Lineage and phylogenetic analysis of HPV-16, -18 in saliva of HNSCC patients

Aim: Head and Neck Squamous Cell Carcinoma (HNSCC) is a global health problem whose incidence varies by geographic region and race according to risk factors. Human papillomavirus (HPV) infection is a significant risk factor for HNSCC. HPV-16 and HPV-18 are two forms of HPV that are carcinogenic. HNSCCs that are HPV positive have a better prognosis rather than HPV negative. The purpose of this research was to characterize HPV-16, -18 variations in the saliva of HNSCC patients by examining the genetic diversity of HPV-16, -18 utilizing the full E6, E7, and L1 genes. Methods:The case-control research included 15 patients with HNSCC and 15 healthy volunteers. Unstimulated entire saliva samples were obtained from the case and control groups by spitting method. Genomic DNA was isolated from all saliva samples. A PCR reaction was used to determine the presence of HPV in saliva. HPV-positive samples were genotyped and data were analyzed. We conducted a variant study on the HPV-16, -18 E6, and E7 genes. Results: Three patients with HNSCC were HPV-positive for two HPV genotypes out of 30 people diagnosed with HPV-DNA. HPV-16 and -18 were the most common genotypes. The HPV-16, -18 E6, and E7 genes were sequenced and compared to the HPV-16, -18 (E6, E7) prototype sequence. In all, HPV-16 lineages A1 and HPV-18 lineages A3 were discovered. Conclusion: Regarding the variation of HPV found in Iranian HNSCC patients, the need for further studies in HPV genotyping was seen. Sequencing HPV genes in HNSCC may help answer questions about HPV genotyping in the Iranian population. HPV genotype analysis aids in the development of vaccinations against HNSCC, halting disease progression and preventing HPV-associated HNSCC

Fatores associados à infecção pelo papilomavírus humano na gestação: Uma revisão integrativa / Factores asociados a la infección por el virus del papiloma humano durante el embarazo: Una revisión integradora / Factors associated with human papillomavirus infection during pregnancy: An integrative review

Objetivo: Identificar os fatores associados à infecção pelo papilomavírus humano em gestantes. Método: Revisão integrativa realizada nas seguintes bases de dados: BDENF, LILACS, MEDLINE e IBECS. Foram utilizados os seguintes descritores: "Papilomavirus Humano", "HPV", "Gravidez", "Infecções Sexualmente Transmissíveis" e "IST" (com respectivas traduções para o inglês). Resultados: Seis artigos compuseram a amostra final deste estudo. O design de pesquisa mais prevalente foi o estudo transversal (n: 03). Verificou-se que os fatores associados à infecção pelo HPV estavam relacionados a características sociodemográficas (menor idade, baixa escolaridade, estado civil solteira e consumo de álcool na gestação) e maternas (multiparidade). Conclusão: Verificou-se que alguns fatores podem estar associados à presença de infecção pelo HPV em gestantes, como características sociodemográficas e maternas. Faz-se necessário que os profissionais de saúde tenham um olhar mais atento a este público, afim de contribuir para disseminação da informação e consequente prevenção.(AU)

Objective: To identify factors associated with human papillomavirus infection in pregnant women. Method: Integrative review carried out in the following databases: BDENF, LILACS, MEDLINE and IBECS. The following descriptors were used: "Papilomavirus Humano", "HPV", "Gravidez", "Infecções Sexualmente Transmissíveis" and "IST" (with respective translations into English). Results: Six articles made up the final sample of this study. The most prevalent research design was the cross-sectional study (n: 03). It was found that the factors associated with HPV infection were related to sociodemographic (younger age, low education, single marital status and alcohol consumption during pregnancy) and maternal (multiparity) characteristics. Conclusion: It was found that some factors may be associated with the presence of HPV infection in pregnant women, such as sociodemographic and maternal characteristics. It is necessary that health professionals have a closer look at this public, in order to contribute to the dissemination of information and consequent prevention.(AU)

Objetivo: Identificar los factores asociados a la infección por el virus del papiloma humano en mujeres embarazadas. Método: Revisión integrativa realizada en las siguientes bases de datos: BDENF, LILACS, MEDLINE e IBECS. Se utilizaron los siguientes descriptores: "Papilomavirus Humano", "HPV", "Gravidez", "Infecções Sexualmente Transmissíveis" y "IST" (con sus respectivas traducciones al inglés). Resultados: Seis artículos constituyeron la muestra final de este estudio. El diseño de investigación más prevalente fue el estudio transversal (n: 03). Se encontró que los factores asociados a la infección por VPH se relacionaron con características sociodemográficas (menor edad, baja escolaridad, estado civil soltero y consumo de alcohol durante el embarazo) y maternas (multiparidad). Conclusión: Se encontró que algunos factores pueden estar asociados a la presencia de infección por VPH en gestantes, como las características sociodemográficas y maternas. Es necesario que los profesionales de la salud tengan una mirada más cercana a este público, a fin de contribuir a la difusión de información y consecuente prevención.(AU)

Prevalencia y genotipicación de virus papiloma humano vaginal y cervical en trabajadoras sexuales de un centro de salud sexual en la zona Norte de Santiago, Chile / Prevalence and genotypes of cervical and vaginal HPV in female sex workers attending a Sexual Control Centre, North Area of Santiago, Chile

INTRODUCCIÓN: En Chile, el cáncer de cuello uterino (CCU) es la segunda causa de muerte por neoplasias malignas en la mujer. El principal agente causal es el virus papiloma humano (VPH). Comparando con la población general, los o las trabajadoras(es) sexuales (TS) tienen alto riesgo de adquirir VPH. OBJETIVO: Analizar la prevalencia y genotipos del VPH cervical y vaginal en TS que se atienden en un Centro de Salud Sexual de Santiago, Chile. Pacientes y MÉTODO: Se realizó un estudio transversal en 97 mujeres TS, de 19 a 70 años de edad. Se obtuvieron dos muestras por paciente, una de exocérvix y otra de paredes vaginales. El ADN de VPH fue identificado por reacción de polimerasa en cadena (RPC) y su genotipo fue investigado para 32 tipos de VPH. RESULTADOS: La prevalencia de VPH global fue de 45%, observándose portación cervical en 41,2% y vaginal en 36,1%, con una coinfección de 32%. El 63% de las muestras tenía genotipos de alto riesgo. Los VPH de alto riesgo más frecuentes fueron el VPH 66 (12%), VPH 58 (9,3%), seguidos por VPH 16, VPH 59 y VPH 82 con igual frecuencia (8% c/u). Treinta y dos mujeres (43%) fueron infectadas con genotipos múltiples. CONCLUSIÓN: El VPH es una infección frecuente entre las TS. Este es el primer estudio en Chile sobre prevalencia y genotipos de VPH en TS.

BACKGROUND: In Chile, cervical cancer is the second leading cause of death from malignancy in women. The main causal agent of cervical cancer is the human papillomavirus (HPV). Compared with the general population, sex workers (SW) are at increased risk of acquiring HPV. AIM: To analyze the prevalence and genotypes of cervical and vaginal HPV in female SW attending a Sexual Control Centre. METHODS: A cross-sectional study was carried out on 97 women (19-70 years old). Two samples were taken per patient, one from exocervix and the other from vaginal walls. HPV DNA. was identified by polymerase chain reaction (PCR) and genotyping using specific probes for 32 types of HPV. RESULTS: The overall frequency of HPV was 45%, 41.2% in cervical carrier and 36.1% in vaginal carrier, 32% were co-infected, 63% of HPV were high-risk genotypes. The most frequent high-risk HPV was HPV 66 (12%), HPV 58 (9.3%), followed by HPV 16, HPV 59 and HPV 82 with the same frequency (8% each one). Thirty two (43%) of females were infected with multiple genotypes. CONCLUSION: HPV is frequent infection among SW. This is the first study in Chile on the prevalence and genotypes of HPV in sex workers.

Genital infection by Human Papillomavirus (HPV) in women from Santa Catarina/Brazil / Infecção genital pelo Papilomavírus Humano (HPV) em mulheres de Santa Catarina/Brasil

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in women. About 80% of sexually active women will have contact with this virus at some point in their lives. Most infections will be transient, but when the infection becomes persistent and associated with a high oncogenic risk of Human Papillomavirus, there may be progression to cancer, especially cervical cancer. The best way to prevent Human Papillomavirus infection is through the use of vaccines, which have been available to the public in Brazil since 2014. Objective: This study aimed to assess the most prevalent types of Human Papillomavirus in the state of Santa Catarina, Brazil, and its mesoregions and if the majority of diagnosed types are contained in the Human Papillomavirus vaccines currently available on the market. Methods: A total of 20,000 Human Papillomavirus tests were evaluated for the diagnosis of genital Human Papillomavirus infection in women from the state of Santa Catarina, Brazil. The prevalence of infection was evaluated according to age and the city of origin of the exams. Human Papillomavirus detection was performed using molecular biology tests, such as hybrid capture (for diagnosis of the Human Papillomavirus group, high or low oncogenic risk) and polymerase chain reaction (viral genotyping) techniques. Results: The diagnosis of Human Papillomavirus infection was performed on women between 1 and 102 years of age. The age with the highest Human Papillomavirus positivity, as expected, was 20­25 years (45.6%) and the lowest after 70 years (7.1%). The highest Human Papillomavirus positivity of the exams was observed in the Serrana region of Santa Catarina state (58.9% of the exams). A high-oncogenic-risk Human Papillomavirus was detected in 93% of positive samples and was the most frequent in all age groups. Mixed infection (high- and low-risk Human Papillomavirus) was more prevalent in the 66­70 age group (29.3%) and in the Southern Region of Santa Catarina (26.4%). The most frequent genotypes in the state of Santa Catarina were non-16/18 high oncogenic risk Human Papillomavirus (76.9% of positive cases). Human Papillomavirus 16 was found in 17.1% of positive cases and Human Papillomavirus 18 in 6.6%. Conclusion: The most prevalent types of Human Papillomavirus in the state of Santa Catarina in the past 6 years are the non-16/18 high oncogenic risk Human Papillomavirus types, which are viral types not covered by the current Human Papillomavirus vaccines available in Brazil.

A infecção por Papilomavírus Humano é a infecção sexualmente transmissível mais frequente na mulher. Cerca de 80% das mulheres sexualmente ativas entrarão em contato com esse vírus em algum momento. A maioria das infecções será transitória, mas quando ela é persistente, associada aos Papilomavírus Humano de alto risco oncogênico, poderá progredir para câncer, principalmente de colo de útero. A melhor forma de se prevenir da contaminação pelo vírus é por meio de vacina, disponível no sistema público do Brasil desde 2014. Objetivo: Avaliar os tipos de Papilomavírus Humano mais prevalentes no estado de Santa Catarina e suas mesorregiões, e se a maioria dos tipos diagnosticados estão contidos nas vacinas contra o Papilomavírus Humano atualmente disponíveis no mercado. Métodos: Foram avaliados 20 mil exames para diagnóstico da infecção genital pelo Papilomavírus Humano em mulheres de todo o estado. A prevalência da infecção foi comparada de acordo com a idade e a procedência dos exames. A detecção do Papilomavírus Humano deu-se pelos exames de biologia molecular pelas técnicas de captura híbrida (para diagnóstico do grupo de Papilomavírus Humano, alto ou baixo riscos oncogênicos) e de PCR (genotipagem viral). Resultados: Foram avaliados exames para diagnóstico da infecção de mulheres entre um e 102 anos de idade. A faixa etária de maior positividade, como era de ser esperado, foi dos 20 aos 25 anos (45.6%) e a menor depois dos 70 anos (7.1%). A maior positividade dos exames foi observada na região Serrana do estado (58.9% dos exames). O Papilomavírus Humano de alto risco oncogênico foi detectado em 93% dos casos positivos e foi o mais frequente em todas as faixas etárias. A infecção mista (Papilomavírus Humano de alto e baixo riscos) foi mais prevalente na faixa etária dos 66 aos 70 anos (29.3%) e na região Sul Catarinense (26.4%). Os genótipos mais frequentes no estado foram os Papilomavírus Humano de alto risco oncogênico não 16/18 (76.9% dos casos positivos). O Papilomavírus Humano 16 foi encontrado em 17.1% dos casos positivos e o Papilomavírus Humano 18 em 6.6%. Conclusão:Os tipos de Papilomavírus Humano mais prevalentes no estado de Santa Catarina, nos últimos seis anos, são os Papilomavírus Humano de alto risco oncogênico não 16/18, tipos virais não cobertos pelas atuais vacinas contra o Papilomavírus Humano disponíveis no Brasil.

Autotoma para detección de VPH comparada con muestra convencional en el tamizaje de cáncer cervicouterino / Self-sampling for HPV detection compared with a conventional sample in cervical cancer screening

El cáncer de cuello uterino es la cuarta causa de mortalidad por cáncer en mujeres; 88 % de los casos provienen de países en vías de desarrollo debido al escaso acceso al tamizaje y tratamiento. Debido a esto, en los países de bajo desarrollo humano estrategias como la autotoma para la detección del virus del papiloma humano han adquirido gran importancia en la actualidad, aumentando hasta en un 45 % el tamizaje en estos países. La presente revisión bibliográfica tiene como objetivo determinar si existen diferencias entre técnica convencional para detección del virus del papiloma humano y la autotoma en países de mediano y bajo desarrollo humano, así como las ventajas y limitantes que esta presenta. Se realizó la búsqueda de la literatura mediante las bases de datos PubMed, Google Scholar y SciELO, empleando artículos originales, ensayos clínicos, de revisión, entre otros. Se demostró que la autotoma para la detección del virus del papiloma humano tiene una especificidad similar a la toma convencional por parte de personal médico y que incrementa el tamizaje, ya que es más aceptada que la muestra tomada por el clínico debido a que facilita el acceso y aborda las limitantes socioculturales percibidas por las usuarias

Cervical cancer is the fourth leading cause of cancer mortality in women; 88% of cases come from developing countries due to poor access to screening and treatment. Due to this, in countries with low human development, strategies such as self-testing for the detection of human papillomavirus have become very important today, increasing screening in these countries by up to 45%. The objective of this bibliographical review is to determine if there are differences between the conventional technique for detecting the human papillomavirus and self-testing in countries with medium and low human development, as well as the advantages and limitations that it presents. The literature search was carried out using the PubMed, Google Scholar and SciELO databases, using original articles, clinical trials, reviews, among others. It was shown that self-sampling for the detection of human papillomavirus has a similar specificity to conventional sampling by medical personnel and that it increases screening, since it is more accepted than the sample taken by the clinician because it facilitates access. and addresses the sociocultural limitations perceived by users

Stratifin em Tumores de Cabeça e Pescoço: Um alvo molecular identificado por Phage Display / Stratifin in head and neck tumors: a molecular target identified by Phage Display

Nos últimos anos, houve um aumento na frequência dos casos de tumores de cabeça e pescoço apesar da diminuição do consumo do tabaco e álcool, e isso tem sido atribuído, em parte, à infecção pelo Papilomavírus Humano HPV. Por apresentar baixa sobrevida em 5 anos e ter alta morbidade, tem se buscado novos alvos moleculares para terapias combinadas. Nesse contexto nosso grupo identificou, através da tecnologia de Phage Display, uma sequência peptídica com interação preferencial por células tumorais com relação à células não transformadas, e ensaios adicionais identificaram seu alvo como sendo a proteína Stratifin. Stratifin tem sido reportado como um oncogene em diversos modelos tumorais, entretanto seu papel em carcinoma de células escamosas de cabeça e pescoço (CCECP) permanece desconhecido e poucos trabalhos na literatura reportam sua atividade em CCECP e/ou outro tumores relacionados ao HPV. Dessa forma, o objetivo desse trabalho foi explorar o potencial valor clínico e o papel biológico da Stratifin em CCECP. Dados do perfil de expressão e de metilação assim como dados clínicos foram extraídos em base de dados do The Cancer Genoma Atlas TCGA. Paralelamente, o perfil de expressão de Stratifin foi verificado através de ensaios de RT/qPCR e Western Blot em um painel de linhagens celulares de CCECP que contempla as principais características moleculares para esses tipos tumorais. A partir da observação de que todas as linhagens expressam Stratifin, utilizou-se a tecnologia de CRISPR/Cas9 para modular sua expressão (nocauteando ou superexpressando o gene) de modo a se observar parâmetros relacionados ao processo tumorigênico. Dessa forma, foi possivel verificar os efeitos da Stratifin em ensaios de proliferação, viabilidade após tratamentos com quimioterápicos, irradiação, crescimento livre de ancoragem e clonogenicidade. Como resultados, observamos que expressão aumentada de Stratifin no tecido tumoral quando comparado ao tecido normal, foi positivamente relacionada com o grau histológico, negatividade para HPV, mutação em TP53 e CDKN2A. Biologicamente, o nocaute de Stratifin foi relacionado com maior sensibilidade à quimioterápicos, menor capacidade de formação de colônias, e reduzida capacidade de crescimento livre de ancoragem. Esses resultados sugerem que Stratifin atue como um oncogene em CCECP, entretanto ensaios adicionais devem ser realizados para corroborar esse achados

Over recent years, there has been an increase of head and neck tumors frequency despite the decrease in tobacco and alcohol consumption, and this has been attributed, in part, to Human Papillomavirus infection. Due to its low 5-year survival and high morbidity, new molecular targets for combined therapies have been sought. In this context, our group identified, through Phage Display technology, a peptide sequence with preferential interaction by tumor cells in relation to non-transformed cells, and further assays identified its target as the Stratifin protein. Stratifin has been reported as an oncogene in several tumor models, however its role in head and neck squamous cell carcinoma (HNSCC) remains unknown and few works in the literature report its activity in HNSCC and/or other HPV-related tumors. Therefore, the aim of this study was to explore the potential clinical value and biological role of Stratifin in HNSCC. Expression profile data as well as clinical data were extracted from The Cancer Genome Atlas - TCGA database. In parallel, the expression profile of Stratifin was verified through RT/qPCR and Western Blot assays in a panel of HNSCC cell lines that address the main molecular characteristics for these tumor types. Since all cell lines express Stratifin, CRISPR/Cas9 technology was used to modulate its expression (gene knocking out or overexpressing) in order to check parameters related to the tumorigenic process. Thus, it was possible to verify the Stratifin effects in proliferation assays, viability after chemotherapy treatments, irradiation, anchorage-free growth and clonogenicity. As a result, we observed an increased expression of Stratifin in tumor tissue when compared to normal tissue, which was positively related to histological grade, HPV negativity, mutation in TP53 and CDKN2A. Biologically, knockout of Stratifin was associated with greater sensitivity to chemotherapy, less colony-forming capacity, and reduced anchorage-free growth capacity. These results suggest that Stratifin acts as an oncogene in HNSCC, however additional assays should be performed to corroborate these findings

Infection with high-risk genotypes of human papillomavirus and cervical cytological findings among kidney transplant recipients in Kenya: a single centre experience

Background: High-risk human papillomavirus (hrHPV) infection is linked with uterine cervix premalignant lesions and invasive carcinoma of the uterine cervix. Methods: Descriptive cross sectional study carried out among female kidney transplant (KTx) recipients in Kenyatta National Hospital, Nairobi-Kenya. We studied the risk factors for acquisition of hrHPV, examined cervical cytology and assayed for 14 hrHPV DNA using Cervista® HPV HR test and Cervista® MTA (Hologic®) automated platforms. Results: The 14-hrHPV genotypes assayed were 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 and the prevalence rate was 31.25 % (10/32). Abnormal cervical cytology was noted in 4/32 (12.5%) and included low-grade squamous intraepithelial lesion (2/32), atypical squamous cells of undetermined significance (1/32) and atypical glandular cells (1/32). The average age was 41.9years with mean age at first coitus being 20.4 years. Majority of the women 20(62.5%) were married while 8(25%) were single. About 18(56.3%) had only one sexual partner. About 20% of women were nulliparous and 4(12.5%) had a parity of five. Duration sincetransplantation ranged between 1-21 years. Conclusions: The burden of hrHPV and abnormal cervical cytology in our study seemed lower than that reported elsewhere and even in general population. This study may form basis for further studies about HPV infections and carcinoma of the uterine cervix among the kidney allograft recipients in our setting

Tipificación del virus del papiloma humano en lesiones de cavidad bucal. Estudio desarrollado en los servicios de estomatología, Facultad de Odontología de la Universidad de Cartagena y el Hospital Alemán de Buenos Aires / Typing of human papillomavirus in oral cavity lesions in stomatology services at the Faculty of Dentistry of the Universidad de Cartagena and the Hospital Alemán de Buenos Aires

Objetivo: describir las características clínicas epidemiológicas en cavidad bucal de la infección por VPH y la asociación con su tipificación molecular. Métodos: se realizó un estudio analítico de corte transversal en 52 pacientes que acudieron a los servicios de estomatología en la Facultad de Odontología de la Universidad de Cartagena y al Hospital Alemán de Buenos Aires, a quienes se les abrió historia clínica y se les practicó prueba de PCR en tiempo real para la tipificación del VPH. Resultados: el análisis de los datos se efectuó a través de frecuencia y porcentaje. En cuanto a la parte inferencial, se usó la prueba chi cuadrado con un nivel de confianza P<0,05. De los 52 pacientes analizados, 67.3% eran mujeres con un predominio de edad entre los 50-59 años. El serotipo mayormente encontrado fue VPH 6, seguido del VPH 11 y otros tipos de VPH. La lesión elemental más preponderante fue la verrugosidad y la ubicación de predominio, la lengua. Conclusión: las infecciones por VPH se manifiestan frecuentemente en cavidad bucal con verrugosidades en lengua. Su estudio epidemiológico, incluyendo su tipificación, permitiría encontrar lesiones características para un diagnóstico, seguimiento y tratamiento oportuno.

Objective: Analyze the most common epidemiological clinical characteristics of HPV infection in the oral cavity and its molecular typing. Methods: An observational, analytical, cross-sectional study was carried out in 52 patients who attended the stomatology services of the Universidad de Cartagena and the Hospital Alemán de Buenos Aires; a complete clinical history was carried out, including stomatological examination, biopsy, pathological study and real-time PCR test for HPV typing. Results: The data analysis was carried out by means of frequency and percentage. Regarding the inferential part, the chi-square test was used with a confidence level of P <0.05. Of the 52 studied patients 67.3% were women; with a predominant age between 50-59 years. The most common serotype found was HPV 6, followed by HPV 11 and other types of HPV. The predominant lesion was the wart and the predominant location, the tongue. Conclusion: The HPV infections are frequently manifested in oral cavity with Verrugosities in language and its typing, would allow a timely diagnosis of pharynx cancer.

Vaccination against human papillomavirus in Brazilian schoolchildren: National Survey of School Health, 2019 / Vacinação contra o papilomavírus humano em escolares brasileiros: Pesquisa Nacional de Saúde do Escolar, 2019 / Vacunación contra el virus del papiloma humano en escolares brasileños: Encuesta Nacional de Salud del Escolar, 2019

Abstract Objective: to analyze the prevalence of schoolchildren vaccinated against human papillomavirus (HPV) and the reasons related to non-vaccination. Method: cross-sectional study, with data from the 2019 National Survey of School Health. The sample consisted of 160,721 students aged 13 to 17 years. The prevalence and confidence intervals (95%CI) of vaccinated adolescents were estimated according to location, sex, and administrative dependence of the school. The differences between the strata were evaluated with the Chi-square test. Adjusted prevalence ratios (aPR) and 95%CI were estimated with the Poisson regression model. Results: most of the students were vaccinated (62.9%), and the prevalence of girls (76.1%) was higher than that of boys (49.1%). The most prevalent reason for not vaccinating was "did not know they had to take" (46.8%), with the highest aPR in public schoolchildren in Brazil (1.6; 95%CI 1.5;1.7), from the Northeast region (1.2; 95%CI 1.1;1.2), and in students from private schools in the Northeast regions (1.1; 95%CI 1.1;1.2) and North (1.3; 95%CI 1.2;1.4). Conclusion: one out of every two Brazilian schoolchildren was vaccinated against HPV. Misinformation was a recurring reason for non-vaccination. The North and Northeast regions had the highest prevalence of non-vaccinated people, observed mainly in adolescents from public schools.

Resumo Objetivo: analisar a prevalência de escolares vacinados contra o papilomavírus humano (HPV) e os motivos relacionados à não vacinação. Método: estudo transversal, com dados da Pesquisa Nacional de Saúde do Escolar de 2019. A amostra foi composta por 160.721 estudantes de 13 a 17 anos. Foram estimadas as prevalências e intervalos de confiança (IC95%) de adolescentes vacinados segundo localização, sexo e dependência administrativa da escola. Avaliaram-se as diferenças entre os estratos pelo teste Qui-quadrado. Estimaram-se as razões de prevalência ajustadas (RPa) e os IC95% pelo modelo de regressão de Poisson. Resultados: a maioria dos escolares foram vacinados (62,9%), sendo a prevalência de meninas (76,1%) superior à de meninos (49,1%). O motivo mais prevalente foi "não sabia que tinha que tomar" (46,8%), sendo as RPa mais elevadas em escolares de escolas públicas do Brasil (1,6; IC95% 1,5;1,7), da região Nordeste (1,2; IC95% 1,1;1,2) e em estudantes de escolas privadas das regiões Nordeste (1,1; IC95% 1,1;1,2) e Norte (1,3; IC95% 1,2;1,4). Conclusão: um a cada dois escolares brasileiros foi vacinado contra o HPV. A desinformação foi um motivo frequente para a não vacinação. As regiões Norte e Nordeste apresentaram as maiores prevalências de não vacinados, observadas principalmente em adolescentes de escolas públicas.

Resumen Objetivo: analizar la prevalencia de escolares vacunados contra el virus del papiloma humano (VPH) y las razones relacionadas con la no vacunación. Método: estudio transversal, con datos de la Encuesta Nacional de Salud del Escolar de 2019. La muestra estuvo compuesta por 160, 721 estudiantes de 13 a 17 años. Se estimaron las prevalencias e intervalos de confianza (IC95%) de adolescentes vacunados según ubicación, sexo y dependencia administrativa de la escuela. Las diferencias entre estratos se evaluaron mediante la prueba de Chi-cuadrado. Se estimaron las razones de prevalencia ajustadas (RPa) y los IC95% por el modelo de regresión de Poisson. Resultados: la mayoría de los escolares fueron vacunados (62,9%), siendo la prevalencia de niñas (76,1%) superior a la de los niños (49,1%). La razón más prevalente fue "no sabía que tenía que tomar" (46,8%), siendo las RPa más elevadas en escolares de escuelas públicas de Brasil (1,6; IC95% 1,5; 1,7), de la región Nordeste (1,2; IC95% 1,1; 1,2) y en estudiantes de escuelas privadas de las regiones de Nordeste (1,1; IC95% 1,1; 1,2) y Norte (1,3; IC95% 1,2; 1,4). Conclusión: uno de cada dos escolares brasileños ha sido vacunado contra el VPH. La desinformación fue una razón frecuente para la no vacunación. Las regiones Norte y Nordeste presentaron las mayores prevalencias de no vacunados, observadas principalmente en adolescentes de escuelas públicas.

Knowledge, attitudes, and practices of adolescents regarding human papillomavirus / Conhecimentos, atitudes e práticas de adolescentes sobre o papilomavírus humano

ABSTRACT OBJECTIVE To analyze knowledge, attitudes, and practices of adolescent students from public schools in the municipality of Teresina, state of Piauí, regarding human papillomavirus (HPV). METHODS Cross-sectional, analytical study carried out in 12 public schools in the municipality of Teresina, with a random sample of 472 15-year-old adolescents. All participants answered a validated questionnaire, which evaluated sociodemographic characteristics, level of knowledge about HPV, attitudes regarding vaccination and vaccination status. The levels of knowledge and attitude were classified by standardized scores and practice by the vaccination situation. The analyses were carried out using the SPSS software. In the bivariate analysis, simple logistic regression was used generating odds ratios to identify the associations of sociodemographic characteristics, knowledge, and attitude with HPV prevention practice. Variables that presented p-value ≤ 0.20 in the bivariate analysis were inserted in a multivariate logistic regression model. Statistical significance was set at p < 0.05. RESULTS Among the participants, 27.3% had sufficient knowledge, 34.1% had positive attitudes, and 74.6% had adequate practice. In the multivariate analysis, we observed a statistically significant association among females (ORa = 15.62; 95%CI: 9.08-26.9), satisfactory knowledge (ORa = 2.09; 95%CI: 1.15-3.81), and positive attitudes (ORa = 1.89; 95%CI: 1.10-3.23) with proper practice. CONCLUSIONS Being female, having a satisfactory level of knowledge about HPV and the vaccine, and having positive attitudes towards HPV vaccination reinforce the appropriate practice of vaccination. These findings demonstrate the need to expand the knowledge of adolescents, generating positive attitudes towards vaccination within an appropriate perspective.

RESUMO OBJETIVO Analisar conhecimentos, atitudes e práticas de adolescentes estudantes de escolas públicas do município de Teresina-PI sobre o papilomavírus humano (HPV). MÉTODOS Estudo transversal, analítico, realizado em 12 escolas da rede pública do município de Teresina, com uma amostra aleatória de 472 adolescentes de 15 anos. Todos os participantes responderam a um questionário validado, que avaliou as características sociodemográficas, o nível de conhecimento sobre o HPV, atitudes relacionadas à vacinação e ao status vacinal. Os níveis de conhecimento e atitude foram classificados por meio de escores padronizados e a prática mediante a situação vacinal. As análises foram realizadas com o uso do SPSS. Na análise bivariada, utilizou-se a regressão logística simples, por meio de odds ratio para identificar as associações entre as características sociodemográficas e o conhecimento, e a atitude com a prática de prevenção contra o HPV. As variáveis que na análise bivariada apresentaram valor de p ≤ 0,20 foram submetidas ao modelo multivariado de regressão logística. A significância estatística foi fixada em p < 0,05. RESULTADOS Dentre os participantes, 27,3% apresentaram conhecimento suficiente, 34,1% atitudes positivas e 74,6% prática adequada. Na análise multivariada observou-se associação estatisticamente significativa entre o sexo feminino (ORa = 15,62; IC95%: 9,08-26,9), conhecimento satisfatório (ORa = 2,09; IC95%: 1,15-3,81), e atitudes positivas (ORa = 1,89; IC95%: 1,10-3,23) com a prática adequada. CONCLUSÕES Ser do sexo feminino, ter nível de conhecimento sobre o HPV e a vacina classificados como satisfatório, bem como ter atitudes positivas frente à vacinação contra o HPV reforçam a prática adequada de vacinação. Estes achados demonstram a necessidade de ampliar o conhecimento dos adolescentes, gerando atitudes positivas com vistas à vacinação dentro de uma perspectiva adequada.

Carcinoma escamocelular bucal. Caso clínico y revisión de la literatura / Oral squamous cell carcinoma. Case report and review of literature

Introducción: el cáncer escamocelular (CEC) representa el 90-95% de todos los tipos de cáncer. En México, la frecuencia de CEC bucal (CECB) se ha incrementado y presenta una incidencia entre el 1 y el 5%. El CECB se asocia con sujetos en la quinta y séptima década de la vida, el sexo masculino, positivos a tabaquismo, alcoholismo, factores genéticos, inmunosupresión, infección por virus del papiloma humano (VPH) y estilos de vida poco saludables, entre otros. El objetivo de este trabajo fue presentar un caso clínico como ejemplo de las características emergentes en un paciente con CECB. Caso clínico: mujer de 38 años, con úlcera indurada, parcialmente adherida a planos profundos y dolorosa, asociada con un aumento de volumen, ubicada en vientre y borde lateral de lengua. Se realizó biopsia y con el diagnóstico histopatológico de carcinoma escamocelular invasor bien diferenciado, se procedió a determinar la presencia delVPH y resultó positivo a VPH 16. Se realizó tratamiento oncológico combinado (quirúrgico-radiación-quimioterapia), con buenos resultados para la paciente respecto a la estética y función. Conclusiones: se analizaron varios estudios que evalúan la presencia del VPH en lesiones de CECB, como un factor de riesgo que involucra con mayor frecuencia casos de pacientes jóvenes, la localización en lengua y antecedentes negativospara tabaquismo y alcoholismo frente a casos de CECB no asociados al VPH. Se requieren datos que contribuyan a dilucidar diversos aspectos aún desconocidos sobre la infección bucal por VPH y su relación con el CECB.

Background: Squamous cell cancer (SCC) represents 90-95% of all types of cancer. In Mexico, the frequency of oral SCC (OSCC) has increased, with an incidence between 1 and 5%. OSCC is associated with subjects in the 5 and 7th decade of life, males, positive for smoking, alcoholism, genetic factors, immunosuppression, human papillomavirus (HPV) infection, and unhealthy lifestyles, among others. Theobjectiveof thisworkwas to presenta clinical case as an example of the emerging characteristics in a patient with OSCC. Clinical case: 38-year-old female patient, with indurated ulcer, partially adhered to deep planes and painful, associated with an increase in volume, located on the belly and lateral edge of the tongue. A biopsy was performed and with the histopathological diagnosis of well differentiated invasive squamous cell carcinoma, the presence of HPV was determined, resulting positive for HPV-16. Combined cancer treatment was performed (surgical radiation-chemotherapy), with good results for the patient regarding aesthetics and function. Conclusions: We analyzed several studies evaluating the presence of HPV in lesions of OSCC, as a risk factor that involves more frequently cases of young patients, with location in tongue, and negative antecedents for smoking and alcoholism compared to cases of OSCC not associated with HPV. Data are required to help elucidate various still unknown aspects of oral HPV infection and its relationship with OSCC.

Perception on cervical cancer and enhancing strategies to screening uptake among women in Bamenda, Cameroon: A qualitative method

The treatment of cervical cancer has a good prognosis if diagnosed early. Hence, screening is very vital. The aim of this study was to evaluate the perception of women on cervical cancer and strategies to enhance its screening uptake in the city of Bamenda, Cameroon. Qualitative study was carried out from July, 2019 to August, 2019. Eight focus group discussions were organized in five different quarters in the city of Bamenda. These quarters and participants were purposively selected and each group constituted 6 to 8 Participants. Ethical clearance and administrative authorization for the study were obtained prior to the study. Data was analyzed using thematic analysis with the help of QDA Miner. A total of 53 study participants took part in this study. Their ages ranged between 21 to 45 years. Most participants did not know about cervical cancer. Their perceived barriers to cervical cancer screening included: inadequate sensitization; financial challenges and embarrassing testing strategies; lack of awareness on the availability of screening centers; poor attitude of health personnel. Proposed strategies to enhance cervical cancer screening were: sensitization of the population, recruitment of more competent staff, testing centers should be located closed to the target population, less embarrassing screening methods should be used, health care workers should demonstrate positive attitudes during care, female staff should manage the screening units, screening cost should be subsidized. Due to the Small purposive sample size and qualitative nature of this study, the findings are not generalizable

Estimated prevalence of human papillomavirus among Nigerian women: A systematic review and meta-analysis

HPV prevalence in Nigeria has been challenging to quantify given regional population heterogeneity and differences in diagnostic methodology. We conducted a systematic review and meta-analysis of 17 studies, each of which summarized HPV prevalence in women residing in six geopolitical zones of Nigeria. The estimated pooled prevalence (effect size) of HPV in Nigeria was 32% (CI: 23-41%). HPV prevalence was 29% (CI: 20-39%) among studies that detected HPV by genotype. HPV prevalence among studies that used serologic detection was 38% (CI: 12-65%). When stratified by region, a study in the South East (SE) geopolitical zone reported the highest prevalence of 71% (CI: 61-80%) while a study in the South South (SS) geopolitical zone reported the lowest prevalence of 4.9% (CI: 3-9%). HPV prevalence in Nigeria was high. Heterogeneity between study regions and differing HPV detection methods both contribute to variation in estimates. Using pooled estimates serves to inform future strategies for epidemiologic surveillance and future design of HPV and cervical cancer prevention initiatives. (Afr J Reprod Health 2022; 26[6]:89-96).

A nested case-control study on the relationship between red blood cell folate and the prognosis of low-grade cervical intraepithelial neoplasia / 中华预防医学杂志

Objective: To evaluate the relationship between red blood cell folate (RBC folate) and the prognosis of low-grade cervical intraepithelial neoplasia (CIN 1). Methods: In the married women cohort established in 2014, 564 women with CIN 1 diagnosed by pathology were recruited. The demographic characteristics and factors of cervical intraepithelial neoplasia were collected. Meanwhile, the infection status of human papillomavirus (HPV) was detected by molecular diversion hybridization, and the level of RBC folate was measured by chemical photoimmunoassay. After 24 months of follow-up, pathological examination was performed again to observe the prognosis of participants. The women with reversal were taken as the control group,and those with continuous and progressive CIN 1 were taken as the case group respectively. The relationship between RBC folate and CIN 1 outcome was evaluated by logistic regression model. Results: 453 women completed the follow-up, aged (49.72±6.84) years old. CIN 1 was reversed in 342 women, continued in 58 cases and progressed in 53 cases. The RBC folate level M (Q1,Q3) were 399.01 (307.10, 538.97) ng/ml, 316.98 (184.74, 428.49) ng/ml and 247.14 (170.54, 348.97) ng/ml, respectively. With the decrease of RBC folate, the risk of continuous and progressive CIN 1 increased (all P<0.001), while the risk of reversal CIN 1 decreased gradually (P<0.001). Combined with high-risk human papillomavirus (HR-HPV) infection status, low level of RBC folate could increase the risk of CIN 1 progression regardless of HR-HPV infection (HR-HPV infection: OR=21.34, 95%CI: 3.98-114.54; HR-HPV uninfection: OR=11.15, 95%CI: 2.34-53.13). Conclusion: Low level of RBC folate could increase the risk of CIN 1 persistence and progression regardless of HR-HPV infection.

SFRP1, Posible biomarcador en la progresión o regresión de lesiones de cérvix asociado al Virus del Papiloma Humano / SFRP1, Possible Biomarker in the Progression or Regression of Cervical Pre-neoplastic Lesions Associated with Human Papilloma Virus

Resumen Objetivo: Comparar la expresión de mRNA y proteínas de SFRP1, PTPRN, CDO1, EDNRB, CDX2, EPB41L3 y HAND1 en pacientes con lesión intra-epitelial cervical de bajo y alto grado, con posterior progresión o regresión. Material y Método: Se realizó análisis de expresión de genes mediante RT-PCR y análisis de expresión de proteínas por inmunohistoquímica. El análisis estadís tico fue realizado con las pruebas: Wilcoxon, coeficiente de correlación de Spearman e índice de concordancia. Las muestras fueron pareadas en momento 1 y momento 2. Resultados: SFRP1 mostró tendencia de mayor expresión de mRNA en lesión intra-epitelial de bajo grado (momento 2) Vs. alto grado (momento 1). La expresión de proteínas por inmunohistoquímica de SFRP1 en casos de progresión (83,3 %) mostró disminución en su graduación (p = 0,0313*); los demás genes en estudio no tuvieron cambios estadísticamente significativos. Discusión: SFRP1 mostró comportamiento ajustado a resultados de estudios previos donde se encontró hipermetilado en lesiones intra-epiteliales de alto grado; su subexpresión por hipermetilación se reportó en otros canceres, proceso que colabora con su silenciamiento y transición epitelial-mesenquimatosa del cáncer de cuello uterino. Conclusiones. SFRP1 es potencial biomarcador en lesiones preneoplásicas del cuello uterino asociadas al virus de papiloma humano.

Abstract Objective. The aim of this work was to compare the expression of mRNA and proteins of SFRP1, PTPRN, CDO1, EDNRB, CDX2, EPB41L3 and HAND1 in patients with low and high grade cervical intraepithelial lesion, with subsequent progression or regression. Material and Methods: Gene expression analysis was conducted through RT-PCR and protein expression analysis was performed by immunohistochemistry. The statistics analysis were Wilcoxon test, Spearman's correlation coefficient and concordance index. The samples were paired during moment 1 (initial patient diag nosis) and moment 2 (follow-up histological diagnosis). Results: SFRP1 showed a trend of higher mRNA expression in low-grade intra-epithelial lesions (moment 2) Vs. high-grade (moment 1). The expression of proteins by immunohistochemistry of SFRP1 in progression cases (83.3%) showed a decrease in its graduation (p = 0.0313*); the other genes under study had no statistically significant. Discussion: SFRP1 showed a biological behavior adjusted to the results of previous studies where hypermethylation was found in high-grade intra-epithelial lesions; its subexpression by hypermethylation has been reported in other cancers, a process that collaborates with its silencing and epithelial-mesenchymal tran sition of cervical. Conclusions. SFRP1 is a potential biomarker in preneoplastic lesions of the cervix associated with human papillomavirus.

Differences in HPV infection and HPV-related lesions between the cervix and anus in hiv-positive women / Diferenças na infecção por HPV e lesões HPV-relacionadas entre colo uterino e ânus em mulheres hiv positivas

Introduction: the prevalence of cervical and anal human papillomavirus (HPV) infection in women infected with human immunodeficiency virus (HIV) is high. However, little is known about the differences in the susceptibility of these infections and related lesions. The aim of this study was to describe the association between the prevalence of cervical and anal HPV infection and HPV-related lesions in HIV-positive women. Methods: this study included 88 HIV-positive women attending an outpatient clinic in a university hospital. Ectocervical, endocervical, and anal samples were collected for colpocytology and anal cytology. A polymerase chain reaction-based technique was used to detect HPV deoxyribonucleic acid in endocervical and anal swab samples. Results: the cervical and anal HPV positivity rates were 35.21% and 78.8%, respectively. The presence of HPV-related lesions on colpocytology was associated with anal HPV positivity (P = 0.027). The ratio between cervical HPV infection and cervical HPV-related lesions was 2.5. The ratio between anal HPV infection and anal HPV-related lesions was 4.3. Overall, 30% had concomitant HPV DNA in the cervix and anus. Conclusion: there are differences in the susceptibility of infections and related lesions between the cervix and anus. Despite a higher incidence of anal HPV, the progression to HPV-related lesion does not occur via the same manner in the cervix and anus. Moreover, cervical HPV-related lesions in HIV-positive women may serve as a cue for anal preventive strategies, and further investigations in these women may be useful.

Introdução: as infecções cervicais e anais pelo papilomavírus humano (HPV) em mulheres infectadas com o vírus da imunodeficiência umana (HIV) são muito prevalentes. Entretanto, pouco se sabe sobre as diferenças na suscetibilidade entre essas infecções e as lesões HPV-relacionadas. Objetivo: descrever a associação entre as prevalências de infecção cervical e anal pelo HPV e lesões relacionadas em mulheres HIV-positivas. Metodologia: este estudo incluiu 88 mulheres HIV-positivas atendidas em ambulatório de hospital universitário. Amostras ectocervicais, endocervicais e anais foram coletadas para colpocitologia e citologia anal. Uma técnica baseada na reação em cadeia da polimerase foi usada para detectar o ácido desoxirribonucléico (DNA) do HPV em amostras de swabs endocervical e anal. Resultado: as taxas de positividade do HPV cervical e anal foram de 35,21% e 78,8%, respectivamente. As lesões relacionadas ao HPV na colpocitologia foram associadas à positividade anal para o HPV (P = 0,027). A proporção entre infecção cervical por HPV e lesões cervicais relacionadas foi de 2,5. A proporção entre a infecção anal por HPV e as lesões anais relacionadas foi de 4,3. 30% tinham DNA-HPV concomitante no colo do útero e ânus. Conclusão: existem diferenças na suscetibilidade de infecções e de lesões relacionadas entre o colo e o ânus. Apesar de maior incidência de HPV anal, a progressão para lesões relacionadas não ocorre da mesma forma no colo e no ânus. Além disso, lesões cervicais relacionadas ao HPV em mulheres HIV positivas podem servir como pista para estratégias preventivas anais. Investigações adicionais podem ser úteis.

Hemorrhagic cystitis and giant condyloma acuminatum of anus in a receptor of haploidentical hematopoietic transplant / Cistitis hemorrágica y condiloma acuminado gigante del ano en un receptor de trasplante hematopoyético haploidéntico

ABSTRACT Introduction: The reactivations of latent virus after bone marrow transplants affect the outcome of these patients. Hemorrhagic cystitis caused by BK virus, constitute a frequently lethal complication characterized by abdominal pain, hematuria and renal damage. The incidence is between 13-70 % in hematopoietic transplant receptors. The management includes antibiotics, antivirals, hyperhydration and forced diuresis, platelets and hyperbaric oxygen. Condyloma acuminatum of the anus associated to human papillomavirus is rare among transplanted patients (0.3-1.3 %). It is characterized by an invading mass in the region of the anus producing pain and bleeding. The treatment of choice is the surgical resection of the tumor. Objectives: To describe the clinical characteristics and evolution of hemorrhagic cystitis and anal condyloma acuminatum in a receptor of haploidentical hematopoietic transplant. Discussion: A 20-year-old man with diagnosis of acute myeloid leukemia, on day +21 post-transplant presented macroscopic hematuria associated to BK virus reactivation and resolved with hyperbaric oxygen. On day + 59 post-transplant, anal pain started and a perianal, cauliflower-like mass over 5 cm, was observed. He was diagnosed with condyloma acuminatum of the anus and surgical resection was successfully performed. Conclusions: We reported a unique case of concurrence of both, hemorrhagic cystitis and condyloma acuminatum of the anus after haploidentical hematopoietic transplant. The proper management of these two pathologies allowed a satisfactory evolution of the patient.

RESUMEN Introducción: La reactivación de virus latentes en el organismo después del trasplante de progenitores hematopoyéticos (TPH) afecta la evolución de estos pacientes. La cistitis hemorrágica por virus BK constituye una complicación frecuentemente mortal caracterizada por dolor suprapúbico, hematuria y daño renal. La incidencia varía entre 13 y 70 % de los receptores de trasplante hematopoyético. El tratamiento comprende el uso de antibióticos, antivirales, hidratación y diuresis forzada, plaquetas y oxígeno hiperbárico. El condiloma acuminado del ano asociado al virus del papiloma humano es extremadamente raro en pacientes trasplantados (0,3-1,3 %). Se caracteriza por una masa que invade la región del ano produciendo dolor y sangramiento. El tratamiento de elección consiste en la resección quirúrgica del tumor. Objetivos: Describir las características clínicas, el manejo y la evolución de cistitis hemorrágica y condiloma acuminado anal en un receptor de trasplante hematopoyético haploidéntico. Presentación del caso: Paciente de 20 años de edad con diagnóstico de leucemia mieloide aguda que en el día + 21 del trasplante comenzó con hematuria macroscópica asociada a virus BK que resolvió con oxígeno hiperbárico. En el día +59 comenzó con dolor anal y se observó una masa perianal en forma de coliflor de aproximadamente 5 cm. Se diagnosticó condiloma acuminado del ano y se realizó resección quirúrgica del tumor con todo éxito. Conclusiones: Se presenta un caso único donde concurren cistitis hemorrágica y condiloma acuminado del ano después del trasplante hematopoyético haploidéntico. El manejo apropiado de estas dos patologías condujo a la evolución satisfactoria del paciente.

Update on human papillomavirus - Part II: complementary diagnosis, treatment and prophylaxis,

Abstract In this nonsystematic review, the complementary diagnosis, treatment, prevention, and control of human papillomavirus are discussed. The histopathology is addressed regarding its indications, main findings and limitations, as a complementary diagnostic method largely used by dermatologists. Electron microscopy is briefly reviewed, along with its contribution to the accumulated knowledge on HPV, as well as the relevance of research in using this technology for future advances in diagnosis and treatment. Molecular information about the virus is continuously increasing, and the practical applications of HPV serology, molecular identification and genotyping are discussed. Vaccines are a valuable tool in primary HPV infection prevention and are now available in many countries; their composition, indications, and adverse effects are revisited. Local and systemic treatment options are reviewed and off-label prescriptions are discussed. Finally, health education focusing on HPV infection as a sexually transmitted infection of worldwide relevance and the many barriers to improve primary and secondary prevention are addressed.