Investigation on cervical HPV infection situation among 3 315 females in western Guangxi area / 国际检验医学杂志

Objective To investigate the infection status quo and genotype distribution of human papillomavirus(HPV) infection situation among females in west Guangxi area.Methods Cervical exfoliative cells samples from 3 315 women were collected to detect HPV genotyping with Cape flow-through hybridization.Then the results were statistically analyzed.Results The overall HPV infection rate was 21.30%(706/3 315),in the females of HPV positive infection,the high-risk type infection was predominant,accounting for 89.52%(632/706).The HPV infection type was dominated by single type infection,accounting for 72.66% the double infection accounted for 22.10%(156/706). The 21 HPV subtypes were detected.The high-risk HPV subtypes with high detection rate were HPV52(26.77%),HPV16(15.30%) and HPV58(15.01%).The low-risk HPV subtypes with high detection rate were HPV CP8304(11.90%) and HPV6(3.68%).The HPV subtypes were distributed differently at different ages.In 7 age groups of≤20,>20-30,>30-40,>40-50,>50-60,>60-70,>70 years old,the infection rates of high risk HPV were 21.62%(8/37), 19.26%(120/623),17.66%(220/1 246), 14.88%(153/1 028), 16.83%(51/303),15.52%(9/58) and 30.00%(6/20) respectively,showing no statistically significant differences among them(χ2=10.019,P=0.124).Conclusion Cervical HPV infection are mainly high-risk HPV subtypes and single type infection in females of western Guangxi area.The HPV subtypes with high infection rate are 52,16,58 and CP8304.

Analysis of the distribution of various types of HPV and their influencing factors among women with normal cervical cytology in the Shanghai area / 中华健康管理学杂志

Objective To understand the various HPV types and the factors influencing their distribution among women with normal cervical cytology in the Shanghai area, to provide basic data for cervical cancer prevention and vaccine use.Methods A questionnaire-based survey was conducted among 3 372 married women in the Shanghai area. A PCR reverse dot blot (PCR-RDB) method was adopted for HPV genotyping of cervical exfoliated cell samples from 3 206 women. Odds ratio (OR) for HPV infection were analyzed using logistic regression. Results Of the 3 206 women investigated, 669 (20.87%) were positive for HPV infection. The highest incidence of HPV infections was seen in the age groups of 55-59 years, 50-54 years and 45-49 years, with the rates of positive detection being 27.67%, 21.65%, and 21.55%, respectively. While 70.4% of the positive cases had a single infection, 29.6% showed multiple infections. In cases with multiple infections, double infection was predominant (20.63%). The top five high-risk gene types were HPV52(3.65%),HPV53(2.71%),HPV51(2.03%),HPV58(1.87%),and HPV16 (1.40%). The top three low-risk gene types were HPV81 (2.03%), HPV42 (1.43%), and HPV55 (1.31%). Among the women with HPV infections,there were 483 having medium-high-risk HPV infection.There were significant differences in the age,the age at first sexual activity,sexual activities per week,education,and alcohol consumption between HPV positive and HPV negative patients. Age stratification showed that the infection rates in the 55-59 years old group were significantly higher than that in the other age groups(χ2=15.349, P=0.000). Both single factor and multivariate non-conditional logistic regression analyses showed that higher education and the start of sexual activity at a later age were protective factors for medium-high-risk HPV infection,with regression coefficients of-0.165 and-0.08,respectively (P<0.01) in the multivariate analysis. The risk factors included age between 55- 59 years, menstrual status (menopause), sexual activity (≥3 times per week) and alcohol consumption. High-risk HPV infections also had the same risk factors,and the odds ratios were 1.558,1.275,and 1.678,respectively(P<0.01).However, 55-59 years of age and alcohol consumption are independent risk factors for medium-high risk HPV infection. Conclusions High-risk HPV in women of Shanghai is commonly caused by HPV52, HPV53, HPV51,HPV58,and HPV16.The high-risk group includes women who are 55-59 years old.While drinking is an independent risk factor for medium-high risk HPV infection, a moderate sex life and delayed age at first sex can reduce the risk of high-risk HPV infections.

Correlación cito-colpo-histológica de lesiones causadas por el virus del papiloma humano (HPV) y la utilidad de la técnica de PCR para determinar la infección por HPV / Correlation of cyto-colpo-histology in human papillomaviruses (HPV) lesions and the use of PCR technique in determining HPV infection

Introducción: El cáncer de cuello uterino es una patología prevalente más aun en países sub-desarrollados y existe una relación causal entre la infección persistente con algún tipo oncogénico de HPV y el desarrollo de dicha neoplasia.Se cuenta con un estudio de screening mundialmente aceptado y que también previene el carcinoma cervical que es el Papanicolaou y colposcopia, y en los últimos años se han incorporado estudios de biología molecular para el estudio del ADN viral.Material y Métodos: Se estudiaron a 60 pacientes. Se tomo como método gold standard a la biopsia de cuello uterino y a 29 pacientes se les realizo PCR para identificar ADN-HPV. La edad promedio de las pacientes fue de 30,95 años con mayor cantidad de pacientes en el rango etareo de 21-25 años. Resultados: El 70% tuvo citología negativa y 48 pacientes tuvieron biopsia positiva, 16 con resultado positivo de PCR. Obtuvimos una alta especificidad el Papanicolaou con respecto a la biopsia (90%), no así en comparación con el test de PCR (S=56% E=50%) debido al número pequeño de pacientes que se sometieron a este estudio. Discusión: Las mujeres menores de 30 años son las que más chances tienen de contraer la infección, no así de desarrollar la enfermedad debido a la historia natural de la misma, por lo que aconsejamos continuar con el screening regular de Papanicolaou/colposcopia e introducir con lapsos de 3 años o más en mujeres mayores a 30 años los estudios de biología molecular.Conclusiones: Se espera poder contar con mayores estrategias que nos permitan usar los beneficios de los test ADN-HPV sin sobre tratar a mujeres que probablemente atraviesan por una infección transitoria.

Introduction: Cervical cancer is a prevalent pathology, especially in underdeveloped countries, and there is a causal relationship between persistent infection with some type of oncogenic HPVs and the development of said neoplasia. There are two universally-accepted screening studies which also prevent cervical cancer, i.e. Pap smear and colposcopy, and, in the last few years some molecular biology studies have been adopted for the study of viral DNA. Material and methods: 60 patients were studied. Cervical biopsy was the gold standard method used and 29 patients were tested using the PCR technique to identify HPV-DNA. Patients' average age was 30.95, most of whom belonged to the 21-25 years old age span. Results: 70% of patients had negative cytology test and 48 patients obtained positive biopsy results, 16 had positive results in the PCR test. The Pap smear specificity was higher as regards the biopsy (90%), unlike the PCR test (S=56% E=50%) due to the small number of patients that underwent this study. Discussion: Women younger than 30 years old have more chances of infection, but no of developing the disease considering its natural history. Therefore, we recommend continuing with the Pap smear/colposcopy regular screening and introducing molecular biology studies in women older than 30 years old, every 3 years or more.Conclusions: We hope to have more strategies available which enable the use of HPV-DNA test benefits, without overtreating patients who are probably suffering from a transitory infection.

Correlation between ebv co-infection and HPV16 genome integrity in Tunisian cervical cancer patients

Infection with high risk Human papillomavirus (HR-HPV) is necessary but not sufficient to cause cervical carcinoma. This study explored whether multiple HR-HPV or coinfection with Epstein-Barr virus (EBV) influence the integration status of HPV16 genome. The presence and typing of HPV in a series of 125 cervical specimens were assessed by polymerase chain reaction (PCR) using the specific primers for the HPV L1 region. As for EBV infection, the viral EBNA1 gene was used for its detection through PCR amplification. Disruption of the HPV E2 gene was assessed by amplification of the entire E2 gene with single set of primers, while E2 transcripts were evaluated by a reverse transcription PCR method (RT-PCR). The overall prevalence of HPVDNA was of 81.8% in cervical cancers versus 26.9% in benign lesions. In HPV positive cases, HPV16 and HPV18 were the most prevalent types, followed by HPV types 33, 31. EBV EBNA1 prevalence was statistically more frequent in cervical carcinomas than in benign lesions (29.5%, vs 9.6%; P=0.01). No viral infection was detected in healthy control women. The uninterrupted E2 gene was correlated with the presence of E2 transcripts originating from the HPV episomal forms. It was observed that integration was more common in HPV18 and EBV coinfection. The presence of EBV caused a five-fold [OR= 5; CI= 1.15-21.8; P = 0.04] increase in the risk of HPV16 genome integration in the host genome. This study indicates that EBV infection is acting as a cofactor for induction of cervical cancer by favoring HPVDNA integration.

Factors Related to Human Papilloma Virus Infection Rate in Women / 가정의학회지

BACKGROUND: It is not clear which demographic factors would be considered for human papillomavirus (HPV) infection in Korean women and how women understand the HPV infection. This study was conducted to find the factors related to HIV infection and the realities of follow-up tests and perception among women infected with HPV. METHODS: The subjects were 2,113 women (median 41 years old) who received a Papanicolaou smear and a HPV DNA test at a health promotion center from March 2006 to October 2007. The follow-up rate and perception for HPV infection among women infected by HPV were surveyed using telephone. RESULTS: Overall prevalence of HPV infection was 17.3% (N = 365). However, the prevalence of HPV infection among women younger than 30 years old reached 30.7% (17.6% for low-risk group of HPV, 13.1% for high-risk group of HPV). The odds for being infected with HPV was 3.2 (95% confidence interval, 2.0 to 5.2) among unmarried women younger than 30 years old compared to those at the ages of 30 years or older. Married women younger than 30 years were also 2.1-4.3 times more likely to be infected with low-risk group of HPV compared to those aged 30 years or older. Among those infected with HPV and answered to the survey (N = 282), 51.4% took irregular gynecologic follow-up and 66.2% did not have information for the need or importance of follow-up examination. CONCLUSION: The risk of being infected with HPV seems to be higher for unmarried women younger than 30 years old. Additionally, a standardized guideline should be provided to improve follow-up examination and knowledge about HPV infection.

Relato de dois casos de condiloma imaturo: descrição dos achados colposcópicos, cervicográficos, cito-histológicos e moleculares / Report of two cases of immature cervical condyloma: description of colposcopic, cervicographic, cytohistological and molecular findings

Por meio da descrição de dois casos, os autores visam chamar a atenção para a forma de apresentação do condiloma imaturo ou metaplasia papilar imatura atípica (MPIA), assim como para as dificuldades de detecção citológica, classificação histológica e interpretação adequada. As características do condiloma imaturo ao colposcópio e na cervicografia foram relacionadas com seu aspecto histopatológico e com o padrão colposcópico do condiloma acuminado típico cervical. Exames citopatológicos resultaram negativos ou com células escamosas atípicas de significado indeterminado (ASCUS). Em um dos casos foi realizada captura híbrida para papilomavírus humano (HPV), que identificou tipos virais de alto e baixo graus. A partir do estudo dos casos concluiu-se que: a) o condiloma imaturo pode ser identificado por exame colposcópico ou cervicográfico, podendo ser precedido ou acompanhado do diagnóstico citológico de ASCUS ou detecção de HPV por teste molecular; b) a caracterização histopatológica dessas lesões como de baixo grau evita o tratamento cirúrgico desnecessário.

Based on the report of two cases, we aim to highlight the presentation of immature condyloma or atypical papillary immature metaplasia (AIM) as well as the difficulties in its cytological detection, histopathological classification and accurate interpretation of results. The colposcopic and cervicographic characteristics of the immature condyloma were related to its histopathological features and the colposcopic standard of acuminated condyloma. Cytopathological exam results were negative or presented atypical squamous cells of undetermined significance (ASCUS). In one case, a hybrid capture test for human papillomavirus (HPV) was carried out, what identified viral types of high and low grades. The study concluded that: 1) immature condylomas may be identified by means of colposcopic or cervicographic exam, and may be preceded or followed by a cytological diagnosis for ASCUS or HPV detection using molecular test; 2. histopathological characterization of these lesions as low grade avoids unnecessary surgical treatment.