Human papillomavirus infection in Rio de Janeiro, Brazil: a retrospective study

There is considerable data to support a central role for human papillomavirus (HPV) in the etiology of cervical cancer. More than a 100 HPV types have been described, and 40 have been isolated from benign and malignant genital lesions. Consequently, there is strong motivation to evaluate HPV testing for cervical cancer screening. Few studies concerning the natural history of HPV infection have been conducted in the state of Rio de Janeiro. We determined the prevalence of HPV types in female genital lesions by using Hybrid Capture Assay (HCA) and we retrospectively analyzed the course of HPV infection. Our sample included 788 women attended at Laboratórios Sérgio Franco. The average age of the participants was 29.6 years. HPV prevalence and cytological diagnosis were determined. The overall prevalence of HPV DNA in the study group was 50.1 percent (395/788), ranging from 25 percent (NORMAL) to 100 percent in high-grade intraepithelial lesions (HSIL). High risk HPV was found in 12 percent inflammatory, 58.3 percent HPV, 63.2 percent LSIL and 100 percent HSIL. A retrospective analysis of 78 patients showed that 22 presented persistent lesions, 2 had progressive lesions, 4 had regressive lesions, 13 showed latent infections, 18 were transiently infected and 19 were submitted to curative treatment. No cases of cancer were registered in this population, which can afford private medical care and regular follow-up exams. We suggest that HCA be used in specific cases involving persistent and recurrent lesions.

Análise epidemiológica da patologias genitais associadas a papilomavírus / Epidemiologic analysis of genital pathologies associated to papillomavirus

Estudando-se casos de infecçoes genitais associadas a papilomavírus em um hospital universitário, verificou-se que as patologias mais frequentes eram o condiloma acuminado e câncer epidermóide. Objetivo. Analisar a prevalência das lesoes genitais associadas a papilomavírus e distribuiçao por sexo, idade e cor. Métodos. Foram estudadas 223 pacientes atendidas no Hospital Universitário Antonio Pedro, estado do Rio de Janeiro, durante os anos de 1988 a 1992. Após diagnóstico clínico, biópsias das pacientes foram submetidas a análise histológica. Resultados. Os resultados mostraram que, entre as doenças do trato genital associadas a papilomavírus, o condiloma acuminado e o carcinoma epidermóide eram as mais frequentes. Os casos de carcinoma epidermóide mantiveram prevalência estável ao longo do período, enquanto que o número de casos condiloma acuminado aumentou de três para 33 por ano. As duas patologias foram mais frequentes em indivíduos de cor branca. Nao houve diferença significativa entre sexo e presença de condiloma. A média de idade para carcinoma epidermóide nao sofreu variaçao significativa no período estudado, enquanto decaiu para o condiloma acuminado nos períodos de 1988 para 1989 e de 1991 para 1992. Conclusao. As lesoes genitais associadas a papilomavírus aumentaram significativamente no período de cinco anos. Maior atençao deve ser dada as campanhas de controle de diagnóstico precoce.

Prevalence of human papillomavirus DNA in female cervical lesions from Rio de Janeiro, Brazil

A hundred-sixty paraffin-embedded specimens from female cervical lesions were examined for human papillomavirus (HPV) types 6, 11, 16 and 18 infections by non-isotopic in situ hybridization. The data were compared with histologic diagnosis. Eighty-eight (55) biopsies contained HPV DNA sequences. In low grade cervical intraepithelial neoplasias (CIN I), HPV infection was detected in 78.7 of the cases, the benign HPV 6 was the most prevalent type. HPV DNA was detected in 58 of CIN II and CIN III cases and in 41.8 of squamous cell carcinomas (SCC). Histologically normal women presented 20 of HPV infection. Oncogenic HPV was found in 10 of these cases, what may indicate a higher risk of developing CINs and cancer. Twenty-five percent of the infected tissues contained mixed infections. HPV 16 was the most common type infecting the cervix and its prevalence raised significantly with the severity of the lesions, pointing its role in cancer pathogenesis. White women presented twice the cervical lesions of mulatto and African origin women, although HPV infection rates were nearly the same for the three groups (approximately 50). Our results showed that HPV typing by in situ hybridization is a useful tool for distinguishing between low and high risk cervical lesions. Further studies are required to elucidate risk factors associated with HPV infection and progression to malignancy in Brazilian population.

Human papillomavirus detection in genital lesions by in situ hybridization and ultrastructural observations

Detection of papillomavirus DNA in sity hybridization technique was perfomed in 29 symptomatic patients (6 males and 23 females) during the period of 1989-1991 at the Clinic for Sexually Transmitted Diseases, Universidade Federal Fluminense, State of rio de Janeiro. All the male patients had condyloma acuminata. Only HPV 6/11 were found in these lesions. Clinical features inthe female patients included vulvar condyloma acuminata, bowenoid populosis, flat cervical condyloma, cervical condyloma acuminatum and cervical intraepithelialneoplasia grade II (CIN II). We also found cases of condyloma acuminata associated to vulvar intraepithelial neoplasia grade III (VIN III), as well as to vaginal invasive carcinoma. HPV 6/11 and 16/18 were found in vulvar condyloma acuminata. Mixed infection by 6/11-16/18 HPV were also seen in these lesions as well as in the patient who had cervical condyloma acuminatum. HPV 16/18 were found in the condyloma acuminatum plus VIN III and in the CIN II lesions. We have found HPV31/33/51 in the specimen of condyloma acuminatum plus invasive carcinoma. In order to investigate the ultrastructural aspects of HPV infection in genital tissue, the biopsies of three female patients were observed under electron microscope.Mature virus particles were found in the cells of a condyloma acuminatum as wellas in the condyloma acuminatum plus invasive carcinoma case. In another sample, chromosome breakages were found in the nuclei of the infected cells although no viral particles were observed

Echovirus type 19 and herpes simplex type 2 infection in human placenta tissue explants

1. Light and electron microscopy have been used to characterize echovirus 19 and herpes simplex type 2 infection of human placenta tissue in vitro. Immunofluorescence, autoradiography and virus adsorption were used to determine virus replication in this system. 2. Placental tissue was permissive to echovirus 19. Trophoblast cells were lysed with liberation of mature virions. However, during the 48-h period of observation, few cells were damaged and the trophoblastic structure was maintained. 3. HSV-2 infection in placental tissue was aborted although trophoblastic cells allowed virus adsorption, penetration and uncoating. A characteristic cytopathic effect was observed in infected trophoblastic cells in spite of the abortive infection

Electron microscopy of Hofbauer cells after embedding with placental erythrocytes

A quantidade de células Hofbauer isoladas de placentas humanas a termo é insuficiente para que se obtenha um bom "pellet" para observaçäo à microscopia eletrônica. Com a utilizaçäo de hemácias da própria placenta como suporte, foi possível obter micrografias eletrônicas nítidas dessas células, evidenciando-se a sua estrutura, semelhante a macrófagos