Correlation between persistent high-risk human papillomavirus infection and vaginal microecology and cervical lesions / 中国热带医学

@#Abstract: Objective To investigate the correlation between persistent and non-persistent HPV infection and vaginal microecology and cervical lesions, and to provide the basis for HPV prevention and treatment. Methods In this prospective study, 229 female patients with high-risk type (HR-HPV) were selected for cervical cytology and vaginal microecological examination in the gynecological outpatient department of Baise Maternal and Child Health Hospital from January 2018 to June 2021. The patients were followed up for 1 year to detect persistent HR-HPV infection. The relationship between HR-HPV persistent infection and vaginal microecology and cervical lesions was analyzed using the HPV-negative group as a control. Results Among 229 patients with HR-HPV, there were 109 patients with persistent HR-HPV infection and 120 patients with non-persistent HR-HPV infection in 1-year follow-up, and the incidence of persistent HR-HPV infection was 47.6%. In the HR-HPV persistent and non-persistent infection and HPV-negative groups, the bacterial vaginal incidence was 20.2%, 15.0% and 8.6%, respectively; vulvovaginal candidiasis was 19.3%, 13.3% and 7.9%, respectively; trichomoniasis vaginitis was 12.8%, 9.2% and 4.5%, respectively; mixed infection was 10.1%, 6.7% and 2.7%; H2O2 detection rate was 24.8%, 18.3% and 12.0%,the positive rate of pH value was 52.3%, 40.8% and 36.4%, and microecological normal detection rate was 22.9%, 32.7% and 40.2%, respectively. There were significant differences among the three groups (χ2=10.634, 10.522, 9.010, 9.374, 10.054, 8.268, P<0.01). In the HR-HPV persistent and non-persistent infection groups, the rates of atypical squamous cell detection were 12.8% and 10.0%, and 8.3% and 4.2% for low-grade squamous cell lesions, and 4.6% and 1.7% for high-grade squamous cell carcinoma, 2.8% and 0 for squamous cell carcinoma, respectively. There was no significant difference in the composition of atypical squamous cells between the two groups (χ2=4.358, P>0.05), there were significant differences in the composition of low-grade, high-grade and squamous cell carcinoma (χ2=11.472, 12.685, 11.378, P<0.01). Spearman rank correlation analysis showed that the presence or extent of HPV infection was positively correlated with bacterial vaginosis, vulvovaginal candidiasis, trichomonal vaginitis and mixed infection (P<0.05), positively correlated with H2O2, sialdase, leucocyte esterase,pH positive and positive for all four items (P<0.05), negatively correlated with microecology (P<0.01), positively correlated with low grade, high grade and squamous cell carcinoma (P<0.01), and not significantly correlated with atypical squamous cell carcinoma (P>0.05). Conclusion Persistent cervical HPV infection is an important factor of dysregulation in vaginal microecology and aggravates the degree of dysregulation in vaginal microecology, which is related to the development of cervical lesions.

Clinical significance of high-risk HPV-DNA detection combined with TCT in screening and follow-up of cervical lesions / 上海预防医学

ObjectiveTo explore the application value of high-risk HPV-DNA detection combined with TCT in cervical lesion screening and follow-up. MethodsThis study was conducted from February 2019 to February 2021. During this period， 241 subjects who were the patients referred from the primary community hospitals to the center for re-examination of cervical lesions. Of which 80 were patients with cervical intraepithelial neoplasia. Liquid-based cytology （TCT） technology was used to examine the cervical cytological morphology. The second-generation high-throughput sequencing technology and time-of-flight mass spectrometry technology， independently developed by BGI， were used to screen for HPV-DNA typing. At the same time， biopsy sampling was carried out， and the final pathological diagnosis was made. TCT detection and combined HPV-DNA detection were performed on 80 patients to compare the relationship between TCT alone and TCT/HPV-DNA combined test for the diagnosis and prognosis of CIN Ⅱ and CIN Ⅲ. Follow-up was conducted， and the HPV infection and TCT were re-tested. ResultsAmong the 80 cases of cervical intraepithelial neoplasia， 41 cases （51.25%） were between 35 and 44 years old， higher than the other age groups （P<0.001）. Compared with either TCT or HPV-DNA， TCT combined with HPV-DNA had obvious advantages in sensitivity， specificity， positive predictive value， and negative predictive value （P<0.05）. The recurrence rate in CIN Ⅱ and CIN Ⅲ groups was 9.52% and 16.67% respectively after 18 months of the follow-up. ConclusionTCT detection plays a positive role in cervical pre-cancer screening. By combining high-risk HPV-DNA typing and TCT detection， the detection values of sensitivity and specificity are significantly higher， which can improve the accuracy of cervical lesion screening and is of great significance for the follow-up work.

HPV infection and cervical lesion cytotyping among medical staff in a class A hospital of Shanghai / 上海预防医学

Objective To study the relationship between cytology of cervical lesion and HPV in female medical workers. Methods From Fudan University Hospital of Obstetrics and Gynacology the results of cervical cytology screening in 1 093 female medical staff in 2015-2017 and results of HPV screening in 1 085 cases in 2017 were collected.SurePath liquid-based cell preparation was used for cytology and the segr-21 typing kit was used for HPV detection.The relationship between the pathological results of cervical colposcopy biopsy and HPV infection was studied by single factor and multiple factor regression analysis. Results The rate of HPV infection for subjects in the study was 10.0% (108/1 085), with increase in age, the infection rate showed an insignificant rising trend(χ2=4.43, P=0.11).High-risk HPV infection accounted for 95.37% (103/108), and the major high-risk HPV infections were HPV 52, HPV53, HPV58, and HPV16 in descending order.The 3-year cytological positive rates were 1.5%, 1.6% and 4.0%, respectively.Sixty-six of the HPV and/or cytological positive cases underwent colposcopy biopsy, and the proportion of cytology being positive, HPV positive, HPV16 positive, cytology negative in 2015 and 2016 was 41.1%, 19.1%, 60% and 29.7%, respectively.Multiple logistic regression showed that cytology was an independent risk factor, OR=7.87 (95%CI:1.85-33.54). Conclusion The rate of HPV infection in medical staff is lower than that in the general population, but the composition ratio of high-risk HPV infection is very high.It is recommended that women should undergo HPV test regularly from sexual life; early detection of high-risk HPV infection could prevent the occurrence of cervical cancer.The sensitivity and specificity of cervical cytology screening prove to be higher than those of HPV screening in people with low infection rate, and the cytology screening cycle should not exceed one year.

Clinical Observation of Recombinant Human Interferon Gel Combined with Baofukang Suppository in the Treat- ment of Cervical High-risk HPV Infection / 中国药房

OBJECTIVE：To inv estigate therapeutic efficacy and safety of recombinant human interferon gel combined with Baofukang suppository in the treatment of cervical high-risk human papillomavirus （HPV）infection. METHODS ：Totally 259 patients with persistent high-risk HPV infection diagnosed and treated in gynecology department of the First Affiliated Hospital of Hainan Medical University from Aug. 2017 to Sept. 2019 were selected and divided into interferon group （n＝82），Baofukang suppository group （n＝86）and combination group （n＝91）according to random number table. The patients in interferon group and Baofukang suppository group were given Recombinant human interferon α2b gel 1 g, qd or Baofukang suppository 1 capsule，qd； the patients in combination group were given Recombinant human interferon α2b gel and Baofukang suppository 1 capsule，qd；for 3 months. Then the clinical efficacy ，negative time of HPV ，duration of abnormal secretion ，LCT test results ，cervical inflammation score ，HPV relative light unit/critical value （RLU/CO）and the incidence of ADR were recorded. RESULTS ：The total effective rate of combination group was significantly higher than that of interferon group and Baofukang suppository group ， the negative time of HPV and duration of abnormal secretion in combination group were significantly shorter than interferon group and Baofukang suppository group （P＜0.05）. Before treatment ，the normal rate of LCT of 3 groups were 0，and there was no statistical significance in cervical inflammation score and HPV RLU/CO among 3 groups（P＞0.05）. After treatment ，normal rate of LCT was increased in 3 groups，compared with before treatment （P＜0.05），and normal rate of LCT in combination group was significantly higher than interferon group and Baofukang suppository group. The cervical inflammation score and HPV RLU/CO were significantly lower than before treatment ，and the combination group was significantly lower than interferon group and Baofukang suppository group （P＜0.05）. There was no statistical significance in above indicatora after treatment betwent interferon group and Baofukang suppository group and the incidence of ADR among 3 groups during medication （P＞0.05）. CONCLUSIONS：The application of recombinant human interferon gel combined with Baofukang suppository is effective and safe way in the treatment of cervical high-risk HPV infection.

Reduction in HPV 16/18 prevalence among young women following HPV vaccine introduction in a highly vaccinated district, Japan, 2008–2017 / Journal of Rural Medicine

Objective: Human papillomavirus (HPV) vaccination was introduced in Japan in April 2013, as a national immunization program for girls aged 12–16 years, after an initial introduction in 2010 as a public-aid program for girls aged 13–16 years. The Yuri-Honjo district had the highest vaccine coverage among women aged 17–51 years in 2017, due to the original public-aid program. The aim of this study was to evaluate the differences in the vaccine types of HPV16/18 infections between 2008–2012 (pre-vaccine era) and 2013–2017 (vaccine era).Materials and Methods: We evaluated whether HPV vaccination was associated with a decrease in the prevalence of HPV16/18 and high-risk HPV and the incidence of HPV-associated cervical lesions. A total of 1,342 women aged 18–49 years, covering both the pre-vaccine and vaccine eras, who visited Yuri Kumiai General Hospital and underwent HPV genotype tests from June 2008 to December 2017 were compared.Results: Among women aged 18–24 years with higher vaccine coverage (68.2%), the prevalence of HPV16/18 and high-risk HPV decreased from 36.7% and 69.4%, respectively, in the pre-vaccine era to 5.8% and 50.0%, respectively, in the vaccine era (p=0.00013 and p=0.047, respectively). Among those with cervical intraepithelial neoplasia grade 2− and grade 2+, HPV16/18 prevalence decreased from 30.0% to 2.7% (p=0.0018) and from 81.8% to 36.4% (p=0.030), respectively. In this age group, the rate of HPV16/18 positivity decreased significantly. Among age groups with lower vaccine coverage, HPV prevalence did not significantly differ between the two eras.Conclusion: The prevalence of HPV16/18 and high-risk HPV significantly decreased in women aged 18–24 years, most of whom were vaccinated. HPV vaccination effectively reduced the prevalence of HPV16/18 infections in the Yuri-Honjo district.

Prevalencia del virus del papiloma humano en mujeres con citología negativa / Prevalence of Human Papillomavirus Infection in Women with Negative Cytology

Introducción: la infección persistente por los subtipos oncogénicos del virus del papiloma humano es la causa principal del desarrollo del cáncer cérvico-uterino. Las mujeres que presentan citología normal pueden estar infectadas por subtipos de alto riesgo carcinogénico. Objetivo: brindar información actualizada existente en la literatura científica internacional acerca de la prevalencia de la infección por el virus del papiloma humano a nivel mundial y de la importancia de la detección temprana de estos virus en mujeres con citología negativa. Método: se realizó una revisión de los estudios desarrollados a nivel global y para esto se utilizaron las bases de datos PubMed, MedLine, BioMed Central y SciELO. Resultados: la prevalencia de la infección por los subtipos de alto riesgo del virus del papiloma humano en las mujeres con citología normal fue del 10 - 12 por ciento, con algunas diferencias entre países. El mayor pico de frecuencia de esta infección viral se localizó en jóvenes menores de 25 años y, en algunas regiones geográficas, se observó un segundo pico en mayores de 49 años. Los cinco subtipos oncogénicos más frecuentes de estos virus fueron 16, 18, 31, 52 y 58 con ciertas variaciones a nivel global. Conclusiones: el diagnóstico precoz de la infección por el virus del papiloma humano, especialmente los genotipos de alto riesgo, es un factor importante para una mejor prevención del cáncer cérvico-uterino(AU)

Introduction: Persistent infection with the oncogenic subtypes of human papillomavirus is the leading cause of cervical cancer. Women with normal cytology may be infected with subtypes of high carcinogenic risk. Objective: Provide updated information on the prevalence of human papillomavirus infection worldwide and the importance of their early detection in women with negative cytology. Methods: A review of the studies developed at a global level was carried out and PubMed, MedLine, BioMed Central, and SciELO databases were used. Results: The prevalence of infection with high - risk subtypes of human papillomavirus in women with normal cytology was 10 - 12 percent, with some differences between countries. The highest peak of frequency of this viral infection was located in young women under 25 years old and, in some geographic regions a second peak could be observed in those older than 49 years. The five most frequent oncogenic subtypes of these viruses were 16, 18, 31, 52 and 58 with certain variations globally. Conclusions: Early diagnosis of human papillomavirus infection, especially high-risk genotypes, is an important factor for better prevention of cervical-uterine cancer(AU)

Paiteling treatment of cervical cervical high-risk HPV infection outcome / 中国生化药物杂志

Objective To explore the treatment effect on cervical Paiteling cervical high-risk human papiloma virus(HPV) infection outcome.MethodsRandomly selected from our hospital during January 2014 to January 2016 in 120 cases of cervical high-risk HPV infection patients as the research object, of which 40 cases were treated with Paiteling treatment (Paiteling group), 40 patients were treated with foscarnet sodium (foscarnet sodium group).Another 40 patients without intervention (control group).The outcome of HPV infection in three groups was compared.ResultsPatients with negative rate of special spirit (87.50%) and foscarnet sodium group (55.00%) and control group (50.00%) was statistically significant(P<0.05), and the special spirit Group continued the positive rate (2.50%) was significantly lower than the control group (42.50%) and foscarnet sodium group (37.50%).However, there was no significant difference between the groups in the rate of improvement and the incidence of new infections.There was no significant difference between the control group and the positive rate (50.00%) in the control group (42.50%) compared with that in the control group.ConclusionPaiteling treatment of clinical effect of cervical high-risk HPV infection, can effectively improve the symptoms of HPV infection, which can shorten the HPV clearance time, has positive clinical significance.

Selenium compound induces apoptosis of cervical carcinoma cells of high risk HPV subtypes / 基础医学与临床

Objective To investigate the inducing effects and related pathways of selenium dioxide ( SeO2 ) on the apoptosis in 2 human cervical carcinoma cell lines of high risk HPV subtypes .Methods HeLa (HPV-18-positive) and Caski (HPV-16-positive) cells were incubated with different concentrations of SeO 2 for 24 h respectively.Mor-phological changes of HeLa and Caski cells were observed under inverted optical microscope ;cell proliferation and activity were examined by MTT assay;flow cytometry was employed to detect the cell apoptosis;the expressions of apoptosis-related proteins caspase-3 and p53 in cervical carcinoma cell lines were determined by Western blot analysis;the effects of SeO 2 on apoptosis-related miRNA LET-7a expression was detected by stem-loop reverse tran-scription-polymerase chain reaction (RT-PCR).Results Cell morphology was obviously changed in vitro.Cells be-came rounded and shrunken .SeO2 markedly inhibited cell proliferation and viability in a dose-dependent manner in both cell lines; In HeLa cells the inhibitory effects induced by 7.5-30 μmol/L of SeO 2 were significant ( P<0.05);The inhibitory effects on Caski were statistical significant (P<0.05) even with low concentrations of SeO 2. The apoptosis induced by SeO 2 increased dose-dependently in cervical carcinoma cell lines , which were higher in Caski.SeO2 up-regulated the apoptosis-related proteins in cervical carcinoma cell lines .The expressions of caspase-3 and p53 in HeLa cells both significantly increased as compared with control group (P<0.05), and peaked at the concentration of 7.5 μmol/L.Treated with higher concentrations ( 7.5-30 μmol/L ) of SeO 2 , the expression on Caski cells increased significantly ( P<0.05 ) .SeO 2 induced of expression of apoptosis-related miRNA LET-7a both in HeLa cells and Caski cells with statistical meanings ( P<0.05 );the effects reached its peak at the concentration of 7.5 μmol/L bothly.Conclusions SeO2 shows anti-tumor properties via apoptosis pathway by up-regulating the expressions of apoptosis-related proteins caspase-3, the mechanisms of can be potentially explained by p 53 and LET-7a in cervical cancer cell lines.The apoptosis-inducing effect of SeO2 is more sensitive in HPV16+cell line compared with HPV18+cell line.

Prevalência de infecção por HPV de alto risco em mulheres utilizando captura híbrida na prevenção do câncer do colo do útero no sul do Brasil / Prevalence of infection with high-risk HPV in women using hybrid capture conducting prevention of cervical cancer in south ern Brazil

Sabe-se que infecções por HPV de alto risco (HPV AR) estão ligadas ao desenvolvimento de câncer cervical. objetivo: Esse estudo teve como objetivo quantificar a prevalência de infecções por HPV em mulheres da metade sul do Estado do Rio Grande do Sul, Brasil, correlacionando fatores associados ao desenvolvimento de lesões precursoras e câncer cervical. Métodos: Para tanto, 643 mulheres foram incluídas no estudo, preenchendo um questionário padronizado e submetidas aos exames de citologia, colposcopia e HPV AR (Captura Híbrida 2). resultados: A maioria das pacientes tinha idade entre 20 e 39 anos (70,6%), houve decréscimo na porcentagem de fumantes de 23% para 11% e a média de idade ao início da vida sexual era de 18 anos. A prevalência de HPV AR é correlacionada com idades mais jovens, com menos pacientes infectadas por HPV AR quando estas eram mais velhas no momento do início da atividade sexual. Prevalência próxima a 70% foi observada em mulheres que tiveram 4 ou mais parceiros sexuais. Resultados citológicos e colposcológicos alterados tiveram taxas significativamente mais altas de infecção por HPV AR. 334 mulheres foram encaminhadas à biópsia. Destas, 321 tiveram resultados de colposcopia alterados e citopatologia ASC-US/AGC-US, LSILs e HSILs, com 231 biópsias realizadas neste estudo. Nenhum dos resultados indicou câncer. O teste de CH2 mostrou mais especificade do que a citologia, com altos valores preditivos positivos e negativos (49,8% e 78,6%, respectivamente). conclusão: A inclusão de testes para HPV AR nos programas de triagem no Brasil, de acordo com as políticas internacionais, levará à redução de biópsias em mulheres não infectadas e aumentará o intervalo entre exames.

High-risk Human Papillomavirus (HR HPV) infection is known to be linked to cervical cancer, with molecular biology tests being an important tool in diagnosis. objective: This study is aimed to quantify the prevalence of HPV infection in women from the Southern part of the State of Rio Grande do Sul, Brazil, correlating factors associated with the development of precursor lesions and of cervical cancer. Methods: 643 women were enrolled in the study, by filling out a standardized questionnaire and undergoing cytology, colposcopy, and HR HPV Hybrid Capture 2 (HC2) tests. results: Most patients were aged between 20 to 39 years (70.6%), this decreased the percentage of smokers from 23% to 11%. The average age of sexual debut through the period studied was of 18 years old. HR HPV prevalence was correlated with younger ages, with fewer patients infected by HR HPV when they were older at first sexual activity. Almost 70% prevalence of infection was observed in women who had 4 or more sexual partners. Altered cytology and colposcopy results had significantly higher rates of HR HPV infection. 334 women were referred for biopsy. Of those, 321 had altered colposcopy results and cytopathology of ASC-US/AGC-US, LSILs and HSILs, with 231 biopsies performed by the study. None of the results indicated cervical cancer. HC2 showed higher specificity than cytology, with high positive and negative prediction values (49.8% and 78.6%, respectively).conclusion: The inclusion of HR HPV testing in screening programs in Brazil, according to international policies, will lead to fewer biopsies in women without infection and increased interval between screenings.

Determination of human papillomavirus types in giant condyloma acuminatum / 中华皮肤科杂志

ObjectiveTo determine the genotypes of human papillomavirus(HPV) in patients with giant condyloma acuminatum.MethodsSixty-seven outpatients with giant condyloma acuminatum collected from January 2007 to January 2010 were included in this study.Lesional specimens were obtained from these patients.The genotypes of HPV were determined by flow-through hybridization and gene chip assay.ResultsOf the 67 cases of giant condyloma acuminatum,63 (94.02％) were positive for HPV DNA.Among the HPV DNA-positive specimens,84 (60.87％) harbored low risk types of HPV,54 (39.13％) high risk types of HPV.Type 6 and 11were the predominant low risk HPV types,while type 16 and 18 were the major high risk HPV types.

Comparison of the Seeplex HPV4A ACE and the Cervista HPV assays for the detection of HPV in hybrid capture 2 positive media / 부인종양

OBJECTIVE: To validate the efficacy of Seeplex HPV4A ACE for the detection of high-risk (HR) human papillomavirus (HPV) and HPV 16 and/or HPV 18 genotypes as compared to the PCR method and the Cervista HPV assays in cervical swab samples. METHODS: Besides liquid-based cytology, additional 97 cervical swab samples were collected for HPV genotyping by HPV4A ACE, Cervista HPV assays, and PCR method. To check the statistical differences, we also conducted the paired proportion test, Cohen's kappa statistic, and a receiver operating characteristic curve. RESULTS: Seeplex HPV4A ACE and the Cervista HPV HR showed substantial agreement with PCR for detection of HR HPVs (88.3%, kappa=0.767 and 81.7%, kappa=0.636, respectively). Seeplex HPV4A ACE also showed substantial agreement with the Cervista HPV 16/18 test (89.5%, kappa=0.628). Additionally, the sensitivity and specificity of Seeplex HPV4A ACE and Cervista HPV HR were 91.4% vs. 84.5% and 73.4%, vs. 72.7%, respectively, when those higher than low-grade squamous intraepithelial lesions were regarded as abnormalities. HPV genotyping for HPV 16/18 detected cervical intraepithelial neoplasias (CINs) better than HR HPV tests (66.7% vs. 24.6% by HPV4A ACE, 52.6% vs. 25.9% by Cervista HPV assays in CIN II or more, relatively). CONCLUSION: Seeplex HPV4A ACE is an effective method as the PCR and the Cervista HPV assays for the detection of HR HPVs and for genotyping of HPV 16 and 18.