Research progress on diabetes and human papilloma virus infection and vaccination / 公共卫生与预防医学

Diabetes is a common chronic non-infectious disease. Diabetic patients not only suffer from metabolic disorders, but are also prone to immune deficiencies and are at a higher risk of being infected with human papillomavirus (HPV). Many studies at home and abroad have shown that the HPV infection rate of patients with diabetes is higher than that of non-diabetic patients. Patients with diabetes can benefit from HPV vaccination, and the tolerance is good. HPV vaccination is recommended for diabetic patients. This article reviews the research on diabetes, HPV infection, and HPV vaccine, which will provide references for HPV vaccination in diabetic patients.

Human papillomavirus DNA testing with the urine sample is not yet available: the accuracy of two distinct kits

SUMMARY OBJECTIVE: The aim of this study was to assess the results and efficiency of two real-time polymerase chain reaction procedures for detecting human papillomavirus utilizing urine samples. METHODS: This study comprised 151 patients who had previously tested positive for human papillomavirus in their cervical samples. Two different commercial real-time polymerase chain reaction techniques were used for identification and genotyping human papillomavirus in urine specimens. The urine samples of 151 patients were evaluated via the Roche Cobas test, and the urine samples of 91 patients were also evaluated via the Qiagen test. RESULTS: The overall consistency of urine and cervical swab specimens for the identification of human papillomavirus in Roche Cobas and Qiagen tests were 44.8 and 44%, respectively. The rates of positive human papillomavirus results from urine samples were 57 and 70.3%, respectively. The overall concordance among Roche Cobas and Qiagen tests utilizing urine samples for human papillomavirus type 16/18 was 84.3% with a kappa value of 0.675, and for other high-risk-human papillomavirus, it was 75.60% with a kappa value of 0.535. Roche Cobas showed high concordance with Qiagen test. CONCLUSION: human papillomavirus positivity was not detected in all urine samples. It is still inappropriate to recommend the use of urine liquid biopsy for the accurate and reliable detection of human papillomavirus. Due to the lack of a standardized tool, the utilization of urine samples as a screening human papillomavirus test remains a challenge.

Prevalence of high-risk human papillomavirus genotypes among apparently healthy women with normal and abnormal cervical cytology in Kaduna State, Nigeria

Background: About 99.7% of cervical dysplasia and cancer cases are caused by persistent genital high-risk human papillomavirus (hrHPV) infection. Most HPV infections are subclinical and self-limiting but may persists in about 5 to 10% of infected women, resulting in pre-cancerous lesions that can progress to invasive cancer years later. This study is aimed at detecting hrHPV among apparently healthy women of reproductive age in Kaduna State, thus providing more information for effective control of HPV and cervical cancer in Nigeria. Methodology: Cervical smears were taken from 515 randomly selected apparently healthy women across selected secondary and tertiary facilities from 3 Local Government Areas (LGAs) in each Senatorial Zone of Kaduna State, Nigeria. Liquid-based cytology (LBC) technique was used to collect cervical smears and prepare smears for cytology study, while the remaining samples were stored at -80oC for molecular studies. HPV DNA were extracted from the samples and amplified by convectional PCR using specific hrHPV (HPV 16,18,31 and 45) primer sets and a broad spectrum MY09/11 and GP5+/6+ primers for a wider range of HPV genotypes. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 23.0 and relationship between prevalence of hrHPV and socio-demographic factors such as age and marital status were determined using Chisquare or Fisher Exact test with p<0.05 considered statistically significant. Results: The prevalence of total HPV and hrHPV infections in the study population was 11.8% (61/515) and 9.3% (48/515) respectively. A total of 100 HPV genotypes were detected by PCR in the 61 positive smears, with 66 hrHPV types from 48 women, and 34 other HPV types from 13 women. The frequency of hrHPV genotypes detected was HPV 31 (5.8%, n=30), HPV 45 (4.1%, n=21), HPV 16 (1.7%, n=9), and HPV 18 (1.2%, n=6), with other HPV genotypes (6.6%, n=34). The frequency of cervical dysplasia was 6.4% (33/515), which was significantly associated with all HPV genotypes except HPV 16. Single HPV infection was seen in 31 (51.8%) women while multiple infections were seen in 30 (49.2%), with double infection in 21 (34.4%) and triple infections in 9 (14.7%). Conclusion: The prevalence of hrHPV infection was high among women in Kaduna State, Nigeria. DNA-based screening for hrHPV genotypes and production of new vaccine that will protect against the predominant hrHPV genotypes are thus recommended for the prevention of cervical cancer in Nigeria, Africa and beyond.

Genotipificación del virus del papiloma humano en mujeres embarazadas VPH positivas / Genotyping of human papillomavirus in HPV-positive pregnant women

Resumen Antecedentes: Las embarazadas infectadas por el virus del papiloma humano presentan condiciones médicas que influyen en el curso de la enfermedad y pueden potenciar la posibilidad de transmisión vertical. Objetivo: Identificar los genotipos del virus del papiloma humano más frecuentes en mujeres embarazadas. Método: Estudio retrospectivo, observacional y descriptivo. Se emplearon muestras de raspado cervical. La extracción de material genético se hizo por la técnica de fenol-cloroformo y se amplificó empleando iniciadores universales MY09/MY11. Las muestras positivas se genotipificaron con un kit que detecta 37 genotipos diferentes. Resultados: Se identificaron 341 genotipos. Los más frecuentes fueron 16 (10.3%), 52 (8.8%) y 59 (8.6%). En el 75.9% la detección fue con un genotipo y en el 42.7% se detectaron infecciones múltiples. Conclusiones: Es sabido que la infección por virus del papiloma humano en mujeres embarazadas raramente evolucionará a lesiones invasivas. Se deberán considerar tanto las posibles complicaciones obstétricas a corto y largo plazo, así como las posibles repercusiones en la salud del recién nacido. La detección elevada del genotipo 16 sugiere un seguimiento estrecho para considerar un abordaje óptimo posterior a la gestación.

Abstract Background: Pregnant women infected with human papillomavirus have medical conditions that influence the course of the disease and can increase the possibility of vertical transmission. Objective: To identify the most common human papillomavirus genotypes in pregnant women. Method: Retrospective, observational and descriptive study. Cervical scraping samples were used. The extraction of genetic material was done by the phenol-chloroform technique and was amplified using universal primers MY09/MY11. Positive samples were genotyped with a kit that detects 37 different genotypes. Results: Three hundred forty-one genotypes were identified. The most frequent were 16 (10.3%), 52 (8.8%), and 59 (8.6%). In 75.9% the detection was with one genotype and in 42.7% multiple infections were detected. Conclusions: It is known that human papillomavirus infection in pregnant women will rarely evolve to invasive lesions. Both possible short- and long-term obstetric complications, as well as possible repercussions on the health of the newborn, should be considered. The high detection of genotype 16 suggests close follow-up to consider an optimal post-pregnancy approach.

Using High-Resolution Anoscopy to Detect Anal Dysplasia Due to Papillomavirus in Patients with Inflammatory Bowel Disease

Introduction: Anal squamous cell carcinoma is rare, but its incidence and mortality have been increasing globally; 90% of cases are related to human papillomavirus (HPV) infection(1,2). Patients with inflammatory bowel disease (IBD) have a higher risk of infection with this virus; an incidence of 5.5 per 100,000 patients has been identified in the IBD group compared to 1.8 in the non-IBD group(3). Materials and methods: A descriptive case series study was conducted with 21 patients with IBD and no perianal symptoms between January and July 2022 at the Institute of Coloproctology in Medellín. They underwent anal cytology, HPV genotyping, and high-resolution anoscopy after explanation and acceptance of the procedure. If lesions were found, ablative treatment was performed. Results: 23% of this cohort had low-grade squamous lesions, while 14.2% had high-grade lesions with dysplasia changes during anoscopy. Besides, 90.4% had positive HPV genotyping, of which 76.1% were high-grade. Conclusions: Our study suggests that this series of patients with IBD behaves as a high-risk group for developing premalignant lesions in association with HPV. High-resolution anoscopy is a cost-effective, painless, and affordable method that, in expert hands, may impact the diagnosis and management of premalignant lesions and decrease the incidence of anal cancer in patients with IBD.

Introducción: El carcinoma anal de células escamosas es raro, pero su incidencia y mortalidad han ido en aumento globalmente. El 90% de los casos están relacionados con la infección por el virus del papiloma humano (VPH)1,2 y los pacientes con enfermedad inflamatoria intestinal (EII) tienen un mayor riesgo de infección por este virus; se ha identificado una incidencia de 5,5 por 100.000 pacientes en el grupo de EII frente a 1,8 en el grupo sin EII3. Metodología: Se realizó un estudio descriptivo de serie de casos en el que se incluyó a 21 pacientes con EII, sin síntomas perianales, entre enero y julio de 2022 en el Instituto de Coloproctología de Medellín, a quienes se les realizó citología anal, genotipificación del VPH y anoscopia de alta resolución, previa explicación y aceptación del procedimiento. Si se encontraban lesiones, se realizaba tratamiento ablativo. Resultados: El 23% de esta cohorte tenía lesiones escamosas de bajo grado, mientras que el 14,2% presentaba lesiones de alto grado con cambios de displasia al momento de la anoscopia. El 90,4% tenían genotipificación positiva para VPH, de los cuales el 76,1% eran de alto grado. Conclusiones: Nuestro estudio sugiere que esta serie de pacientes con EII se comporta como un grupo de alto riesgo para desarrollar lesiones premalignas en asociación con el VPH. La anoscopia de alta resolución es un método rentable, indoloro y asequible que, en manos expertas, puede impactar el diagnóstico y manejo de lesiones premalignas y disminuir la incidencia de cáncer anal en pacientes con EII.

Percepción de usuarios de Facebook sobre la vacuna contra el VPH en publicaciones del Ministerio de Salud de Perú a partir de procesamiento de lenguaje natural

El objetivo de este estudio fue describir las percepciones de los usuarios de Facebook que realizaron comentarios, en las publicaciones realizadas desde la cuenta oficial del Ministerio de Salud de Perú (MINSA), referentes a la campaña de vacunación contra el VPH. Se analizaron 2748 comentarios en Python con procesamiento de lenguaje natural. Con este proceso se obtuvieron palabras claves que luego fueron interpretadas de manera manual. Se encontraron mayoritariamente cuatro tipos de discursos dentro de ellos: a) apoyo a la publicación sobre la vacuna contra el VPH; b) rechazo a la vacuna contra el VPH; c) Vacuna contra el VPH en niños; d) Dudas sobre la vacuna contra el VPH. En su mayoría, los usuarios que expresaron una postura de rechazo de esta vacuna se respaldaban de links a noticias donde se presentaba un evento supuestamente atribuido a la vacunación o inmunización pero que carecía de una fuente de información confiable y/o verificable.

The objective of this study was to describe the perceptions of Facebook users who commented on posts made by the official account of the Ministry of Health of Peru (MINSA) regarding the HPV vaccination campaign. We analyzed 2748 comments in Python with natural language processing. With this process we obtained keywords that were then interpreted manually. We found mostly four types of discourse, within them: a) support for the publications of the HPV vaccine; b) refusal of the HPV vaccine; c) HPV vaccine in children; d) doubts about the HPV vaccine. For the most part, users who expressed a position against this vaccine relied on links to online news stories that presented an event supposedly attributed to vaccination or immunization but lacked a reliable and/or verifiable source of information.

Comparación de protocolos de vacunación contra el virus del papiloma humano en Ecuador y América Latina / Comparation of vaccination protocols against the human papillomavirus in Ecuador and Latin America

INTRODUCCIÓN: El virus del papiloma humano (VPH), con más de 100 tipos, es de transmisión sexual. Varios países de América Latina han introducido las vacunas contra el VPH. Aunque América Latina es la región que más rápido avanzó en la vacunación contra el VPH, sus sistemas de seguimiento y vigilancia son aún deficientes. OBJETIVO: Comparar las diferentes estrategias de vacunación contra el VPH en Ecuador y América Latina. MÉTODO: Revisión bibliográfica, en la que se obtuvo información de documentos gubernamentales y artículos indexados en los últimos 5 años sobre las estrategias de vacunación contra el VPH en Ecuador y América Latina. RESULTADOS: La mayoría de los países de América Latina han logrado introducir la vacuna contra el VPH, excepto Venezuela, Martinica, Haití, Nicaragua y Cuba. CONCLUSIONES: Los protocolos de vacunación de Ecuador y América Latina necesitan mejorar sus sistemas de seguimiento y aumentar la expansión de datos de cobertura disponibles de manera consistente. Actualmente siguen existiendo desafíos para introducir las vacunas, lograr una alta cobertura y fortalecer el seguimiento, la evaluación y la notificación.

INTRODUCTION: The human papilloma virus (HPV), with more than 100 types, is a sexual transmission infection. Many Latin American countries have introduced the vaccines against the HPV. Although Latin América is the region which advanced faster against the HPV, its surveillance and follow-up systems are yet deficient. OBJECTIVE: To compare the different strategies to assume the vaccination against the HPV in Ecuador and Latin America. METHOD: Bibliographic review, in which information was obtained from government documents and articles indexed in the last five years on vaccination strategies against HPV in Ecuador and Latin America. RESULTS: Most Latin American countries have managed to introduce the vaccine against the HPV, except Venezuela, Martinica, Haiti, Nicaragua and Cuba. CONCLUSIONS: The vaccination protocols of Ecuador and Latin América need to improve their systems of follow-up and monitoring, and increase the expansion of available data in a consistent manner. Now, there are still existing challenges to introduce the vaccines, manage a high reach and fortify the follow-up, the evaluation, and the notification.

¿Está la virtud en el punto medio? La incertidumbre del CIN2 y el papel del VPH / Is virtue at the midpoint? The uncertainty of CIN2 and the role of HPV

Objetivo: La biopsia guiada por colposcopia (BGC) marca el manejo de la neoplasia intraepitelial cervical. El objetivo de este estudio fue evaluar la concordancia de los resultados entre la BGC y la escisión amplia de la zona de transformación (LLETZ, large loop excision of the transformation zone), y la utilidad del genotipado del virus del papiloma humano (VPH) para seleccionar a las pacientes con riesgo de lesión intraepitelial escamosa de alto grado/neoplasia intraepitelial cervical 3 (HSIL/CIN3). Método: Se compararon los resultados de la BGC y de la LLETZ, siendo esta última el método de referencia. Se evaluó la relación del genotipo del VPH con el diagnóstico final de HSIL/CIN3. Resultados: La precisión de la biopsia comparada con LLETZ fue del 61,4%. La tasa de concordancia fue del 64,4% para CIN1, del 31,4% para CIN2 y del 77,4% para CIN3. La tasa global de sobrediagnóstico fue del 18,68% y la de subdiagnóstico del 19,89%. En mujeres menores de 30 años, la concordancia fue del 62,79% (CIN1 65%, CIN2 39,58% y CIN3 73,08%), la tasa de sobrediagnóstico del 22,67% y la tasa de subdiagnóstico del 15,11%. La infección por VPH16 tuvo una odds ratio de 3,86 para el diagnóstico final de HSIL/CIN3+. Conclusiones: El diagnóstico de CIN2 por BGC parece insuficiente para seleccionar a las pacientes para tratamiento escisional, principalmente en mujeres jóvenes. El hallazgo de VPH16 es un factor de riesgo de HSIL/CIN3+ independientemente del resultado de la biopsia.

Objective: Colposcopy-guided biopsy (CGB) is a basic tool for the management of cervical intraepithelial neoplasia. The aim of this study is to evaluate the concordance of results between CGB and large loop excision of the transformation zone (LLETZ), and the usefulness of human papillomavirus (HPV) genotyping to select patients at risk of H-SIL/CIN3. Method: The results of colposcopy-guided biopsy and LLETZ were compared, with LLETZ being the gold standard. The relationship of HPV genotype to the final diagnosis of CIN3 was assessed. Results: The accuracy of CGB compared to LLETZ was 61.4%. The concordance rate was 64.4% for CIN1, 31.4% for CIN2 and 77.4% for CIN3. The overall overdiagnosis rate was 18.68% and underdiagnosis rate was 19.89%. In women under 30 years of age the concordance rate was 62.79% (CIN1 65%, CIN2 39.58% and CIN3 73.08%), and the rate of overdiagnosis and underdiagnosis was 22.67% and 15.11%, respectively. HPV16 infection had an odds ratio of 3.86 for the final diagnosis of CIN3+ and the result was significant regardless of the biopsy result. Conclusions: The CGB result as CIN2 is inaccurate and seems insufficient to select patients for excisional treatment, mainly in young women. HPV16 infection is a risk factor for CIN3+ regardless of the colposcopy-guided biopsy result.

Neoplasia cervical e infección por virus del papiloma humano como factores de riesgo para desarrollo de cáncer anal y lesiones precursoras / Cervical neoplasia and human papilloma virus infection as risk factors for the development of anal cancer and precursor lesions

RESUMEN La incidencia del cáncer anal ha presentado un incremento en los últimos 10 años, sobre todo en población considerada vulnerable. Las mujeres con antecedentes de infección por Virus del Papiloma Humano (VPH) en el tracto genital, tienen mayor riesgo de este tipo de cáncer. Se ha demostrado que, la infección con genotipos de VPH de alto riesgo (AR), en la región anogenital, desempeña un papel en la etiopatogenia de dicho cáncer. Se desconocen muchos aspectos de la historia natural de las lesiones anales, pero se considera que la zona de transición anal presenta un alto recambio celular, por lo que se ha planteado un mecanismo fisiopatológico de infección por VPH-AR y desarrollo de lesiones invasoras, similar al del cáncer cervical. El objetivo de este trabajo fue mostrar el estado actual sobre la información epidemiológica que vincula el riesgo de desarrollar cáncer anal en mujeres con lesiones precursoras de cáncer cervical asociadas a la infección por VPH. La relevancia de dicha información es proporcionar una base de recomendaciones para la detección oportuna de cáncer anal en mujeres consideradas de AR de padecerlo y, favorecer la realización de estudios prospectivos en la población.

ABSTRACT The incidence of anal cancer has increased in the last 10 years, especially in the population considered to be at risk. Women with a history of infection in the genital tract by Human Papillomavirus (HPV) have higher risk of developing this type of cancer. The presence of high-risk (HR) HPV genotypes in the anogenital region has been shown to play a role in the etiopathogenesis of anal cancer. Many aspects of the natural history of anal lesions are unknown, but the anal transition zone is considered to have a high cell replacement. This is why a pathophysiological mechanism of HR-HPV infection and development of invasive lesions similar to those of cervical cancer has been suggested. The aim of this work was to show the current status of the epidemiological information that links the risk of developing anal cancer in women with cervical cancer precursor lesions associated with HPV infection. The relevance of this information is to provide a basis of recommendations for the timely detection of anal cancer in women considered to be at HR of suffering it, and to encourage more prospective studies in this population.

A New Brazilian Device for Cervical Cancer Screening: Acceptability and Accuracy of Self-sampling / Um Novo Dispositivo Brasileiro para Diagnóstico de Câncer Cervical: Aceitabilidade e Precisão da Autoamostragem

Abstract Objective To evaluate the accuracy and patient acceptability toward self-sampling using a new device - SelfCervix® - for detecting HPV-DNA. Methods A total of 73 women aged 25-65 who underwent regular cervical cancer screening from March to October 2016 were included. Women performed self-sampling followed by a physician-sampling, and the samples were analyzed for HPV-DNA. After that, patients were surveyed about their acceptability of self-sampling. Results HPV-DNA detection rate of self-sampling presented high accuracy and was similar to physician-collection. Sixty-four (87.7%) patients answered the acceptability survey. Most patients (89%) considered the self-sampling comfortable, and 82.5% preferred self-sampling to physician-sampling. The reasons cited were time-saving and convenience. Fifty-one (79.7%) reported that they would recommend self-sampling. Conclusion Self-sampling using the new Brazilian device SelfCervix® is not inferior in HPV-DNA detection rate compared with physician-collection, and patients are supportive of the method. Therefore, it might be an option to reach under-screened populations in Brazil.

Resumo Objetivo Avaliar a acurácia e aceitabilidade da auto-coleta utilizando um novo coletor - SelfCervix® - para a detecção de DNA de HPV. Métodos Foram incluídas no estudo 73 mulheres com idade entre 25-65 anos que realizaram seu rastreamento regular do câncer de colo do útero entre Março e Outubro de 2016. Estas mulheres realizaram a auto-coleta, seguida de coleta profissional e as amostras foram analisadas paraa presença de DNA de HPV. Após, elas responderam um questionário sobre a experiência da auto-coleta. Resultados As taxas de detecção de DNA de HPV por auto-coleta foram altas e similares as da coleta profissional. Sessenta e quatro (87,7%) pacientes responderam o questionário de experiência. A maioria (89%) considerou a auto-coleta confortável, e 82,5% preferiram o método comparado a coleta profissional. As razões citadas foram economia de tempo e conveniência. Cinquenta e uma (79,7%) mulheres confirmaram que recomendariam a auto-coleta. Conclusão Auto-coleta utilizando o novo coletor desenvolvido no Brasil não é inferior na detecção de DNA de HPV quando comparada a coleta profissional, e apresenta uma boa aceitabilidade pelas mulheres. Desta maneira, pode ser uma opção para alcançar populações que não realizam o rastreamento padrão.

Safety of human papilloma virus vaccine based on Vaccine Adverse Event Reporting System from 2006 to 2021 / 中国生物制品学杂志

@#Objective To investigate the characteristics of distribution of adverse event(AE)associated with human papillomavirus(HPV)vaccine by analysis of data on AE collected from the Vaccine Adverse Event Reporting System(VAERS).Methods The data on AE reported in VAERS from January 1st,2006 to December 31st,2021 were analyzed and compared by using Pearson Chi-square test and Mann-Whitney U test.Results A total of 53 571 cases of AE were included in the study,in which the ratio of male to female was 0. 25∶1,and the median age of vaccinees was 15 years. A portion of 36. 1%of AE occurred after the first dose,while 90. 7% occurred within 3 d after vaccination. Both the gender ratios(χ~2=72. 570,P < 0. 001) and the median ages(Z = 4. 255,P < 0. 001)of vaccinees in non-serious and serious adverse event(SAE)showed significant difference. In terms of classification of SAE,hospitalization,prolonged hospitalization and disability were more common in females than in males,of which the percentages decreased with the increasing age. Among the AE,syncope was the most common clinical symptom. In the SAE,the highest proportion of deaths was caused by HPV2 vaccine,which was 19. 0%. The proportion of prolonged hospitalization caused by HPV4 vaccine was higher than that by HPV9vaccine. In general,HPV4 vaccine was more prone to cause SAE than HPV9 vaccine(χ~2=183. 267,P < 0. 001).Conclusion In all the AE,the largest proportion occurred in the age group of 9 ～ 17 years,followed by those in the groups of 18 ～ 26 and 27 ～ 45 years. Most of the AE occurred after the first dose. The clinical symptoms of AE caused by three vaccines were different. The analysis of distribution characteristics of AE may provide a reference for the study on clinical safety of HPV vaccine and optimization of vaccination.

Effects of recombinant human interferon α2a suppository on levels of inflammatory factors in cervical mucus of HPV-infected patients / 中国生物制品学杂志

@#Objective To investigate the effects of recombinant human interferon α2a(rhIFNα2a) suppository on the levels of inflammatory factors in the cervical mucus of patients infected with human papillomavirus(HPV).Methods A total of60 HPV-positive patients admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from March to August in 2022 were selected as study objects,and then divided into observation and control groups,30 cases for each group,according to the random number table method.The observation group was given rhIFNα2a suppository therapy by vaginal medication,once every other day,continuous 10 times a month as a course of treatment,and 3 consecutive courses of treatment.The control group did not use drugs.The cervical secretions were collected and the levels of IL-1β,IL-2R,IL-6,IL-8,IL-10 and tumor necrosis factor-α(TNF-α) were measured by chemiluminescence assay.Results After 3 months of treatment,the levels inflammatory factors IL-1β,IL-6,IL-8 and TNF-α in cervical mucus of patients in the observation group were significantly lower than those in the control group(t=-2.717,-2.686,-3.178 and-3.25,respectively,each P <0.05).Compared with before treatment,the levels of IL-1β,IL-6,IL-8 and TNF-α in cervical mucus of patients in the observation group also decreased significantly(t=5.934,4.092,6.495 and 3.287,respectively,each P <0.01),while in the control group,only the level of IL-8 in cervical mucus was significantly different(t=2.345,P=0.024).Conclusion rhIFNα2a suppository can reduce the level of inflammatory factors in cervical mucus,attenuate the inflammatory response and accelerate the clearance of HPV.

Research progress in the protective efficacy of human papillomavirus vaccines in males / 中华微生物学和免疫学杂志

Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens. It can cause a variety of diseases such as condyloma acuminatum, anal cancer, penile cancer and oropharyngeal cancer in men, resulting in a high disease burden. With the development of society, the application of HPV vaccines in males has attracted more attention. Currently, there are many clinical trials and real-world research results of HPV vaccines applied to boys and men worldwide, and many countries have introduced HPV vaccination for underage boys into their national immunization programs. This article intended to review the research progress in the efficacy of HPV vaccines in male population.

Effectiveness of HPV vaccines in real-world study / 中华微生物学和免疫学杂志

Human papillomavirus (HPV) is an epitheliotropic virus. High-risk HPV infections lead to precancerous lesions which may progress to cancer in the cervix, vagina and vulva, while low-risk HPV infections cause benign lesions such as genital warts and recurrent respiratory papillomas. HPV infection remains one of the major public health problems threatening human health. To date, six prophylactic preventive HPV vaccines have been licensed, and the effectiveness of HPV vaccination has gradually appeared in some countries with earlier vaccination. HPV vaccination has been proved to be effective in protecting against diseases related to HPV infection, which leads to significant reductions in the incidence of vaccine-type HPV-related infection, high cervical lesions, anogenital warts, recurrent respiratory papillomatosis and other relevant diseases. The herd protection effect of the vaccines is outstanding. Meanwhile, a bivalent HPV vaccine has been demonstrated for the cross-protection against HPV infections of non-vaccine types (HPV31/33/45) in real-world vaccination practice.

Research progress of awareness and acceptance of HPV vaccination among males / 中华全科医师杂志

Human Papillomavirus (HPV) infection is very common in sexually active men and women. HPV vaccination is the most effective measure for primary prevention for HPV infection and HPV-related diseases ultimately. HPV infection can cause condylomata acuminata in males, and is also associated with penile cancer, anal cancer and oral cancer; however, most male HPV carriers do not have signs or symptoms, so prevention and treatment of HPV infection in men can effectively reduce the risk of HPV infection in their partners. In most countries the HPV vaccination coverage among females is far lower than targeting expectation, and the effective herd immunity has not been achieved yet. Men can directly benefit from HPV vaccination, which is also beneficial for their partners, therefore HPV vaccination for men is worth considering. In this article we briefly describe HPV vaccination in males and overview their awareness and acceptance of HPV vaccination, so as to provide references for promoting HPV vaccination among men in the future.

Clinical analysis of cervical lesions in 1 337 postmenopausal women diagnosed during screening / 中华老年医学杂志

Objective:To screen and diagnose cervical lesions in middle-aged and elderly postmenopausal women and analyze the characteristics of cervical lesions in middle-aged and elderly women.Methods:A retrospective analysis was conducted on the screening data of 1 337 postmenopausal women aged between 50 and 86 years who visited the outpatient clinics of the gynecology department of Beijing Hospital between January, 2015 and December, 2019.Participants were divided into groups based on age, with 787 in the 50-59 years old group, 483 in the 60-69 years old group, 60 in the 70-79 years old group, and 7 in the 80-89 years old group.Exfoliated cervical cells were collected, and high-risk human papillomavirus(HPV)detection and liquid-based cervical cytology examination were performed to confirm the diagnosis based on the pathological results of cervical biopsy.Cervical lesions were analyzed.Results:53.0%(708)of the 1 337 enrolled patients made their hospital visits because of symptoms.There were 666 patients(49.8%)with cervical lesions, including 357 with low-grade squamous intraepithelial lesions(LSIL), 252 with high-grade squamous intraepithelial lesions(HSIL)and 57(4.3%)with cervical cancer.The 70-79 group showed the highest incidence of HSIL at 30.0%(18/60), while the 50~59 group had the highest incidence of LSIL at 30.6%(241/787), and there were significant differences in different types of cervical lesions between different age groups( χ2=28.919, P<0.01). Liquid-based cervical cytology examination revealed a positive rate of 51.6%(166/322)for LSIL, a positive rate of 70.8%(143/202)for HSIL, and a rate of 71.4%(25/35)for cervical cancer.There were significant differences in LSIL, HSIL and other above-mentioned positive rates of lesions( P<0.05). In the cervical malignancy group, cytological high-grade squamous epithelial lesions made up 51.4%(18/35). Intraepithelial lesions or cancerous lesions represented 29.2%(59/202)in the HSIL group.The rate of intraepithelial lesions or cancerous lesions in the LSIL group was 48.4%(156/322), with statistically significance in these differences( χ2=118.806, P<0.01). Chronic cervicitis was found in 52.9%(109)of 206 patients with atypical squamous cells and positive HPV, and in 76.2%(16)of 21 patients without HPV.HPV examination was completed in 1 301 patients, with 69.4%(903)having infections by one HPV strain and 30.6%(398)having infections by mixed HPV strains.Biopsy results showed that the rates of HPV infections in LSIL, HSIL and cancer patients were 84.6%(302/357), 95.9(185/193)and 100%(54/54), respectively, and the differences in these pathological results were statistically significant( P<0.01). HPV16 was the most common subtype in single HPV strain infections.The most common subtypes of HPV infections in cervical lesions with HSIL and above were HPV16 and HPV18.The agreement rate was 52.4%(187/357)for LSIL, 60.7%(153/252)for HSIL, and 64.9%(37/57)for cervical cancer between diagnoses based on cervical biopsy and those based on colposcopy.As the severity of lesions increased, the accuracy of colposcopy also increased.Differences between colposcopic diagnosis and pathological diagnosis on different types of cervical lesions were statistically significant( χ2=550.382, P<0.01).1 310 patients underwent endocervical curettage, identifying 120 cases of HSIL and 39 cases of cervical cancer, with a detection rate of 55.8%(159/285). Conclusions:The incidence of cervical cancer is high in elderly women.The incidences of high-grade lesions and cervical cancer in patients with atypical squamous cells plus HPV infections in the cervix are also high.Postmenopausal patients with cervical lesions are mainly infected by a single HPV subtype, with subtype 16 being the most common one.With increasing severity of lesions, the accuracy of colposcopy-based diagnosis increases and the rate of missed diagnosis decreases.Cervical curettage is an important means to reduce missed diagnosis with colposcopy.

Distribution of human papillomavirus types in cervical cancer population / 中国医师杂志

Objective:To investigate the distribution of human papillomavirus (HPV) subtypes in patients with cervical invasive cancer.Methods:Retrospective selection was conducted on hospitalized patients diagnosed with cervical invasive cancer by pathology at the Third Affiliated Hospital of Sun Yat-sen University from January 2016 to December 2020, with complete relevant information. The age, histological classification, specific HPV infection types at the time of diagnosis of cervical cancer were recorded, and differences in HPV types and single and multiple infections in the squamous cell carcinoma and adenocarcinoma populations were analyzed. The coverage rate of bivalent, tetravalent, and ninvalent HPV vaccines in the cervical cancer population was analyzed.Results:A total of 231 cases of cervical invasive cancer that met the criteria were included, including 183 cases of squamous cell carcinoma, 43 cases of adenocarcinoma, and 5 cases of other histological types. The positive rates of HPV infection in cervical cancer, squamous cell carcinoma, and adenocarcinoma populations were 89.18%(206/231), 92.35%(169/183), and 74.42%(32/43), respectively. The top five types of HPV infection in cervical cancer patients were 16, 18, 58, 52, 31, and 33, respectively; The top five types of infection rate in squamous cell carcinoma patients were HPV16, 18, 58, 52, 31, and 33, respectively; Adenocarcinoma patients only detected 5 types of HPV, with the main types being HPV16 and 18. The infection rates of single HPV type in patients with cervical cancer, squamous cell carcinoma, and adenocarcinoma were 77.49%(179/231), 79.23%(145/183), and 67.44%(29/43), respectively. The multiple infection rates were 11.69%(27/231), 13.11%(24/183), and 6.98%(3/43), respectively. The positive rate of HPV was higher in all age groups of cervical cancer. The coverage rates of bivalent, tetravalent, and ninvalent HPV vaccines covering different types of infections in cervical cancer populations were 66.67% to 74.03%, 67.53% to 74.89%, and 81.39% to 87.44%, respectively.Conclusions:The cervical cancer population is mainly affected by high-risk HPV single infection, mainly including HPV16, 18, 58, 52, 31, 33; The HPV infection rate in the squamous cell carcinoma population is higher than that in the adenocarcinoma group, with the main type being HPV16, while in the adenocarcinoma population, the main types are HPV16 and 18.

High-risk human papillomavirus negative cervical lesions in the cervical cancer screening population / 中国医师杂志

Objective:To investigate the incidence of high-risk human papillomavirus (hrHPV) negative cervical lesions in the screening population, and based on this, to preliminarily evaluate the potential harm (missed diagnosis) and benefits (reduced colposcopy referral) of HPV primary screening compared to combined screening so as to provide reference for the selection of cervical cancer primary screening methods.Methods:This study was a single center cross-sectional study. Women who underwent joint screening [hrHPV typing test combined with cervical liquid based cytology test (LCT)] at the Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to December 31, 2019 were included in the cervical cancer screening. The proportion of hrHPV negative cytological abnormalities and cervical lesions in the population was analyzed and the theoretical colposcopy referral rate of the combined screening and HPV initial screening protocol was calculated. In the population with cervical pathological results, the number of colposcopy examinations required for the diagnosis of cervical intraepithelial neoplasia grade 2 and above (CIN2+ ) was calculated.Results:A total of 35 321 screened women were included. The overall incidence of hrHPV infection, LCT abnormalities and severe LCT abnormalities in the population was 17.13%(6 051/35 321), 18.07%(6 384/35 321), and 3.97%(1 402/35 321), respectively. The negative rate of hrHPV in women with severe cervical cytology abnormalities was as high as 51.28%(719/1 402), and in CIN2+ lesions diagnosed by cervical biopsy, hrHPV negative accounted for 7.15% (49/685). The theoretical colposcopy referral rates for combined screening and initial HPV screening were 11.28%(3 985/35 321) and 8.33%(2 943/35 321), respectively, with an average diagnosis of CIN2+ requiring 3.51 and 2.81 colposcopy examinations, respectively.Conclusions:In the opportunistic screening population, the proportion of hrHPV negative CIN2+ lesions cannot be ignored, and the HPV initial screening strategy may cause missed diagnosis of these lesions. However, compared to combined screening, HPV initial screening has the potential to improve the efficiency of colposcopy. These results suggest that we should carefully choose the HPV initial screening plan.

Screening for cervical cancer and diversion of abnormal screening results / 中国医师杂志

Cervical cancer is still a serious threat to the health of women in China. The current strategy is a three-level prevention strategy, among which the diversion of screening and screening abnormalities in the secondary prevention is an important link in preventing cervical cancer. For more than 20 years, China has implemented diversified screening methods such as cytological examination, high-risk human papillomavirus (HPV) testing, and naked eye screening. With the discovery that high-risk HPV infection is closely related to the occurrence of cervical cancer, the screening method for cervical cancer has shifted from cytological examination to HPV testing as the preferred screening method. This article introduces the advantages and disadvantages of high-risk HPV testing and cytological examination as screening methods, and proposes the issues that need to be paid attention to in screening; The principle of diverting screening abnormalities was proposed, and it was proposed that in the process of diverting, individualized and refined management principles should be implemented for screening abnormality projects based on the patient′s age and fertility requirements.

Surveillance of adverse events following immunization with human papillomavirus vaccines in Hangzhou City from 2017 to 2021 / 预防医学

Objective@#To investigate the incidence of adverse events following immunization (AEFI) of human papillomavirus (HPV) vaccines in Hangzhou City from 2017 to 2021, so as to provide insights into safety monitoring and evaluation for HPV vaccines.@*Methods@#The AEFI caused by immunization of bivalent (HPV2), quadrivalent (HPV4) and nonavalent HPV vaccines (HPV9) reported in Hangzhou City from 2017 to 2021 were captured from the AEFI Surveillance Module of Chinese Disease Control and Prevention Information System, and HPV vaccination data were captured from the Zhejiang Municipal Immunization Information Management System. The incidence, temporal distributions and clinical symptoms of AEFI were analyzed.@*Results@#Totally 922 310 doses of HPV vaccines were immunized in Hangzhou City from 2017 to 2021, and 232 cases with AEFI were reported, with an overall incidence rate of 25.15/105 doses. The reported incidence rates of AEFI caused by HPV2, HPV4 and HPV9 vaccination were 31.13/105 doses, 25.93/105 doses and 22.01/105 doses, respectively. General reactions and abnormal reactions were predominant AEFI, and the reported incidence rates of general reactions and abnormal reactions were 21.58/105 doses and 2.60/105 dose, respectively. AEFI predominantly occurred 0 to 1 day post-immunization (165 cases, 71.12%), and the main clinical symptoms included local swelling of injection sites, hard tubercle and fever, with reported incidence rates of 10.30/105 doses, 5.96/105 doses and 6.18/105 doses, respectively. @*Conclusions@#Low incidence of AEFI was reported following HPV vaccination in Hangzhou City from 2017 to 2021, and all AEFI were mild. The safety of HPV2, HPV4 and HPV9 remains high.