Infecção cervical e anal pelo HPV em mulheres vivendo com HIV/AIDS: uma série de casos / Cervical and anal HPV infection in women living with HIV/AIDS: a series of cases

Introdução: Mulheres que vivem com o vírus da imunodeficiência humana (MVHIV) possuem risco aumentado de coinfecção pelo papilomavírus humano (HPV). A infecção persistente pelo HPV nos órgãos genitais de MVHIV pode resultar em câncer cervical e/ou anal. O objetivo deste estudo foi determinar a frequência da infecção por HPV cervical e anal em MVHIV e estabelecer relações epidemiológicas com os genótipos virais e dados clínicos e sociodemográficos. Métodos: Vinte e três mulheres foram avaliadas. Amostras do colo do útero e do ânus foram coletadas e analisadas por citologia convencional e para detecção do tipo do HPV pela técnica de nested-PCR e sequenciamento. Resultados: O HPV foi detectado em 39,1% das amostras do colo uterino e 47,8% do ânus. Dez tipos de HPV foram identificados, sendo cinco de alto risco e cinco de baixo risco para câncer. O HPV 11 foi o mais prevalente em todas as amostras analisadas. A detecção do HPV foi associada com situação conjugal, níveis linfócitos TCD4+, carga do HIV, citologias cervical e anal anormais. Anormalidade cervical e anal foi observada em 43,5% e 17,4% das mulheres, respectivamente, sendo o genótipo 11 o mais encontrado nesses casos. Conclusão: Tipos de HPV de alto e baixo risco para câncer foram identificados nas amostras. Os resultados destacam a importância da triagem citológica e molecular em MVHIV, mesmo em casos com tipos de HPV de baixo risco.

Introduction: Women living with HIV (WLHIV) have an increased risk of co-infection with human papillomavirus (HPV). Persistent HPV infection in the genital organs of WLHIV may result in cervical and/or anal cancer. The objective of this study was to determine the frequency of cervical and anal HPV infection in WLHIV and establish epidemiological relationships with viral genotypes and clinical and sociodemographic data. Methods: Twenty-three women were evaluated. Cervical and anal samples were collected and analyzed using conventional cytology. HPV type was determined by nested polymerase chain reaction and sequencing. Results: HPV was detected in 39.1% and 47.8% of cervical and anal samples, respectively. Ten types of HPV were identified, of which 5 had high (16, 35, 45, 53, and 56) and 5 had low (11, 44, 61, 70, and 84) oncogenic risk. HPV-11 was the prevalent type among analyzed samples. HPV detection was associated with marital status, CD4+ T lymphocyte count, HIV burden, and abnormal cervical and anal cytology. Cervical and anal abnormalities were observed in 43.5% and 17.4% of women, respectively, with genotype 11 being the most common in these cases. Conclusions: High- and low-oncogenic risk HPV were identified in the samples. The results highlight the importance of cytological and molecular screening in WLHIV, even in cases of low-risk HPV types.

Polymorphism Located in the Upstream Region of the RPS19 Gene (rs2305809) Is Associated With Cervical Cancer: A Case-control Study

Cervical cancer (CC) is caused by persistent human papillomavirus (HPV) infection and affects women worldwide. The progression of an HPV persistent infection to CC is influenced by genetic factors. Three single nucleotide polymorphisms (SNPs) in TP53, NQO1 and RPS19 genes (rs1042522, rs1800566, rs2305809, respectively) were previously associated with CC in European and North American populations. The present case-control study aimed to investigate the association of the SNPs rs1042522, rs1800566, and rs2305809 with CC in an admixed population in southern Brazil. A total of 435 women (106 CC patients and 329 controls) were recruited for this study. All women were interviewed and underwent clinical sampling. SNPs rs1042522 and rs1800566 were evaluated by PCR-RFLP. SNP rs2305809 was determined by real-time PCR. The crude and adjusted ORs with 95% CI were estimated. The recessive genetic model (C/C + C/T) for rs2305809 was more frequent in the control group (79.9%) compared to the cases (69.8%), being associated with CC protection ((adjusted)OR = 0.49; 95% CI: 0.27–0.90). However, the other polymorphisms evaluated did not present significant differences between cases and controls. This study detected a protective association for the recessive genetic model in rs2305809. These results suggest a potential role of the RPS19 gene in CC.