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1.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1567424

ABSTRACT

A fines de 2023 la autoridad sanitaria de Argentina realizó modificaciones en el Calendario Nacional obligatorio, que serán implementadas en forma progresiva durante 2024. Este artículo está enfocado en la reducción del esquema contra el virus del papiloma humano. (AU)


At the end of 2023, the Argentine health authority modified the mandatory National Calendar, which will be implemented progressively during 2024. This article focuses on the reduction in the human papillomavirus scheme. (AU)


Subject(s)
Humans , Female , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/administration & dosage , Vaccine Efficacy , Argentina/epidemiology , Uterine Cervical Neoplasms/prevention & control , Public Health/methods , Immunization Schedule , Treatment Outcome , Papillomavirus Infections/virology , Papillomaviridae/immunology
2.
Epidemiol. serv. saúde ; 32(2): e2022790, 2023. tab, graf
Article in English, Portuguese, French | LILACS | ID: biblio-1440091

ABSTRACT

Objetivo: descrever a cobertura da vacina contra papilomavírus humano (HPV) na região Nordeste do Brasil, no período de 2013 a 2021. Métodos: estudo descritivo conduzido com dados obtidos do Programa Nacional de Imunizações, que estabelece a meta de 80% para a vacina contra o HPV para meninas entre 9 e 14 anos e meninos entre 11 e 14 anos. Resultados: as coberturas para as meninas foram de 73,9%, na primeira, e de 54,3% na segunda dose, e para meninos, as coberturas de cada dose foram de 49,7% e 32,6%, respectivamente; excetuando-se Ceará e Paraíba, que alcançaram coberturas acima de 80% na primeira dose para as meninas, nenhum estado alcançou a meta para as duas doses. Conclusões: entre 2013 e 2021, as coberturas da vacina contra HPV estiveram abaixo da meta para ambos os sexos, com exceção de Ceará e Paraíba, que atingiram a meta para a primeira dose no grupo de meninas.


Objective: to describe human papillomavirus (HPV) vaccination coverage in the Northeast region of Brazil, in the period from 2013 to 2021. Methods: this was a descriptive study conducted with data obtained from the National Immunization Program, which sets a goal of 80% coverage of HPV vaccination in girls aged between 9 and 14 years and boys aged between 11 and 14 years. Results: HPV vaccination coverage in girls was 73.9%, regarding the first dose, and 54.3% regarding the second dose, and for boys, the coverage of each dose was 49.7% and 32.6%, respectively; with the exception of the states of Ceará and Paraíba, which reached coverage above 80% regarding the first dose in girls, none of the states reached the goal for both doses. Conclusions: between 2013 and 2021, HPV vaccination coverage was below the target for both sexes, with the exception of the states of Ceará and Paraíba, which reached the goal for the first dose in the girls.


Objetivo: describir las coberturas de la vacuna contra el papilomavirus humano en la Región Nordeste de Brasil y sus estados, de 2013 a 2021. Métodos: se trata de un estudio descriptivo realizado con datos de cobertura vacunal obtenidos del Programa Nacional de Immunizaciones, que establece la meta del 80% para la vacuna. Los datos de población se obtuvieron del Departamento de Informática del Ministerio de Salud. Resultados: la cobertura de vacunación en niñas fue del 73,9% en la primera y del 54,3% en la segunda dosis; en niños la cobertura de cada dosis fue del 49,7% y 32,6%; Ceará y Paraíba alcanzaron una cobertura superior al 80% para la primera dosis en niñas, y ningún estado alcanzó la meta para las dos dosis. Conclusiones: la cobertura de la vacuna está por debajo de la meta para ambos sexos, con excepción de la primera dosis en niñas en Ceará y Paraíba.


Subject(s)
Humans , Male , Female , Child , Adolescent , Vaccination Coverage/statistics & numerical data , Papillomavirus Vaccines/immunology , Papillomaviridae/immunology , Brazil/epidemiology , Epidemiology, Descriptive , Immunization Programs , Adolescent Health , Health Information Systems
3.
REME rev. min. enferm ; 26: e1477, abr.2022. tab, graf
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1422465

ABSTRACT

RESUMO Objetivo: investigar as notificações dos eventos adversos pós-vacinação papilomavírus humano no estado de Minas Gerais, de acordo com a localidade de notificação, a causalidade, a gravidade e a evolução dos casos. Métodos: estudo epidemiológico realizado com os dados de 2015-2019, notificados no Sistema de Informação de Vigilância de Eventos Adversos. Os dados foram analisados e apresentados em proporções, segundo as macrorregiões de saúde e os anos do estudo. Resultados: em 2015, foram notificados 26,41% eventos adversos, sendo o ano com maior notificação. Na análise das macrorregiões de saúde, Vale do Jequitinhonha apresentou a menor prevalência de registro (0,43%), e a Centro a maior prevalência de notificação (30,95%). Os eventos adversos locais mais prevalentes foram: dor (56,48%) e edema (38,89%). Já quanto aos eventos sistêmicos, a cefaleia (29,69%) e a gastroenterite (29,69%) tiveram os maiores registros de casos. Os eventos classificados como adversos não graves (59,82%) foram os mais prevalentes, e quanto à causa, 35,94% deles foram atribuídos aos erros de imunização. Conclusão: este estudo reforça que os eventos adversos pós-vacina de HPV foram, em sua maioria, eventos não graves, demonstrando, portanto, a segurança da vacina HPV para o público adolescente, contribuindo para o aumento das taxas de cobertura vacinal.


RESUMEN Objetivo: investigar las notificaciones de eventos adversos de papilomavirus humano en el Estado de Minas Gerais, según la localidad de notificación, la causalidad, la gravedad y la evolución de los casos. Métodos: estudio epidemiológico realizado con datos de 2015-2019, notificados en el Sistema de Información de Vigilancia de Eventos Adversos. Los datos fueron analizados y presentados en proporciones, según las macrorregiones sanitarias y los años del estudio. Resultados: en 2015 se notificaron un 26,41% de eventos adversos, siendo el año con mayor notificación. Al analizar las macrorregiones sanitarias, el Valle de Jequitinhonha tuvo la menor prevalencia de registro, con un 0,43%, y el Centro tuvo la mayor prevalencia de notificación (30,95%). Los efectos adversos locales más frecuentes fueron el dolor (56,48%) y el edema (38,89%). En cuanto a los eventos sistémicos, la cefalea (29,69%) y la gastroenteritis (29,69%) presentaron el mayor número de casos. Los eventos clasificados como adversos no graves (59,82%) fueron los más prevalentes y, en cuanto a la causa, el 35,94% de ellos se atribuyeron a los errores de inmunización. Conclusión: este estudio refuerza que los eventos adversos posteriores a la vacuna contra el VPH fueron en su mayoría eventos no graves, demostrando así la seguridad de la vacuna contra el VPH para el público adolescente y contribuyendo al aumento de las tasas de cobertura de vacunación.


ABSTRACT Objective: to investigate reports of adverse events following human papillomavirus vaccination in the state of Minas Gerais, according to the location of notification, causality, severity, and evolution of cases. Methods: epidemiological study carried out with data from 2015-2019, reported in the Adverse Event Surveillance Information System. Data were analyzed and presented in proportions, according to health macro-regions and years of study. Results: in 2015, 26.41% of adverse events were reported, being the year with the highest number of notifications. In the analysis of health macro-regions, Vale do Jequitinhonha had the lowest prevalence of registration (0.43%), and the Center had the highest prevalence of notification (30.95%). The most prevalent local adverse events were pain (56.48%) and edema (38.89%). As for systemic events, headache (29.69%) and gastroenteritis (29.69%) had the highest number of cases. Events classified as non-serious adverse events (59.82%) were the most prevalent, and regarding the cause, 35.94% of them were attributed to immunization errors. Conclusion: this study reinforces that adverse events following HPV vaccination were, for the most part, non-serious events, thus demonstrating the safety of the HPV vaccine for the adolescent public, contributing to the increase in vaccine coverage rates.


Subject(s)
Humans , Adolescent , Immunization/adverse effects , Papillomavirus Infections/epidemiology , Drug-Related Side Effects and Adverse Reactions , Papillomavirus Vaccines , Papillomaviridae/immunology , Information Systems , Epidemiologic Studies , Surveillance in Disasters , Vaccination Coverage
4.
Rev. Ciênc. Plur ; 7(2): 177-195, maio 2021. ilus, tab
Article in Portuguese | BBO, LILACS | ID: biblio-1283578

ABSTRACT

Introdução:Educação em saúde visa sensibilizar a consciência cidadã a partir do conhecimento do sujeito e de estratégias pedagógicas dialógicas. Tal atividade pode envolver os diferentes ciclos de vida, como crianças e adolescentes. Objetivo:relatar a experiência de um grupo tutorial da disciplina Saúde e CidadaniaII da Universidade Federal do Rio Grande do Nortena produção e realização de ações de educação em saúde voltadas a sensibilização para adesão a vacinação contra o Papiloma Vírus Humano no território adscrito a uma Unidade de Saúde da Famíliade Natal/RN no primeiro semestre do ano de 2018. Metodologia:A seleção das temáticas-alvo se deu a partir das percepções dos discentes acerca do contexto epidemiológico do bairro e, sobretudo, dos processos contínuosde escuta ativa, em que profissionais de saúde da Unidadee lideranças do território expuseram as demandas locais. Utilizou-se a ferramenta CANVAS para estruturação do planejamento estratégico das intervenções.Exposições dialogadas, com uso de multimídia, cartazes, jogos educativos e paródias foram empregados na interação com o público da escola do bairro. Resultados:As percepções do grupo discente foram positivas e satisfatórias ao final das intervenções, em meio à ativa participação dos escolares e interesse nas temáticas abordadas, evidenciando adequação das estratégias realizadas. Conclusões:as intervenções buscaram responder a uma demanda de educação em saúde relativa ao adolescente. Ademais, contribuíram para o crescimento acadêmico e pessoal dos discentes ao trabalhar competências do saber, do ser, conviver, essenciais a efetivação do modelo da vigilância à saúde, bem como houve um balanço positivo, uma vez que os resultados esperados no planejamento foram alcançados. Desta forma, concretizou-se oprincípio da integração ensino-serviço-comunidade (AU).


Introduction:Health education aims to raise awareness among citizens based on the subject's knowledge and dialogical pedagogical strategies. This activity can involve different life cycles, such as children and teenagers. Objective: To report the experience of a tutorial group of the discipline Health and Citizenship II of Universidade Federal do Rio Grande do Norte in the production and carrying out of health education actions aimed at raising awareness about adherence to Human Papilloma Virus vaccination in the territory assigned to a Family Health Service in Natal / RN in the first half of the year 2018. Methodology:The selection of the target themes was based on students' perceptions about the epidemiological context of the neighborhood and, above all, on the continuous processes of active listening, in which health professionals and leaders of the territory exposed to the local demands. The CANVAS tool was used to structure the strategic planning of the interventions. Dialogue exhibitions, with multimedia, posters, educational games, and parodies were used in the interaction with the youth public of school.Results:The student group's perceptions were positive and satisfactory at the end of the interventions, amidst the active participation of the students and interest in the topics addressed, evidencing the adequacy of the strategies carried out.Conclusions:the interventions sought the goal of health promotion in a collaborative environment involving adolescents. Also, they contributed to students' academic and personal growth by working on the skills of knowing, being, living together, essential for the implementation of the health surveillance model and a positive balance since the results expected in the planning were achieved. In this way, the principle of teaching-service-community integration was materialized (AU).


Introducción: La educación para la salud tiene como objetivo sensibilizar a los ciudadanos a partir de los conocimientos del sujeto y de estrategias pedagógicas dialógicas. Esta actividad puede implicar a diferentes ciclos vitales, como los niños y los adolescentes. Objetivo:Relatar la experiencia de un grupo tutorial de la disciplina Salud y Ciudadanía II de la Universidad Federal de Río Grande del Norte en la producción y realización de acciones de educación para la salud dirigidas a la sensibilización de la adhesión a la vacunación contra el Virus del Papiloma Humano en el territorio asignado a un Servicio de Salud de la Familia en Natal / RN en el primer semestre del año 2018.Metodología: La selección de los temas objetivo se basó en las percepciones de los estudiantessobre el contexto epidemiológico del barrio y, sobre todo, en los continuos procesos de escucha activa, en los que los profesionales de la salud y los líderes del territorio expusieron las demandas locales. Se utilizó la herramienta CANVAS para estructurar la planificación estratégica de las intervenciones. Se utilizaron exposiciones de diálogo, con multimedia, carteles, juegos educativos y parodias en la interacción con el público juvenil de la escuela. Resultados: Las percepciones del grupo de estudiantes fueron positivas y satisfactorias al final de las intervenciones, en medio de la participación activa de los estudiantes y del interés por los temas abordados, evidenciando la adecuación de las estrategias realizadas. Conclusiones: las intervenciones buscaron el objetivo de la promoción de la salud en un ambiente de colaboración con los adolescentes. Además, contribuyeron al crecimiento académico y personal de los alumnos al trabajar las habilidades de conocer, ser y convivir, esenciales para la implementación del modelo de vigilancia de la salud y un balance positivo ya que se alcanzaron los resultados esperados en la planificación. De esta manera, se materializó el principio de integración enseñanza-servicio-comunidad (AU).


Subject(s)
Humans , Male , Female , Child , Adolescent , Primary Health Care , Teaching Care Integration Services , Health Knowledge, Attitudes, Practice , Health Education , Adolescent Health Services , Papillomaviridae/immunology , Brazil/epidemiology , Research Report
5.
Femina ; 47(12): 857-863, 31 dez. 2019. ilus
Article in Portuguese | LILACS | ID: biblio-1425740

ABSTRACT

A infecção pelo papilomavírus humano (HPV) é muito prevalente e ocorre precocemente após o início da vida sexual. Dentre as patologias associadas, destaca-se o câncer do colo de útero, que, apesar dos programas de rastreamento, continua a acometer muitas mulheres relativamente jovens. O conhecimento da estrutura gênica de diferentes tipos de HPVs e a evolução tecnológica propiciaram o desenvolvimento de vacinas com a finalidade de impedir a infecção por tipos oncogênicos desse vírus. Desde 2007, elas já estão sendo aplicadas mundialmente e alguns resultados positivos já foram observados. A proposta deste capítulo é descrever as vacinas contra HPV disponíveis no Brasil, as indicações de sua utilização, incluindo aquelas contempladas no Programa Nacional de Imunização (PNI) brasileiro, e os efeitos relacionados.(AU)


Subject(s)
Humans , Female , Immunization Programs , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Papillomaviridae/immunology , Uterine Cervical Neoplasms/prevention & control , Mass Screening
6.
São José dos Campos; s.n; 2019. 50 p. il., tab., graf..
Thesis in Portuguese | BBO, LILACS | ID: biblio-1016633

ABSTRACT

A papilomatose laríngea é uma neoplasia benigna causada pelo papilomavírus humano (HPV), sendo os tipos 6 e 11 os mais comuns, e que ocorre em dois grupos etários, juvenil e adulto. A possível coinfecção viral tem sido sugerida em lesões de cabeça e pescoço; nesse sentido, o Epstein Barr vírus (EBV), que também apresenta tropismo por células epiteliais vem sendo estudado neste grupo de lesões. Os objetivos deste estudo foram genotipar os HPVs, investigar a presença de EBV-DNA por PCR e EBV-RNA por hibridização in situ. Além disso, associar a presença de EBV com a imunoexpressão de CD21, os resultados obtidos com a escala laringoscópica de Derkay et al. (1998) e com os dados clinicopatológicos. Oitenta casos de papilomatose laríngea, juvenil (n=36) e adulta (n=44), foram retrospectivamente analisados e subdivididos em grupos de menor e maior severidade, baseando-se na escala de Derkay. Todas as amostras foram HPV posivitas, com 49 casos HPV 6, 26 casos HPV 11, 4 casos HPV 6 e 11, e 1 caso HPV 16. A presença de EBV-DNA foi detectada em 9 amostras, entretanto EBV-RNA não foi não foi identificado em nenhuma amostra. Assim como a presença do EBV-DNA, a imunoexpressão de CD21 não se associou estatisticamente com quaisquer variáveis. A presença de HPV 6 foi mais comum em PLA e, o HPV 11 foi mais comum (p=0,02) e maior em casos de maior severidade (p=0,04), no grupo juvenil. A presença do EBV provavelmente não desempenha papel importante na progressão/severidade desta patologia(AU)


Laryngeal papillomatosis is a benign neoplasm caused by the human papillomavirus (HPV), been types 6 and 11 the most commonly related, and is divided into two groups: juvenile and adult. Viral coinfection has been suggested in head and neck lesions; in this sense, Epstein Barr virus (EBV), which also presents tropism for epithelial cells, has been studied in this group of lesions. The aims of this study are to perform HPV genotyping, investigate EBVDNA presence by PCR and EBV-RNA by in situ hybridization; and associate EBV presence with CD21 immunoexpression. Finally, the results were associated with Derkay laryngoscopic score. Eighty cases of laryngeal papillomatosis, juvenile (n = 36) and adult (n = 44) were retrospectively subdivided into low-risk and high-risk of severity based on the Derkay index. All samples were HPV-positive, with 49 cases of HPV 6, 26 cases of HPV 11, 4 cases of HPV 6 and 11, and 1 case of HPV 16. The presence of EBV-DNA was detected in 9 samples, however EBV-RNA was not identified in any sample. As the presence of EBV-DNA, the CD21 immunoexpression was not statistically associated with any variables. The presence of HPV 6 was more common in ALP, HPV 11 was more common (p = 0.02) and higher in cases of higher severity (p = 0.04) in juvenile group. The presence of EBV probably does not play an important role in the progression/severity of this pathology(AU)


Subject(s)
Humans , Papilloma/diagnosis , Papillomaviridae/immunology , Receptors, Complement 3d/analysis , Herpesvirus 4, Human/classification , Aggression/drug effects
7.
Rio de Janeiro; s.n; 2018. 237 f p. tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-967379

ABSTRACT

A vacina contra o Papilomavírus Humano (HPV) protege contra quatro subtipos virais, sendo os subtipos 16 e 18 associados a cerca de 70% dos casos de câncer do colo de útero no mundo. A incorporação dessa vacina no Brasil ocorreu em um momento em que a avaliação de tecnologias em saúde se encontrava em institucionalização dentro do Ministério da Saúde. Esse estudo examinou o processo de incorporação da vacina Quadrivalente contra o HPV pelo Ministério da Saúde (MS), ocorrida no âmbito da Comissão Nacional de Incorporação de Tecnologias do SUS (CONITEC), a fim de (1) caracterizar o contexto político e institucional em que se deu esta decisão no país, identificando os principais atores envolvidos neste processo e suas posições e influências na tomada de decisão ocorrida; (2) mapear os critérios e fatores que foram considerados na decisão de introdução da vacina contra o HPV pelo governo brasileiro; (3) discutir os aspectos relacionados à implementação da vacina incorporada que foram considerados nos primeiros momentos de sua adoção no SUS. Foi conduzindo, assim, um estudo exploratório, com abordagem qualitativa, do tipo estudo de caso único. Os dados foram coletados através de análise de documentos governamentais, de projetos de lei legislativos e de oito entrevistas com atores-chave, identificados como participantes do processo através dos documentos ou referidos por outros entrevistados. A análise dos dados buscou identificar como ocorreu o processo; as arenas, governamentais ou não, onde foram travados os debates; as posições e os argumentos defendidos pelos atores e como foi realizada a análise pela CONITEC, procurando o entendimento do processo decisório como um todo. A vacina foi registrada pela Agência Nacional de Vigilância Sanitária em 2006 e, desde então, somaram-se as pressões para sua incorporação ao sistema público de saúde, levando à formação de diversos grupos de trabalho, ao longo dos anos. Os resultados iniciais das evidências disponíveis recomendavam a não incorporação da vacina, devido às lacunas do conhecimento acerca de sua eficácia e segurança e devido ao alto impacto orçamentário para o SUS decorrente de seus elevados preços, além de problemas de viabilidade técnica para sua oferta pelo Programa Nacional de Imunizações (PNI). Um estudo de custo-efetividade mostrou em 2012 que a vacina era custo-efetiva ao sistema, mas, antes disso, a Secretaria de Vigilância à Saúde e outras secretarias já avaliavam sua introdução no PNI. A transferência de tecnologia via estabelecimento de uma Parceria de Desenvolvimento Produtivo e a redução de preço foram elementos fundamentais para essa decisão. A incorporação da vacina foi um processo longo, que se estendeu por anos, tendo ocorrido mesmo quando ainda persistiam diversas incertezas sobre seu potencial impacto na incidência de câncer de colo de útero. Embora a decisão tenha ocorrido no âmbito da CONITEC, as discussões se estenderam a diversas arenas, incluindo o meio acadêmico e o legislativo. A incorporação foi aprovada por unanimidade pelo Plenário da CONITEC. A decisão publicada em DOU em novembro de 2013 e sua oferta no PNI fora iniciada em março de 2014, utilizando uma estratégia mista ao incluir escolas e serviços de saúde. Desde então, as coberturas vacinais alcançadas têm estado muito abaixo das metas recomendadas para a vacina alcançar seus objetivos propostos, o que ameaça colocar, em risco futuro, seus objetivos pretendidos de reduzir a incidência do câncer de colo de útero


The vaccine against the Human Papillomavirus (HPV) offers protection against four viral subtypes, and from these the subtypes 16 and 18 are associated with about 70% of cases of cervical cancer in the world. The incorporation of this vaccine in Brazil occurred at a time when the evaluation of health technologies was institutionalized within the Ministry of Health. This study examined the process of incorporation of the Quadrivalent vaccine against HPV by the Ministry of Health (MS), that occurred within the National Commission for the Incorporation of Technologies do SUS (CONITEC), in order to (1) characterize the political and institutional context in which this decision was made in the country, identifying the main actors involved in this process and their positions and influences in the decision-making; (2) map the criteria and factors that were considered in the decision to introduce the HPV vaccine by the Brazilian government; (3) discuss the aspects related to the implementation of the incorporated vaccine that were considered in the first moments of its adoption in the SUS. The exploratory study was conducted through a qualitative approach, of a single case study type. The data were collected through analysis of government documents, legislative bills and eight interviews with key actors, identified as process participants through the documents or referred by other interviewees. The analysis of the data sought to identify how the process occurred; the arenas, governmental or not, where the debates were held; the positions and arguments defended by the actors and how the analysis was carried out by CONITEC, seeking the understanding of the decision-making process as a whole. The vaccine was registered by the National Agency of Sanitary Surveillance in 2006 and, since then, added the pressures for its incorporation into the public health system, leading to the formation of several work groups over the years. The initial results of the available evidence do not recommend incorporation, due to the lack of knowledge about its efficacy and reliability and the high budgetary impact for the SUS due to its high prices and problems of technical feasibility for its offer by the National Program of Immunizations (PNI). A cost-effectiveness study showed in 2012 that the vaccine was cost-effective to the system, but before that the Department of Health Surveillance and other departments already evaluated its introduction in the PNI. The transfer of technology through the establishment of a Productive Development Partnership and the reduction of prices were fundamental elements for this decision. The incorporation of the vaccine was a long process, which lasted for years, occurring even when there were still uncertainties about its potential impact on the incidence of cervical cancer. Although the decision had occurred within CONITEC, the discussions have extended to several arenas, including the academia and legislative environment. The incorporation was unanimously approved by the CONITEC Plenary, the decision published in the DOU in November 2013, and its offer in the PNI was initiated in March 2014, which used a mixed strategy, including schools and health services. Since then, the vaccine coverage achieved has been far below the targets recommended for the vaccine to reach its proposed goals, risking its intended future goals of reducing the incidence of cervical cancer


Subject(s)
Humans , Papillomaviridae/immunology , Technology Assessment, Biomedical/organization & administration , Unified Health System/organization & administration , Brazil , Uterine Cervical Neoplasms/prevention & control , Decision Making , Papillomavirus Vaccines/supply & distribution , Neoplasms/prevention & control
8.
Clinics ; Clinics;73(supl.1): e549s, 2018. tab, graf
Article in English | LILACS | ID: biblio-974946

ABSTRACT

Most human papillomavirus infections are readily cleared by the host immune response. However, in some individuals, human papillomavirus can establish a persistent infection. The persistence of high-risk human papillomavirus infection is the major risk factor for cervical cancer development. These viruses have developed mechanisms to evade the host immune system, which is an important step in persistence and, ultimately, in tumor development. Several cell types, receptors, transcription factors and inflammatory mediators involved in the antiviral immune response are viral targets and contribute to tumorigenesis. These targets include antigen-presenting cells, macrophages, natural killer cells, Toll-like receptors, nuclear factor kappa B and several cytokines and chemokines, such as interleukins, interferon and tumor necrosis factor. In the present review, we address both the main innate immune response mechanisms involved in HPV infection clearance and the viral strategies that promote viral persistence and may contribute to cancer development. Finally, we discuss the possibility of exploiting this knowledge to develop effective therapeutic strategies.


Subject(s)
Humans , Female , Papillomaviridae/immunology , Uterine Cervical Neoplasms/virology , Papillomavirus Infections/virology , Immunity, Innate/immunology , Cell Transformation, Neoplastic , Disease Progression , Immune Evasion
9.
Rev. panam. salud pública ; 38(2): 163-166, ago. 2015.
Article in English | LILACS | ID: lil-764680

ABSTRACT

In 2014, Brazil introduced an HPV immunization program for girls 9-13 years of age as part of the Unified Health System's (SUS) National Immunization Program. The first doses were administered in March 2014; the second ones, in September 2014. In less than 3 months more than 3 million girls received the first dose of quadrivalent HPV vaccine, surpassing the target rate of 80%. This paper examines three elements that may influence the program's long-term success in Brazil: sustaining effective outreach, managing a large technology-transfer collaboration, and developing an electronic immunization registry, with a focus on the State of São Paulo. If these three factors are managed, the Government of Brazil is primed to serve as a model of success for other countries interested in implementing a national HPV vaccination program to decrease HPV-related morbidity and mortality.


En el 2014, se introdujo en Brasil un programa de vacunación contra los VPH dirigido a niñas de 9 a 13 años de edad como parte del Programa Nacional de Vacunación del Sistema Unificado de Salud (SUS). Las primeras dosis se administraron en marzo del 2014; las segundas, en septiembre del 2014. En menos de tres meses, más de tres millones de niñas recibieron la primera dosis de vacuna tetravalente contra los VPH, superando la tasa prevista de 80%. En este artículo se analizan tres elementos que pueden influir en el éxito a largo plazo del programa en Brasil: el mantenimiento de actividades de extensión eficaces, la administración de una amplia colaboración en materia de transferencia de tecnología, y la creación de un registro electrónico de vacunaciones, con hincapié en el Estado de São Paulo. Si se gestionan estos tres factores, el Gobierno de Brasil está dispuesto a servir como modelo exitoso a otros países interesados en introducir un programa nacional de vacunación contra los VPH con objeto de disminuir la morbilidad y la mortalidad relacionadas con los VPH.


Subject(s)
Papillomaviridae/immunology , Immunization Programs , Papillomavirus Vaccines/supply & distribution , Brazil
10.
São Paulo; s.n; 2015. 64 p.
Thesis in Portuguese | LILACS | ID: lil-772904

ABSTRACT

Entre as doenças sexualmente transmissíveis (DST), infecções por papilomavírus humano (HPV) são muito comuns. Apesar de frequentemente transitória, quando há persistência da infecção podem surgir lesões que, se não tratadas, podem progredir para o câncer. A disseminação do HPV tende a ser universal entre indivíduos sexualmente ativos, sendo que o homem, além do risco de câncer anal, peniano e da orofaringe, pode ser importante propagador do vírus entre mulheres. No entanto, pouco se sabe a respeito da prevalência, incidência e remissão de infecções por HPV em homens. Os alimentos e nutrientes poderiam influenciar a progressão do câncer afetando a susceptibilidade à infecção, alterando o estado nutricional, atuando na probabilidade da infecção se tornar persistente e na progressão a lesões neoplásicas, além de alterar a estabilidade e reparo do DNA. Objetivo: Investigar a relação entre nutrientes selecionados e a infecção persistente por HPV em homens. Métodos: Foram utilizados dados secundários de 1248 indivíduos de 18 a 70 anos e que responderam a um Questionário de Frequência Alimentar (QFA), obtidos da coorte brasileira de estudo sobre HPV em homens. O QFA foi desenvolvido e validado para a população do estudo, e posteriormente seus dados foram calibrados e ajustados pela energia. Por meio do teste U de Mann-Whitney foram avaliadas diferenças nas medianas de ingestão dos nutrientes entre grupos com e sem infecção persistente por HPV oncogênico e não-oncogênico, e realizado teste de tendência. A associação entre os nutrientes e o HPV persistente foi testada por regressão logística...


HPV infections are the most common among sexually transmitted diseases. Although most frequently transitory, persistent oncogenic-type HPV infection may progress to a precursor lesion and, if not correctly treated, to cancer. The dissemination of HPV tends to be universal in sexually active individuals. Men, besides being in risk to cancer, in special penile and anal cancer, can be the spreader of this virus to women, contributing to the infection, and hence the cervical cancer. However, little is known about this infection in men. Some studies discuss the possible relation between diet and the risk of HPV and the role of food in persistent infections. Food and nutrients could influence carcinogenesis process by affecting nutritional status, susceptibility to infection and by acting in the probability of infection turning persistent and progressing to neoplastic lesions, besides altering DNA repair and stability. Objective: Investigate the relation of selected nutrients and HPV persistent infection in men of São Paulo, Brazil. Methods: The study population consisted of 1,248 men from the Brazilian cohort of HIM study, aged from 18 to 70 years old, whose answered a quantitative food frequency questionnaire (FFQ) in the baseline. The FFQ was developed and validated for the study population and afterwards calibrated and energy-adjusted. The U Mann-Whitney test was used to assess differences in the medians of nutrient intake between men with persistent and non-persistent infection. The association of dietary intake and persistent HPV infection was assessed in multivariate logistic models...


Subject(s)
Humans , Male , Adult , Middle Aged , Eating , Herpesviridae Infections , Men's Health , Papillomaviridae/immunology , Diet , Men
11.
Einstein (Säo Paulo) ; 11(4): 547-549, out.-dez. 2013.
Article in Portuguese | LILACS, SES-SP | ID: lil-699874

ABSTRACT

A infecção pelo papilomavírus humano é comum e produz manifestações diversas. Essa infecção adquire importância para saúde pública, pois tem sido associada a malignidades do trato genital em homens e mulheres. Atualmente, temos disponíveis duas vacinas para prevenção da infecção pelo papilomavírus humano e, consequentemente, de doenças a ele associadas.


Human papillomavirus infection is common and causes different manifestations. This infection is a public health concern because it has been associated with genital tract malignant diseases among men and women. Currently two vaccines are available to prevent the human papillomavirus infection and its associated diseases.


Subject(s)
Adolescent , Child , Female , Humans , Male , Young Adult , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Vaccination , Alphapapillomavirus , Immunization Schedule , Papillomaviridae/immunology , Papillomavirus Infections/virology , Papillomavirus Vaccines/classification , Uterine Cervical Neoplasms/prevention & control
12.
São Paulo; s.n; 2011. 153 p.
Thesis in Portuguese | LILACS | ID: lil-643253

ABSTRACT

Introdução. O Papilomavírus humano (HPV), particularmente o tipo 16, têm sido associado com risco e prognóstico de tumores de cabeça e pescoço. Contudo, o papel do DNA do HPV e resposta sorológica na sobrevida neste grupo de pacientes ainda não está claro. Objetivos. Avaliar o efeito do HPV (resposta sorológica e detecção do DNA no tecido tumoral) na sobrevida de pacientes com carcinoma epidermóide de cabeça e pescoço, considerando-se as distintas localizações anatômicas (cavidade oral, orofaringe, hipofaringe e laringe). Material e métodos. Coorte de 1.475 pacientes com carcinoma epidermóide de cabeça e pescoço, oriundos de dois estudos multicêntricos, diagnosticados entre novembro de 1998 e dezembro de 2008 e acompanhados até 30 de junho de 2009. Detecção de DNA do HPV no tecido tumoral foi feita pela técnica de PCR (Polymerase Chain Reaction) em tecido fresco e material parafinado. Resposta sorológica às proteínas do HPV foi determinada pela técnica Multiplex Luminex. Sobrevida global e específica pela doença foram calculadas pelo método atuarial (tábuas de vida). Curvas de sobrevida de Kaplan-Meier e teste Log-rank para comparação de curvas de sobrevida foram calculados. Hazard ratio (HR) do efeito da infecção pelo HPV nos tumores de cabeça e pescoço e respectivo intervalo com 95 por cento de confiança (IC95 por cento ) foram calculados via modelo de regressão de Cox ajustado pelas variáveis: estudo de origem dos casos, sexo, idade, educação, consumo de tabaco e de álcool, estadiamento do tumor e tratamento, assim como hábitos sexuais para a subcoorte com esta informação. Resultados. Prevalência de DNA do HPV 16 no tecido tumoral foi de 6,7 por cento nos casos recentes (2003-2008) comparado com 1 por cento nos casos iniciais (1998-2002) para a subcoorte de São Paulo. Aumento da soropositividade para HPV 16 E7 nos casos do estudo mais recente (2003-2008) comparado com os casos do estudo inicial (1998-2002) resultou estatisticamente significante. Foi observada pobre concordância entre os resultados de sorologia e DNA do HPV.


Subject(s)
Humans , Allergy and Immunology , Actuarial Analysis/statistics & numerical data , DNA, Viral/immunology , Multicenter Studies as Topic , Neoplasms, Squamous Cell , Head and Neck Neoplasms/epidemiology , Papillomaviridae/immunology , Cohort Studies , Longitudinal Studies , Survival Analysis
13.
Rev. chil. infectol ; Rev. chil. infectol;27(1): 60-64, feb. 2010.
Article in Spanish | LILACS | ID: lil-537173

ABSTRACT

Sexually transmitted diseases are highly prevalent and a public health concern worldwide. Herpes simplex virus (HSV) and human papilloma virus (HPV) are described. The development of rapid, sensible and specific diagnostic assays has been difficult because of their pathogenic features. In the last years, molecular biology based techniques allowed a better and wider range of diagnosis, as in the HPV-cancer association. In this article, standardized diagnostic methodologies for HSV and HPV are reviewed.


Las Infecciones virales de transmisión sexual son altamente prevalentes y constituyen un problema de salud pública en el mundo. Entre los agentes que se contagian por esta vía, se describe acerca de virus herpes simplex (HSV) y virus papiloma humano (HPV). Las características patogénicas de estas infecciones han dificultado la implementación de técnicas diagnósticas rápidas, sensibles y específicas para el diagnóstico clínico habitual. En los últimos años las metodologías diagnósticas sustentadas en la biología molecular han permitido mej orar y ampliar el rango de diagnóstico posible para estos agentes infecciosos y relacionarlos con otras patologías, como es el caso de HPV y cáncer. En el presente artículo se revisan metodologías diagnósticas implementadas para el diagnóstico microbiológico de HSV y de HPV.


Subject(s)
Female , Humans , Male , Herpes Simplex/diagnosis , Papillomaviridae , Papillomavirus Infections/diagnosis , Simplexvirus , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/virology , Herpes Simplex/transmission , Papillomaviridae/genetics , Papillomaviridae/immunology , Papillomavirus Infections/transmission , Simplexvirus/genetics , Simplexvirus/immunology
14.
Article in English | IMSEAR | ID: sea-135898

ABSTRACT

Cervical cancer is the first cancer to be shown to be 100 per cent attributable to a virus; oncogenic human papillomaviruses (HPV), particularly types 16 and 18, collectively worldwide contribute to 70 per cent squamous cell carcinomas, 85 per cent of adenocarcinomas. Cervical cancer is the second commonest cancer of women, yet largely preventable with high-quality, well-organized screening of the appropriate population. Screening programmes are either nonexistent, or function opportunistically in many poorer countries, resulting in high incidence and mortality. Recently developed, prophylactic HPV vaccines against HPV 16, 18, as cervical cancer preventative vaccines, in phase 3 clinical trials have been shown, to be highly efficacious, safe and immunogenic. With the potential for cross protection against related HPV types, estimates for prevention are in the order of 75 to 80 per cent. Thus a further option exists in the battle to reduce these cancers in women. Challenges however include implementing a vaccination programme with wide coverage to the target populations to be a successful public health tool, integration and maintenance of current screening programmes where they are in existence, the need for reduced costs of the current vaccines, long-term immunogenicity (will there be a need for further doses?), appropriate education messages to the general community, governments, as well as the medical profession.


Subject(s)
Clinical Trials, Phase III as Topic , Female , Humans , Male , Mass Screening , Papillomaviridae/immunology , Papillomaviridae/pathogenicity , Papillomavirus Vaccines/adverse effects , Papillomavirus Vaccines/immunology , Papillomavirus Vaccines/pharmacology , Population Surveillance , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control
15.
Article in English | IMSEAR | ID: sea-135894

ABSTRACT

HPV infection in the genital tract is common in young sexually active individuals, the majority of whom clear the infection without overt clinical disease. However most of those who develop benign lesions eventually mount an effective cell mediated immune response and the lesions regress. Regression of ano-genital warts is accompanied histologically by a CD4+ T cell dominated Th1 response; animal models support this and provide evidence that the response is modulated by CD4+ T cell dependent mechanisms. Failure to develop effective CMI to clear or control infection results in persistent infection and, in the case of the oncogenic HPVs, an increased probability of progression to CIN3 and invasive carcinoma. The central importance of the CD4+ T cell population in the control of HPV infection is shown by the increased prevalence of HPV infections and HGSIL in individuals immunosuppressed as a consequence of HIV infection. The prolonged duration of infection associated with HPV seems to be associated with effective evasion of innate immunity as reflected in the absence of inflammation during virus replication, assembly and release, and down regulation of interferon secretion and response thus delaying the activation of adaptive immunity. Serum neutralising antibody to the major capsid protein L1 usually develops after the induction of successful cell mediated immunity and these antibody and cell mediated responses are protective against subsequent viral challenge in natural infections in animals. Prophylactic vaccines consisting of HPV L1 VLPs generate high anti L1 serum neutralizing antibody concentrations and in clinical trials have shown greater than 95 per cent efficacy against both benign and neoplastic genital HPV associated disease. These vaccines are delivered intramuscularly and therefore circumvent the immune evasion strategies of the virus.


Subject(s)
Animals , CD4-Positive T-Lymphocytes/immunology , Cross Protection , Cytotoxicity, Immunologic , Female , Humans , Immunity, Cellular , Immunity, Humoral , Interferons/metabolism , Male , Papillomaviridae/immunology , Papillomaviridae/pathogenicity , Papillomavirus Infections/epidemiology , Papillomavirus Infections/immunology , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/pharmacology
16.
Mem. Inst. Oswaldo Cruz ; 104(1): 1-10, Feb. 2009. tab
Article in English | LILACS | ID: lil-507199

ABSTRACT

Human papillomavirus (HPV) is responsible for all cases of cervical cancer, as well as a great percentage of other anogenital tumors and oropharyngeal tumors. Since the main etiologic factor for these diseases is a virus, prophylactic measures are the best way to reduce the burden caused by the infection and associated disease. This review brings up to date information on the two commercially available prophylactic HPV vaccines against HPV, as well as presenting the ongoing research on HPV peptide, protein and dendritic cell based therapeutic vaccines.


Subject(s)
Animals , Female , Humans , Papillomaviridae/immunology , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/immunology , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/virology
17.
Rev. méd. Chile ; 136(11): 1485-1492, nov. 2008. tab
Article in Spanish | LILACS | ID: lil-508971

ABSTRACT

This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific ínformatíon of the licensed HPV vaccines: Gardasil® and Cervarix®. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual actívíty, Le. approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program.


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Advisory Committees , Immunization , Papillomaviridae , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Chile/epidemiology , Papillomaviridae/classification , Papillomaviridae/genetics , Papillomaviridae/immunology , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Papillomavirus Vaccines/adverse effects , Papillomavirus Vaccines/immunology , Societies, Medical , Young Adult
18.
IJI-Iranian Journal of Immunology. 2008; 5 (2): 82-91
in English | IMEMR | ID: emr-86751

ABSTRACT

Cervical cancer is the most prevalent tumor in developing countries and the second most frequent cancer among female population worldwide. Specific human papillomaviruses and, most notably, HPV types 16 and 18 are recognized as being causally associated with cervical carcinomas. The early HPV type 16 genes, E6 and E7, directly participate in the in vitro transformation of primary human keratinocytes and represent an excellent target for immune therapy of HPV related disease. The aim of this study was the evaluation of the efficacy of a DNA vaccine containing human papillomaviruse type 16 E7 gene [Iranian isolate] in induction of CTL responses in an animal model. In this study, the expression vector containing HPV type 16 E7 gene was constructed and chosen as a model antigen in the development of a therapeutic DNA vaccine in an animal model. CTL responses, cytokine assay, lymphocyte stimulation test, CD4 and CD8 staining and flowcytometry were done for evaluating of the immune responses. Our findings indicate that the target DNA vaccine can induce an E7-specific CTL response, which is important in the lysis of infected tumor cells, compared to negative control [p < 0.005] after in vivo immunization in the mouse system. The developed vaccine may be promising as an anti-cancer vaccine


Subject(s)
Animals, Laboratory , Papillomaviridae/immunology , Papillomaviridae/genetics , Vaccines, DNA , Uterine Cervical Neoplasms/virology , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/immunology , Models, Animal , Mice , Cancer Vaccines , Genetic Vectors
19.
In. Coelho, Francisco Ricardo Gualda; Soares, Fernando Augusto; Foch, José; Fregnani, José Humberto Tavares Guerreiro; Zeferino, Luiz Carlos; Villa, Luisa Lina; Federico, Miriam Honda; Novaes, Paulo Eduardo Ribeiro dos Santos; Costa, Ronaldo Lúcio Rangel. Câncer do colo do útero. São Paulo, Tecmedd, 2008. p.67-78, ilus.
Monography in Portuguese | LILACS | ID: lil-494634
20.
Indian J Biochem Biophys ; 2007 Oct; 44(5): 350-6
Article in English | IMSEAR | ID: sea-27290

ABSTRACT

Cervical cancer is the second most common cancer in the women worldwide and the most frequent in developing countries, including India. Human papilloma virus (HPV) is the major etiological factor in cervical cancer patients. Host factors are also critical in regulating tumor growth and cytokines that modulate immunologic control may be of particular importance. In the present study, we investigated the correlation between the presence of HPV and type of cytokines expressed in cervical carcinomas and attempted to elucidate the possible reasons for the immune suppression. Cytokines investigated were type-1 cytokine IFN-gamma (shows immunostimulatory function and capable of limiting tumor growth) and type-2 cytokines IL-4, IL-10 and IL-6 (show immunosuppressive function and capable of stimulating tumor growth). Our data demonstrated the presence of HPV sub-types 16 and 18 in 86% and 13.8% of cervical tumor biopsies, respectively. The cervical tumor biopsies showed increased presence for mRNA for IL-10 and IL-1alpha, while none of the biopsies showed expression for IFN-gamma. A correlation was observed between the presence of HPV in cervical tumor biopsies and mRNA for IL-10. Increased percentages of CD4+CD25+ regulatory T cells (Tregs) were observed in circulation in cervical cancer patients, providing evidence for increased immune suppression. IL-10 may play a key role in maintenance of Tregs and explains the immunosuppressive state of cervical cancer patients.


Subject(s)
Female , Humans , Immunity, Innate/immunology , Interleukin-10/immunology , Papillomaviridae/immunology , Papillomavirus Infections/complications , Suppressor Factors, Immunologic/immunology , T-Lymphocytes, Regulatory/immunology , Uterine Cervical Neoplasms/immunology
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