (all P < 0.01). Conclusion Hyperthermia can remarkably suppress the expression of HPV-6/I 1 E6 and E7 genes, which may be a possible mechanism under the regression of warts induced by local hyperthermia.