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Ciênc. Saúde Colet ; 26(12): 6223-6234, Dez. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1350498


Resumo O objetivo deste artigo é analisar a associação entre o desconhecimento sobre a campanha de vacinação contra o HPV entre adolescentes e fatores individuais e contextuais. Estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (2015). Foi realizada a análise bivariada e calculadas as Razões de Prevalência em uma Regressão de Poisson multinível (IC95%) para verificar o efeito das variáveis no desfecho. O desfecho esteve associado significativamente a ter 15-19 anos de idade (RP=1,36), estudar no turno da tarde/noite (RP=1,05), já ter tido relações sexuais (RP=1,10), com autopercepção do estado de saúde ruim ou muito ruim (RP=1,23), insatisfeito (RP=1,14) ou indiferente (RP=1,15) à sua imagem corporal, que falta às aulas sem consentimento dos pais (RP=1,10) e que estuda em escola pública (RP=1,24). Houve menor prevalência do desfecho entre o sexo feminino (RP=0,24) e em estados com maior desigualdade de renda (RP=0,80). O desconhecimento sobre a campanha de vacinação contra o HPV entre adolescentes foi associado às características individuais e do contexto da escola e da unidade de federação. Esses achados indicam a importância de fortalecer a promoção à saúde voltada aos jovens em vulnerabilidade.

Abstract The scope of this article is to analyze the association between lack of awareness of the HPV vaccination campaign among Brazilian adolescents and individual and contextual factors. It involved a cross-sectional study with data from the National Student Health Survey (2015). Bivariate analysis was performed and Prevalence Ratios were calculated, in a multilevel Poisson Regression (95%CI) to verify the effect of variables on the outcome. The outcome was significantly associated with being 15-19 years old (PR=1.36), studying during the afternoon/night shift (PR=1.05), having already had sexual intercourse (PR=1.10), with self-perceived poor or very poor health status (PR=1.23), dissatisfied (PR=1.14) or indifferent (PR=1.15) regarding their body image, playing truant from classes without parental consent (PR=1.10) and studying at a public school (PR=1.24). There was less prevalence of the outcome among females (PR=0.24) and in states with greater income inequality (PR=0.80). The lack of awareness about the HPV vaccination campaign among adolescents was associated with individual characteristics, the context of the school and the unit of the federation. These findings indicate the importance of enhancing health promotion for vulnerable young people.

Humans , Female , Adolescent , Adult , Young Adult , Papillomavirus Infections/prevention & control , Papillomavirus Infections/epidemiology , Students , Cross-Sectional Studies , Vaccination , Immunization Programs , Multilevel Analysis
An. bras. dermatol ; 96(1): 1-16, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1152799


Abstract Infection with human papilloma virus (HPV) is related to a great number of cutaneous and mucosal manifestations. The spectrum of HPV ranges from inapparent infections, through various clinical benign presentations including cutaneous and mucosal disease, to malignant and premalignant conditions. New HPV types are currently described in the literature; many of them are characterized as high-risk types due to their oncogenic potential. Knowledge regarding their epidemiology and pathogenesis is important to understand not only infection and disease processes, but also to formulate the clinical and laboratory basis for diagnosis, therapeutics, and prophylactic measures. This non-systematic review aims to discuss and to update those aspects, with an emphasis on relevant topics for dermatologists. HPV infection and related diseases in the Brazilian scenario are highlighted, including common dermatologic conditions seen at clinics as well as the condition of a public health problem as a sexually transmitted infection. The oncogenicity of the virus and the variety of clinical outcomes - especially in the immunocompromised individuals - are addressed.

Humans , Papillomaviridae , Precancerous Conditions , Papillomavirus Infections/epidemiology , Alphapapillomavirus , Brazil/epidemiology
ABCD arq. bras. cir. dig ; 34(1): e1528, 2021. tab, graf
Article in English | LILACS | ID: biblio-1248502


ABSTRACT Background: Currently, persistent human papillomavirus (HPV) infection has been related in some geographic regions as a risk factor for esophageal squamous cell carcinoma. It results in the immunoexpression of the p16 protein, which has been used as marker of the oncogenic lineage by this etiological agent. Aim: To correlate epidemiological aspects of esophageal squamous cell carcinoma with the prevalence of HPV infection. Methods: Fifty-eight cases were analyzed and submitted to histopathological and immunohistochemical analysis by p16. Results: Of the 58 cases evaluated, 40 were men and 18 women, with a mean age of 63.2 years. p16 immunoexpression was positive in 46.55%. Conclusion: The prevalence of HPV infection is high in esophageal squamous cell carcinoma presenting in almost half of the cases (46.55%), without gender differentiation.

RESUMO Racional: Atualmente a infecção persistente pelo papilomavírus humano (HPV) tem sido relacionada em algumas regiões geográficas como fator de risco para o carcinoma epidermoide do esôfago. Ela resulta na imunoexpressão da proteína p16, que tem sido utilizada como marcadora da linhagem oncogênica por este agente etiológico. Objetivo: Correlacionar aspectos epidemiológicos do carcinoma epidermoide do esôfago com a prevalência de infecção pelo HPV. Métodos: Foram analisados 58 casos buscando-se perfil epidemiológico dos pacientes, com suas peças submetidas à análise histopatológica e imunoistoquímica pelo p16. Resultado: Dos 58 casos avaliados, 40 eram homens e 18 mulheres, com idade média de 63,2 anos. A imunoexpressão pelo p16 foi de 46,55%. Conclusão: A prevalência de infecção pelo HPV é alta no carcinoma epidermoide de esôfago apresentando-se em quase a metade dos casos (46,55%), sem diferenciação de idade quanto aos gêneros.

Humans , Male , Female , Middle Aged , Esophageal Neoplasms/epidemiology , Carcinoma, Squamous Cell/epidemiology , Papillomavirus Infections/complications , Papillomavirus Infections/epidemiology , Alphapapillomavirus , Esophageal Squamous Cell Carcinoma , Papillomaviridae
Chinese Medical Journal ; (24): 1838-1844, 2021.
Article in English | WPRIM | ID: wpr-887613


BACKGROUND@#Cervical cancer remains a major public health issue for the Uyghur women and other women living mainly in rural areas of Xinjiang. This study aims to investigate the distribution of human papillomavirus (HPV) infection and cervical cancer in rural areas of Xinjiang, China.@*METHODS@#Cervical cancer screening was performed on rural women aged 35 to 64 years from Xinjiang, China in 2017 through gynecological examination, vaginal discharge smear microscopy, cytology, and HPV testing. If necessary, colposcopy and biopsy were performed on women with suspicious or abnormal screening results.@*RESULTS@#Of the 216,754 women screened, 15,518 received HPV testing. The HPV-positive rate was 6.75% (1047/15,518). Compared with the age 35-44 years group, the odds ratios (ORs) of HPV positivity in the age 45-54 years and 55-64 years groups were 1.18 (95% confidence interval [CI]: 1.02-1.37) and 1.84 (95% CI: 1.53-2.21), respectively. Compared with women with primary or lower education level, the ORs for HPV infection rates of women with high school and college education or above were 1.37 (95% CI: 1.09-1.72) and 1.62 (95% CI: 1.23-2.12), respectively. Uyghur women were less likely to have HPV infection than Han women, with an OR (95% CI) of 0.78 (0.61-0.99). The most prevalent HPV types among Xinjiang women were HPV 16 (24.00%), HPV 33 (12.70%), and HPV 52 (11.80%). The detection rate of cervical intraepithelial neoplasia (CIN)2+ was 0.14% and the early diagnosis rate of cervical cancer was 85.91%. The detection rates of vaginitis and cervicitis were 19.28% and 21.32%, respectively.@*CONCLUSIONS@#The HPV infection rate in Xinjiang is low, but the detection rate of cervical cancer and precancerous lesions is higher than the national average level. Cervical cancer is a prominent public health problem in Xinjiang, especially in southern Xinjiang.

Adult , Alphapapillomavirus , China/epidemiology , Early Detection of Cancer , Female , Humans , Middle Aged , Papillomaviridae/genetics , Papillomavirus Infections/epidemiology , Rural Population , Uterine Cervical Neoplasms/epidemiology
Article in English | WPRIM | ID: wpr-880687


OBJECTIVES@#Human papillomavirus (HPV) is a kind of spherical DNA virus, which is related to many factors such as immune status and pregnancy. Due to the decrease of immunity, pregnant women are more likely to have HPV infection, which causes serious imbalance of vaginal microecology and is not beneficial to pregnancy outcome. Therefore, this study focuses on the impact of HPV infection on vaginal microecology and maternal and neonatal outcomes.@*METHODS@#A total of 140 pregnant women with HPV infection during pregnancy, who received obstetric examination in the First Affiliated Hospital of Hainan Medical College from November 2017 to July 2019, were selected as a HPV infection group, and 150 normal pregnant women with HPV negative in the same period were selected as a control group. Vaginal secretions were collected from all the pregnant women at 28-34 weeks of gestation to evaluate vaginal pH, cleanliness and microecological status, and to record pregnancy outcomes for all pregnant women.@*RESULTS@#The proportions of vaginal pH>4.5, constituent ratio of flora density and diversity of I-II, positive detection rate of vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV) in HPV infected pregnant women were significantly higher than those in the control group (all @*CONCLUSIONS@#Pregnant women with HPV infection during pregnancy are more likely to have vaginal microecological disorders, and can increase the risk of adverse pregnancy outcomes such as premature delivery and chorioamnionitis.

Candidiasis, Vulvovaginal , Cesarean Section , Female , Humans , Infant, Newborn , Papillomavirus Infections/epidemiology , Pregnancy , Vaginosis, Bacterial
Rev. cuba. med. trop ; 72(1): e500, ene.-abr. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126700


Introducción: Existen pocos estudios sobre la circulación del virus del papiloma humano en mujeres ecuatorianas, particularmente residentes en el Cantón Cañar. Objetivo: Determinar la circulación del virus del papiloma humano, las alteraciones en la citología cérvico-vaginal de mujeres cañaríes y el comportamiento de algunas variables sociodemográficas y clínico-epidemiológicas. Métodos: Estudio analítico de corte transversal desde julio 2017-septiembre 2018. Se colectaron células cervicouterinas de 100 mujeres entre 15 y 55 años de edad para determinar la infección viral y alteraciones citológicas. Se investigó la asociación entre variables sociodemográficas y clínico-epidemiológicas con la infección viral. Resultados: El 51 por ciento (51/100) de las mujeres examinadas resultó positivo al virus, con predominio de los genotipos oncogénicos. El genotipo 31 fue el más frecuente (56,9 por ciento; 29/51), seguido por el genotipo 58 (43,1 por ciento; 22/51). Las mujeres mayores de 50 años, tenían una probabilidad menor de estar infectadas (3,9 por ciento; 2/51). La probabilidad de infección fue mayor en mujeres solteras, con antecedentes de infecciones de transmisión sexual, que padecían procesos cervicales inflamatorios, y en las fumadoras. La infección con genotipo 66 estuvo asociada al uso de anticonceptivos hormonales (53,3 por ciento; 8/15); p= 0,045, RP= 3,08 IC95 por ciento (1,00-9,46). Se obtuvo el 97 por ciento de citologías negativas para malignidad; no se diagnosticaron casos con lesiones de alto grado. Conclusiones: La elevada prevalencia de infección con genotipos oncogénicos en contraste con la baja frecuencia de citologías positivas, indica la necesidad de implementar programas eficientes para la detección precoz del cáncer cervicouterino en la población del Cañar y divulgar campañas de educación sexual y reproductiva(AU)

Introduction: Few studies are available about the circulation of human papillomavirus among Ecuadorian women, particularly those from Cañar Canton. Objectives: Determine the circulation of human papillomavirus, alterations in the cervical-vaginal cytology of women from Cañar Canton, and the behavior of some sociodemographic and clinical-epidemiological variables. Methods: An analytical cross-sectional study was conducted from July 2017 to September 2018. Cervical cells were collected from 100 women aged 15-55 years to determine viral infection and cytological alterations. An analysis was performed of the relationship of sociodemographic and clinical-epidemiological variables to viral infection. Results: Of the women examined, 51 percent; (51/100) tested positive for the virus, with a predominance of oncogenic genotypes. Genotype 31 was the most common (56.9 percent;; 29/51), followed by genotype 58 (43.1 percent; 22/51). Women aged over 50 years had a lesser probability of being infected (3.9 percent;; 2/51). Infection probability was greater among single women, with a history of sexually transmitted infections, who suffered from inflammatory cervical processes, and smokers. Infection by genotype 66 was associated to the use of hormonal contraceptives (53.3 percent;; 8/15); p= 0.045, PR= 3.08 CI95 percent; (1.00-9.46). Of the sample cytologies, 97 percent; were negative for malignancy; no case was diagnosed of high-grade lesions. Conclusions: The high prevalence of infection by oncogenic genotypes, as opposed to the low frequency of positive cytologies, points to the need to implement efficient programs aimed at early detection of cervical cancer in the population of Cañar Canton, as well as sexual and reproductive education campaigns(AU)

Humans , Female , Papillomavirus Infections/pathology , Papillomavirus Infections/epidemiology , Cross-Sectional Studies , Cytological Techniques/methods , Ecuador , Genotype
Rev. epidemiol. controle infecç ; 10(1): 72-78, jan.-mar. 2020. ilus
Article in Portuguese | LILACS | ID: biblio-1179203


Justificativas e Objetivos: Câncer de colo de útero é considerado um problema de saúde pública mundial. Seu diagnóstico é realizado através do exame citopatológico (EC) e seu desenvolvimento relacionado à infecção pelo papilomavírus humano (HPV). Este estudo objetiva avaliar o perfil de mulheres atendidas em centros de referência em saúde de Porto Alegre, Rio Grande do Sul, assim como a relação de alterações observadas ao EC com presença do HPV. Métodos: Estudo transversal realizado em mulheres atendidas em unidades básicas de saúde e um ambulatório de referência de hospital público terciário, no período de julho de 2014 a janeiro de 2017. Coletaram-se amostras representativas da endo/ectocérvice para realização do EC e investigadas quanto à presença molecular do HPV. Resultados: Foram analisadas 169 mulheres com idade média entre 31 e 40 anos, das quais 125 (74%) informaram que a sexarca ocorreu na faixa de 15-20 anos e 37,9% relatou ter tido de três a cinco parceiros sexuais. Em relação ao EC, 71 (42%) apresentaram resultado negativo para lesão intraepitelial ou malignidade e 98 (58%) alguma anormalidade de células escamosas: 20 (11,8%) atipias; 22 (13%) lesão intraepitelial escamosa de baixo grau e 56 (32,6%) lesão intraepitelial de alto grau (HSIL). Cinquenta (29,6%) apresentaram positividade para HPV, destas 56,4% foram diagnosticadas com HSIL (p<0,01). Conclusão: Os resultados revelam alta frequência de HPV em amostras com alterações citopatológicas, em mulheres jovens e com grau de exposição ao HPV, reforçando a importância do papel da sua identificação precoce na investigação da carcinogênese cervical.(AU)

Background and Objectives: Cervical cancer is considered a worldwide public health problem. Its diagnosis is made through cytopathological examination and its development related to human papillomavirus (HPV) infection. This study aims to evaluate the profile of women treated at reference health centers in Porto Alegre, Rio Grande do Sul, as well as the relation of changes observed to cytopathological examination with the presence of HPV. Methods: This is a cross-sectional study carried out in women treated at basic health units and a referral clinic of a public tertiary hospital, from July 2014 to January 2017. Representative samples of the endo/ectocervix were collected to perform the cytopathological examination and investigated for the molecular presence of HPV. Results: 169 women with mean age between 31 and 40 years were analyzed, of whom 125 (74%) reported that the onset of sexual activity occurred in the 15-20 years age group, and 37.9% reported having had three to five sexual partners. In relation to cytopathological examination, 71 (42%) had a negative result for intraepithelial lesion or malignancy and 98 (58%) some squamous cell abnormality: 20 (11.8%) atypical; 22 (13%) low-grade squamous intraepithelial lesion and 56 (32.6%) high-grade intraepithelial lesion (HSIL). Fifty (29.6%) were positive for HPV, of which 56.4% were diagnosed with HSIL (p < 0.01). Conclusion: The results reveal a high frequency of HPV in samples with cytopathological changes, in young women and with a degree of exposure to HPV, reinforcing the importance of the role of its early identification in the investigation of cervical carcinogenesis.(AU)

Justificación y objetivos: El cáncer de cuello uterino se considera un problema de salud pública en todo el mundo. Su diagnóstico se realiza mediante el examen citopatológico (EC), y su desarrollo está relacionado con la infección por el virus del papiloma humano (VPH). Este estudio objetivó evaluar el perfil de mujeres atendidas en los centros de referencia en salud de Porto Alegre, Rio Grande do Sul (Brasil), así como la relación de las alteraciones observadas en el EC con la presencia del VPH. Métodos: Estudio transversal realizado en las mujeres atendidas por unidades de atención primaria y por una clínica ambulatoria de referencia del hospital público terciario en la ciudad de Porto Alegre, en el período de julio de 2014 a enero de 2017. Se recolectaron muestras representativas de endo/ectocérvice para realizar la CE, las cuales se clasificaron según el sistema Bethesda y se investigaron la presencia molecular del VPH. Resultados: Analizamos 169 mujeres con promedio de edad entre 31 y 40 años, de las cuales 125 (74%) informaron que el sexarche ocurrió en el rango de 15-20 años. La mayoría (37,9%) informó haber tenido de 3 a 5 parejas sexuales; y el 37,3% estaban usando anticonceptivos orales. Con respecto a la EC, 71 (42%) se clasificaron como negativos para lesión intraepitelial o malignidad; y el 98 (58%) tenían alguna anormalidad de células escamosas: 20 (11,8%) de atipias; 22 (13,0%) lesión intraepitelial escamosa de bajo grado y 56 (32,6%) lesión intraepitelial de alto grado (HSIL). La frecuencia de positividad del VPH encontrada fue de 50 (29,6%), de estas un 56,4% fueron diagnosticadas con HSIL (p<0,01). Conclusiones: Estos resultados revelan una alta frecuencia de VPH en muestras con alteraciones citopatológicas presentes en mujeres jóvenes con cierto grado de exposición al VPH, lo que refuerza la importancia de identificarse tempranamente en el análisis de la carcinogénesis cervical.(AU)

Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Papillomaviridae/isolation & purification , Papillomavirus Infections/pathology , Papillomavirus Infections/epidemiology , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Cross-Sectional Studies , Age Distribution , Papanicolaou Test , Squamous Intraepithelial Lesions of the Cervix/pathology , Squamous Intraepithelial Lesions of the Cervix/virology
J. oral res. (Impresa) ; 9(1): 51-56, feb. 28, 2020. ilus, tab
Article in English | LILACS | ID: biblio-1151481


Some genotypes of the human papilloma virus (HPV) in the oral cavity cause genetic instability that may lead to cancer. Clinical and histological diagnoses are key tools; however, molecular techniques allow predicting, detecting and monitoring the disease. Objective: To identify the frequency of four high-risk HPV genotypes and their association with lesions in the oral cavity. Materials and Methods: Descriptive cross-sectional study with a sample of 48 patients diagnosed with hyperplastic lesions and others currently classified as potentially malignant disorders (PMDs) of the oral cavity, who underwent biopsies, histopathological analysis, and HPV16, 18, 31, and 45 detection and genotyping by polymerase chain reaction (PCR). Results: Epithelial hyperplasia was the most frequent lesion found in 45.8% (n=22) of patients. Nicotine palatinus and leukoplakia were found in 8.3% and 6.2%, respectively; oral cancer in 6.2%. The total frequency of HPV was 12.5% (6/48). Oral papilloma was found in 6.1% (3/48), and nicotine palatinus and oral cancer in 2.0% each (1/48). HPV16, HPV31, and HPV45 were detected, while HPV18 was not observed. HPV16 was the most frequent genotype found (4 out of 6 patients), while HPV31 and HPV45 were found in one patient each. Only one genotype per lesion was found. The presence of HPV was associated with lesions (χ2=11.810; p=0.0375). No significant association with age and gender was found. Conclusion: High-risk HPV continues to be present in oral lesions. The HPV16 viral genotype was the most frequent in the studied lesions.

Algunos genotipos del virus del papiloma (VPH) en boca, producen inestabilidad genética dando lugar al cáncer. El diagnóstico clínico e histológico son herramientas claves, sin embargo, técnicas moleculares permiten predecir, detectar y dar seguimiento a la enfermedad. Objetivo: Identificar la frecuencia de cuatro genotipos del VPH de alto riesgo y su asociación con lesiones en cavidad bucal. Material y Métodos: Estudio descriptivo de corte transversal con una muestra de 48 pacientes diagnosticados con lesiones hiperplásicas y otros clasificados actualmente como desordenes potencialmente malignos (DPM) de la cavidad bucal, a quienes se les realizó biopsias, análisis histopatológico y detección y genotipificación VPH16, 18, 31, y 45 mediante reacción en cadena a la polimerasa (PCR). Resultado: La hiperplasia epitelial fue la lesión más frecuente en 45,8% (n=22). La palatinitis nicotínica y la leucoplasia, se encontraron 8,3% y 6,2% respectivamente, cáncer oral, en 6,2%. La frecuencia total de VPH fue 12,5% (6/48). El papiloma oral estuvo en un 6,1% (3/48), palatinitis nicotínica y cáncer oral en 2,0% (1/48).Se detectó VPH16, VPH31 y VPH45, mientras que VPH18 estuvo ausente. ElVPH16 fue el de mayor frecuencia con 66,7% (4/6), el VPH31 y VPH45 se encontraron en 16,7% (1/6). No se evidenció más de un genotipo por lesión. La presencia de VPH estuvo asociado con las lesiones (χ2=11,810; p=0,0375). No se encontró asociación significativa con edad y género. Conclusión: El VPH de alto riesgo sigue estando presente en lesiones bucales. El genotipo viral VPH16 se encontró con mayor frecuencia en las lesiones estudiadas.

Humans , Mouth Neoplasms , Papillomavirus Infections/epidemiology , Human papillomavirus 16 , Human papillomavirus 18 , Mouth/injuries , Epidemiology, Descriptive , Colombia , Focal Epithelial Hyperplasia , Papillomavirus Infections/diagnosis
Braz. j. med. biol. res ; 53(2): e9560, 2020.
Article in English | LILACS | ID: biblio-1055496


Our aim was to review the major contributions of studies conducted in different Latin American (LA) countries to the field of human papillomavirus (HPV) epidemiology, natural history, risk of disease, and prevention strategies, mainly in the uterine cervix. Although cytological screening is established in several countries in LA, incidence and mortality rates from cervical cancer (CC) are still extremely high. Finally, data from large cohort studies conducted in LA countries provided seminal data to propose primary and secondary prevention modalities: the HPV vaccine has been introduced in the national immunization programs of several LA countries and multiple screening experiences using HPV testing are under evaluation in the region.

Humans , Male , Female , Papillomaviridae , Uterine Cervical Neoplasms/virology , Papillomavirus Infections/epidemiology , Papillomavirus Vaccines/administration & dosage , Primary Prevention , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/prevention & control , Mass Screening , Papillomavirus Infections/complications , Papillomavirus Infections/prevention & control , Secondary Prevention , Latin America/epidemiology
Rev. saúde pública (Online) ; 54: 93, 2020. tab, graf
Article in English | SES-SP, LILACS, BBO, SES-SP | ID: biblio-1139466


ABSTRACT OBJECTIVE To estimate the prevalence of high-risk human papillomavirus (HR-HPV) anal infection and associated factors in human immunodeficiency virus (HIV) positive patients in Medellín. METHODS Descriptive cross-sectional study in 300 HIV-positive patients, adults, with history of anal intercourse, treated in two health care services of Medellín 2017-2018. We conducted a structured survey on sociodemographics, sexual behavior and medical history. HPV was detected in anal swabs tested by the COBAS 4800 system. Exploratory data analysis of risk factors associated with HR-HPV was conducted by chi-square test of independence and both raw and adjusted prevalence ratios used the Poisson regression model, at a 95% confidence interval. RESULTS The high-risk HPV had a prevalence of 82.7%; HPV16 had a prevalence of 32.7%, HPV18 a prevalence of 21.7% and other HPV types scored 78.3%. The high-risk HPV prevalence in women was of 68.2% and 83.8% in men. The risk factors associated with high-risk HPV after adjustment were age under 30 years, elementary education, casual sex partners, and first sexual activity before 18 years old. CONCLUSIONS The high incidence of high-risk HPV, along with the occurrence of coinfections by multiple types in the study population shows their susceptibility to develop some type of anal intra-epithelial neoplasia. It is important to establish sexual health programs focused on primary health care.

RESUMEN OBJETIVO Estimar la prevalencia de la infección anal por el virus del papiloma humano de alto riesgo y factores asociados en pacientes con el virus de inmunodeficiencia humana (VIH) de Medellín. MÉTODOS Estudio descriptivo transversal en 300 pacientes VIH positivos, adultos, con historia de relaciones sexuales anales, atendidos en dos instituciones de salud de Medellín 2017-2018. Se aplicó una encuesta estructurada sobre características socio-demográficas, comportamiento sexual y antecedentes clínicos. El VPH se detectó en muestras de exfoliado anal mediante la prueba COBAS 4800. Se realizó análisis exploratorio de factores de riesgo asociados al VPH-AR mediante la prueba Chi cuadrado de independencia y razones de prevalencia cruda y ajustadas por regresión de Poisson, con intervalos del confianza. RESULTADOS La prevalencia global de VPHAR fue 82,7%; VPH 16 de 32,7%, VPH 18 de 21,7% y otros tipos 78,3%. La prevalencia de VPHAR en mujeres fue de 68,2% y en hombres, 83,8%. Los factores de riesgo asociados al VPH-AR luego del ajuste fueron tener menos de 30 años, algún grado de educación básica primaria, pareja ocasional e inicio de relaciones sexuales antes de 18 años. CONCLUSIONES La alta frecuencia de infección por VPHAR, así como la existencia de co-infecciones por múltiples tipos en la población de estudio muestra la susceptibilidad que tienen para desarrollar algún grado de Neoplasia Intraepitelial Anal. Es importante establecer programas de promoción de la salud sexual con enfoque de atención primaria.

Humans , Male , Female , Adult , Anal Canal/virology , HIV Infections/epidemiology , Papillomavirus Infections/epidemiology , Sexual Behavior , Prevalence , Cross-Sectional Studies , Risk Factors , Colombia/epidemiology , Risk Assessment , Middle Aged
Rev. chil. infectol ; 36(4): 421-427, ago. 2019. tab
Article in Spanish | LILACS | ID: biblio-1042657


Resumen Introducción: El inicio precoz de actividad sexual puede favorecer el desarrollo de alteraciones cervicales y de infecciones de transmisión sexual, en especial del virus papiloma humano (VPH) muy frecuente en adolescentes y jóvenes. Objetivo: Analizar el estado del cuello uterino, presencia del VPH y conductas sexuales en mujeres menores de 25 años. Material y Métodos: Participaron 182 estudiantes universitarias de 18-24 años, sanas, sexualmente activas y no vacunadas para VPH. Se realizó Papanicolaou (Pap) y clasificación del VPH en alto y bajo riesgo (AR y BR) mediante reacción de polimerasa en cadena en tiempo real. Las conductas sexuales fueron consultadas privadamente. Resultados: El 46,9% de los Pap presentaron alteraciones citológicas (inflamación inespecífica/hemorrágico: 29,4% y frotis atípicos (FA):10,2%). La frecuencia de los VPH-AR fue 24,3%; de éstos, 67,4% presentó un Pap alterado. Hubo asociación entre alteraciones citológicas y presencia de VPH (p < 0,0001) y años de actividad sexual y FA o neoplasia intraepitelial grado I (NIE I) (p = 0,009). El 11,9% de las jóvenes estudiadas (21/177) presentó FA o NIE I, con 66,7% de casos VPH-AR. Conclusiones: Estos hallazgos alertan la vulnerabilidad de estas jóvenes que tendrían un riesgo potencial de persistencia viral, NIE y eventualmente cáncer. Es importante enfatizar consejería y prevención previo a la edad normada de ingreso al programa de cribado para cáncer cérvico uterino en Chile.

Background: The early onset of sexual activity can promote the development of cervical alterations and sexually transmitted infections, especially the human papillomavirus (HPV) very common in adolescents and young people. Aim: The condition of the cervix, HPV and sexual behavior in young women under 25 years of age were analyzed. Methods: 182 university students, healthy, sexually active, 18-24 years old, without vaccine for HPV participated. Papanicolaou (Pap) test and classification of high and low risk HPV (HR and LR) were performed by real time polymerase chain reaction. The sexual behaviors were consulted in private. Results: The 46.9% of Pap presented cytological alterations, non-specific inflammation/hemorrhagic (29.4%) and atypical smear (10.2%) being de most frequent. The overall frequency of HPV-HR was 24.3%, of these 67.4% presented an altered Pap. There was an association between cytological alterations and HPV (p < 0.0001) and years of sexual activity and atypical smear or cervical intraepithelial neoplasia grade I (CIN I) (p = 0.009). 11.9% of young women (21/177) presented atypical smear or CIN I, with 66.7% of cases HPV-HR. Conclusions: These findings alert the vulnerability of these young women who would have a potential risk of viral persistence, CIN and eventually cancer. It is important to emphasize counseling and prevention prior to the regular age of admission to the screening program for cervical cancer. This study was financed by the Universidad de La Frontera through Projects DI15-0047 and DI17-0123.

Humans , Female , Adolescent , Young Adult , Papillomaviridae/isolation & purification , Sexual Behavior/statistics & numerical data , Students/statistics & numerical data , DNA, Viral/analysis , Papillomavirus Infections/diagnosis , Papillomaviridae/genetics , Universities , Chile/epidemiology , Mass Screening , Polymerase Chain Reaction , Risk Factors , Papillomavirus Infections/epidemiology , Papanicolaou Test
Rev. bras. ginecol. obstet ; 41(6): 387-393, June 2019. tab
Article in English | LILACS | ID: biblio-1013625


Abstract Objective Themain objective of the present study was to estimate the annual treatment costs of invasive cervical cancer (ICC) per patient at an oncology center in Brazil from a societal perspective by considering direct medical, direct nonmedical, and indirect costs. Methods A cost analysis descriptive study, in which direct medical, direct nonmedical, and indirect costs were collected using a microcosting approach, was conducted between May 2014 and July 2016 from a societal perspective. The study population consisted of women diagnosed with ICC admitted to a tertiary hospital in Recife, state of Pernambuco, Brazil. The annual cost per patient was estimated in terms of the value of American Dollars (US$) in 2016. Results From a societal perspective, the annual ICC treatment cost per patient was US $ 2,219.73. Direct medical costs were responsible for 81.2% of the total value, of which radiotherapy and outpatient chemotherapy had the largest share. Under the base-case assumption, the estimated cost to the national budget of a year of ICC treatment in the Brazilian population was US$ 25,954,195.04. Conclusion We found a high economic impact of health care systems treating ICC in a poor region of Brazil. These estimates could be applicable to further evaluations of the cost-effectiveness of preventing and treating ICC.

Resumo Objetivo O objetivo principal do presente estudo foi estimar os custos anuais por paciente do tratamento do câncer do colo do útero (CCU) invasivo em um centro de oncologia no Brasil, sob a perspectiva da sociedade, considerando os custos diretos médicos, diretos não médicos e indiretos. Métodos Foi realizado um estudo descritivo de análise de custos, no qual os custos médicos diretos, não médicos diretos e indiretos foram coletados por meio de uma abordagem de microcustos, realizado entre maio de 2014 e julho de 2016 sob a perspectiva da sociedade. A população do estudo foi composta por mulheres diagnosticadas com CCU invasivo internadas em um hospital terciário em Recife, PE, Brasil. O custo anual por paciente foi estimado emtermos de dólares americanos (US$) para o ano de 2016. Resultados O custo anual do tratamento do CCU invasivo sob a perspectiva da sociedade foi de US$ 2.219,73 por paciente. Os custos médicos diretos foram responsáveis por 81,2% do valor total, dos quais a radioterapia e a quimioterapia ambulatorial tiveram a maior participação. Sob o pressuposto do caso base, o custo estimado para o orçamento nacional de um ano de tratamento do CCU invasivo na população brasileira foi de US$ 25.954.195,04. Conclusão Foi encontrado um alto impacto econômico dos sistemas de saúde para o tratamento do CCU invasivo em uma região pobre do Brasil. Essas estimativas poderão ser aplicáveis emavaliações adicionais do custo-efetividade da prevenção e tratamento do CCU.

Humans , Female , Adult , Aged , Aged, 80 and over , Young Adult , Gynecologic Surgical Procedures/economics , Uterine Cervical Neoplasms/economics , Mass Screening/economics , Health Care Costs/statistics & numerical data , Papillomavirus Infections/economics , Early Detection of Cancer/economics , Vaginal Smears , Brazil/epidemiology , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/therapy , Uterine Cervical Neoplasms/epidemiology , Costs and Cost Analysis , Papillomavirus Infections/prevention & control , Papillomavirus Infections/therapy , Papillomavirus Infections/epidemiology , Papillomavirus Vaccines/economics , Health Services Research , Hospitalization/statistics & numerical data , Middle Aged
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(1): 6-15, abr. 2019. ilus, tab
Article in Spanish | LILACS, BDNPAR | ID: biblio-1007859


En Paraguay la incidencia de cáncer de cuello uterino (CCU) es superior a las observadas en otros países de la región. El agente etiológico asociado al CCU es el virus papiloma humano (VPH), esencialmente tipos de alto riesgo oncogénicos. El objetivo es describir aspectos epidemiológicos de la infección genital por el virus papiloma humano de alto riesgo (VPH-AR) en mujeres de 25 a 64 años que consultaron en servicios de Patología Cervical del MSPyBS, de mayo a diciembre de 2013. Se utilizó el Cobas 4800 HPV Test (Roche) que permite la detección individual de VPH-16 y VPH-18 y un pool de otros VPH-AR que incluye 12 genotipos de alto riesgo. Los otros VPH-AR fueron tipificados por hibridación reversa en línea (RLB). Entre las 495 mujeres incluidas, se detectaron 72 casos positivos (14,5%) de VPH-AR. Se identificaron 19 tipos virales; siendo el más frecuente VPH-16 (2,1%), seguido del VPH-31, 33, 58 y 66; el VPH-18 aparece en sexto lugar. Este trabajo aporta los primeros datos sobre la implementación de técnicas moleculares para detección y tipificación de VPH como parte del sistema de salud pública de Paraguay. El predominio de VPH-16, confirma su amplia circulación a nivel mundial y dado su mayor potencial oncogénico, representa una alerta a considerar, en especial en las mujeres mayores de 30 años portadoras de una infección persistente. Estos resultados apoyan la importancia de la implementación criteriosa y la utilización apropiada de las pruebas moleculares actualmente disponibles para la prevención y control del CCU(AU)

Humans , Female , Adult , Middle Aged , Papillomaviridae/genetics , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Paraguay/epidemiology , Cross-Sectional Studies , Human papillomavirus 16/genetics , Human papillomavirus 18/genetics , Genotyping Techniques
Salud pública Méx ; 61(1): 86-94, ene.-feb. 2019. tab
Article in Spanish | LILACS | ID: biblio-1043362


Resumen: Objetivo: Evaluar el impacto de la prueba de VPH (prueba de VPH) en los problemas que históricamente afectaron al tamizaje de cáncer cervical en América Latina, tomando como caso al Proyecto Demostración para la Introducción de la prueba de VPH en Jujuy (PDJ), Argentina. Material y métodos: Se sintetizó la evidencia sobre los problemas del tamizaje cervical en la región. Se analizó el impacto en los problemas a partir de la introducción de la prueba de VPH. El impacto se clasificó en directo/indirecto y positivo/negativo. Resultados: El impacto directo-positivo se dio en los problemas de adherencia a la edad/frecuencia de tamizaje, laboratorios de citología, baja/moderada sensibilidad de la citología y baja cobertura. El impacto directo-negativo se vinculó con el triaje de autotoma y el envío/etiquetado de muestras. El impacto indirecto-positivo se relacionó con la reorganización programática realizada para introducir la prueba de VPH. Conclusiones: La prueba de VPH representa una ventana de oportunidad para el mejoramiento del tamizaje pero no resuelve los problemas programáticos.

Abstract: Objective: To assess the impact of HPV testing on longstanding problems faced by screening programs in Latin America, using the case of the Jujuy Demonstration Project (JDP) in Argentina. Materials and methods: The study measured the level of impact produced by the introduction of HPV-testing on problems faced by cytology programs by analyzing modifications on specific problems produced during the JDP. Impact was classified as direct/indirect, and positive/ negative. Results: Direct/positive impact was found in issues concerning age and screening frequency, cytology laboratories and screening sensitivity, and low coverage. Direct/negative impact was mainly related to the adherence to triage cytology by HPV+ women with self-collected-tests, and the delivery and labelling of samples. Indirect impact of HPV-Test was mostly positive, and related to the programmatic reorganization which was facilitated by the introduction of HPV testing. Conclusions: HPV testing provides an opportunity window for improving primary screening, but does not solve programmatic problems.

Humans , Female , Vaginal Smears , Uterine Cervical Neoplasms/prevention & control , Mass Screening/statistics & numerical data , Papillomavirus Infections/diagnosis , Human Papillomavirus DNA Tests , Argentina/epidemiology , Precancerous Conditions/diagnosis , Precancerous Conditions/epidemiology , Social Problems , Program Evaluation , Patient Acceptance of Health Care , Mass Screening/methods , Mass Screening/organization & administration , Data Collection , Guideline Adherence , Papillomavirus Infections/epidemiology , Developing Countries , Social Determinants of Health
Braz. oral res. (Online) ; 33: e031, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039304


Abstract: Variable rates of HPV infection have been reported in healthy oral mucosa worldwide. The main objective of this study was to detect and genotype HPV infection in users and nonusers of drugs with clinically healthy mucosa from the Northeast Brazil. Samples from 105 patients were amplified using the primers MY09/MY11 and GP5+/GP6+, and genotyping was performed by multiplex-PCR for HPV-6/11, 16 and 18. A total of 81.9% samples were positive. Among drug users, 84.5% presented the virus and 20.4% showed multiple infections. Among non-drug users, 78.7% were positive and 13.5% had multiple infections. Limited information is available on oral HPV in Brazilian population, especially for drug users, and our results showed higher HPV infection rates in both users and nonusers of drugs. More studies and researches focused on drug users including factors like sexual behavior, nutrition and cultural habits are necessary to enhance the comprehension of this relationship, and develop preventive strategies.

Humans , Male , Female , Adolescent , Adult , Young Adult , Substance-Related Disorders/complications , Substance-Related Disorders/virology , Papillomavirus Infections/etiology , Papillomavirus Infections/epidemiology , Mouth Mucosa/virology , Papillomaviridae/isolation & purification , Risk-Taking , Sexual Behavior , Socioeconomic Factors , Brazil/epidemiology , DNA, Viral , Case-Control Studies , Polymerase Chain Reaction , Prevalence , Cross-Sectional Studies , Prospective Studies , Risk Factors , Sex Distribution , Age Distribution , Risk Assessment , Middle Aged
Salud pública Méx ; 60(6): 722-733, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-1020937


Abstract: Objective: To describe the methods of a study aimed at evaluating high risk-HPV (hrHPV)-based screening and cervical cytology as triage compared to conventional cervical cytology as primary screening in the detection of grade 2+ cervical intraepithelial neoplasia in the National Cancer Screening Program (NCSP) of Mexico. Materials and methods: We will use information originated from the Womens Cancer Information System of Mexico regarding cervical cancer from 2008 to 2018. The database includes cytology results, diagnostic confirmation by histopathology and/or treatment colposcopy. We will then carry out statistical analyses on approximately 15 million hrHPV. Results: We will evaluate the overall performance of hrHPV-based screening as part of the NCSP and compare hrHPV-based to cytology-based screening under real-life conditions. To guarantee an unbiased comparison between hrHPV with cytology triage and conventional cytology we will use propensity score matching. Conclusion: Decision makers may use our results to identify areas of opportunity for improvement in NCSP processes.

Resumen: Objetivo: Describir los métodos de un estudio que busca comparar el beneficio de la introducción de la prueba de VPH de alto riesgo como prueba primaria frente a la citología convencional para la detección de la neoplasia intraepitelial cervical grado 2 o mayor, dentro del Programa de Prevención y Control del Cáncer de la Mujer, para el periodo de 2008 a 2018. Material y métodos: Se utilizarán los registros del Sistema de Información de Cáncer de la Mujer, se realizarán los análisis estadísticos con aproximadamente 15 millones de resultados de VPH-alto riesgo, además se utilizarán los resultados de citología, colposcopia, histología y los casos referenciados al centro oncológico para tratamiento. Para comparar ambos grupos usaremos "propensity score matching". Resultados: Se evaluará el desempeño general de la prueba de VPH-alto riesgo, en condiciones reales dentro del Programa Nacional de Prevención y Control de la Mujer y su tendencia en el tiempo. Conclusiones: Los resultados de estudio ayudarán a los tomadores de decisiones a identificar áreas de oportunidad para mejorar el programa en México.

Humans , Female , Adult , Middle Aged , Uterine Cervical Neoplasms/epidemiology , Databases, Factual , Cervical Intraepithelial Neoplasia/epidemiology , Papillomavirus Infections/epidemiology , Early Detection of Cancer/statistics & numerical data , Human Papillomavirus DNA Tests/statistics & numerical data , Vaginal Smears , Prevalence , Triage , Sensitivity and Specificity , Cervical Intraepithelial Neoplasia/diagnosis , Colposcopy , Age Distribution , Propensity Score , Geography, Medical , Procedures and Techniques Utilization , Mexico/epidemiology
Salud pública Méx ; 60(6): 703-712, Nov.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-1020935


Abstract: Objective: To evaluate the effectiveness of a combined strategy of human papillomavirus virus (HPV) vaccination and high-risk HPV screening to reduce the occurrence of anogenital and oropharyngeal neoplasms among men who have sex with men, people with HIV, homeless people, transgender women, female sex workers and rape victims. Materials and methods: This mixed methods study evaluates the effectiveness of a combined vaccination-screening strategy to reduce HPV prevalence/incidence and occurrence of cervical intraepithelial neoplasms grade 2+ and/or anal intraepithelial neoplasms grade 2+, using Kaplan-Meier. The time-to-event method will evaluate time from positive results for specific anogenital HPV to incidence of anogenital lesions containing that HPV type. Results: People vaccinated against HPV and screened for HPV as a primary test will have lower prevalence and incidence of HPV infection and consequently lower frequency of HPV-related anogenital and oropharyngeal lesions. Conclusions: This study will generate scientific evidence on effectiveness of a combined vaccination-screening strategy to reduce the burden of HPV-associated neoplasms.

Resumen: Objetivo: Evaluar la efectividad de una estrategia combinada de vacunación contra el virus de papiloma humano (VPH) y tamizaje de VPH de alto riesgo para reducir neoplasias anogenitales y orofaringeas entre hombres que tienen sexo con hombres, personas con VIH, personas en situación de calle, mujeres transgénero, trabajadoras sexuales y víctimas de violación. Material y métodos: Este estudio evaluará la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la ocurrencia de neoplasias intraepiteliales cervicales grado 2+ o neoplasias intraepiteliales anales grado NIA2+ utilizando Kaplan-Meier. Se evaluará tiempo de resultados positivos para tipos específicos de VPH anogenital a incidencia de lesiones anogenitales con ese tipo de VPH. Resultados: Las personas vacunadas contra VPH y con tamizaje de VPH tendrán menor prevalencia e incidencia de infecciones por VPH y por ende menor frecuencia de lesiones anogenitales y orofaringeas relacionadas con VPH. Conclusiones: Este estudio generará evidencia científica sobre la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la carga de neoplasias asociadas al VPH.

Humans , Male , Female , Adult , Young Adult , Anus Neoplasms/prevention & control , Mouth Neoplasms/prevention & control , Carcinoma in Situ/prevention & control , Immunization Programs , Papillomavirus Infections/epidemiology , Early Detection of Cancer , Anus Neoplasms/epidemiology , Comorbidity , HIV Infections/epidemiology , Risk , Cervical Intraepithelial Neoplasia/epidemiology , Crime Victims , Vulnerable Populations , Papillomavirus Vaccines , Social Marginalization , Mexico/epidemiology
Salud pública Méx ; 60(6): 653-657, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-1020929


Abstract: Objective: To determine the prevalence and risk factors for oral high-risk human papillomavirus (HR-HPV) infection in human immunodeficiency virus(HIV)-infected men. Materials and methods: Consecutive male outpatients with HIV-infection were enrolled. Demographic and behavioral risk data were obtained. Anal swabs and oral rinses were tested for HR-HPV DNA. Oral, pharyngeal and video laryngoscopy examinations were performed for detection of lesions. Results: The prevalence of HR-HPV oral infection was 9.3% (subtypes other than HR HPV 16/18 predominated). The prevalence of anal HR-HPV infection was 75.7%. The risk factors for oral infection with HR-HPV were tonsillectomy (OR=13.12) and years from HIV diagnosis (OR=1.17). Conclusions: Tonsillectomy and years from HIV diagnosis were associated with oral HPV infection. No association was found between oral and anal HR-HPV infections. This is the first study reporting the prevalence and risk factors for oral HR-HPV infection in Mexican HIV-infected population.

Resumen: Objetivo: Determinar la prevalencia y los factores de riesgo para infección oral por virus de papiloma humano de alto riesgo (VPH-AR) en individuos con VIH. Material y métodos: Se incluyeron pacientes ambulatorios consecutivos con VIH. Se recabó información demográfica y sobre factores de riesgo conductuales. Se detectó DNA de VPH-AR en hisopado rectal y enjuague bucal. Se efectuó exploración de boca, faringe y videolaringoscopía para detectar lesiones. Resultados: La prevalencia de VPH-AR oral fue 9.3% (predominaron subtipos diferentes de VPH-AR 16/18). La prevalencia de VPH-AR anal fue 75.7%. Los factores de riesgo para VPH-AR oral fueron la tonsilectomía (OR=13.12) y los años de diagnóstico del VIH (OR=1.17). Conclusiones: La tonsilectomía y los años de diagnóstico del VIH se asociaron con VPH-AR oral. No hubo asociación entre VPH-AR oral y anal. Este es el primer reporte sobre prevalencia y factores de riesgo para VPH-AR oral en población mexicana con VIH.

Humans , Male , Adolescent , Adult , Middle Aged , Aged , Young Adult , Pharyngeal Diseases/epidemiology , HIV Infections/epidemiology , Papillomavirus Infections/epidemiology , Mouth Diseases/epidemiology , Anus Diseases/epidemiology , Papilloma/virology , Sexual Behavior , Alcohol Drinking/epidemiology , Mouth Neoplasms/epidemiology , Smoking/epidemiology , Comorbidity , HIV Infections/blood , Cross-Sectional Studies , Prospective Studies , Surveys and Questionnaires , CD4 Lymphocyte Count , Mexico/epidemiology