Perfil de infecciones por VPH en lesiones cervicales / HPV infection profile in cervical lesions

Resumen Introducción: La prevalencia de los diferentes genotipos de virus del papiloma humano (VPH) varía dependiendo de la severidad de la lesión y región geográfica. Objetivo: Identificar infecciones múltiples de VPH en lesiones cervicales de bajo y alto grado en un grupo de mujeres del Bajío mexicano referidas con citología no concluyente. Métodos: Estudio piloto de mujeres referidas de unidades del primer nivel de atención de Guanajuato, México, por citología sugerente de lesión cervical. Los raspados cervicales fueron sujetos a extracción de ADN y genotipificación del VPH mediante microarreglos. Resultados: Se colectaron 100 casos consecutivos y fueron analizados 90; se observó 26 % de positividad a VPH en mujeres sanas y 62 % presentó algún grado de lesión. Los genotipos de VPH más frecuentes fueron 59, 31, 16 y 51. En la mayoría de las muestras se encontró infección múltiple. Conclusiones: Se identificó heterogeneidad de VPH en las muestras de la población estudiada en contraste con los reportes internacionales; además, son comunes las infecciones múltiples en lesiones precursoras y disminuyen en las lesiones de alto grado. Estos datos podrían influir en los actuales programas de vacunación anti-VPH.

Abstract Introduction: The prevalence of the different genotypes of human papillomavirus (HPV) varies depending on lesion severity and geographic region Objective: To identify multiple HPV infections in low- and high-grade cervical lesions in a group of women from the Mexican Bajío region referred with inconclusive cytology. Methods: Pilot study of women referred from primary care units of Guanajuato, Mexico, with cytology suggestive of cervical lesion. Cervical smears were subjected to DNA extraction and HPV genotyping using microarrays. Results: 100 consecutive cases were collected and 90 were analyzed; HPV positivity was observed in 26% of healthy women, 62% had some degree of cervical lesion. The most common HPV genotypes were 59, 31, 16 and 51. Multiple infections were found in most samples. Conclusions: HPV heterogeneity was identified in the samples of the study population in contrast to worldwide reports; furthermore, multiple infections are common in precursor lesions and decrease in high-grade lesions. These data could have an impact on current HPV vaccination programs.

Infección por virus papiloma humano en pacientes con citología de cuello uterino negativa

Objetivo: Examinar la prevalencia de la infección por virus papiloma humano en pacientes con citologías de cuello uterino negativas, en un programa de pesquisa de cáncer de cuello de la Misión Barrio Adentro. Métodos: Se analizaron 3883 muestras citológicas convencionales de cuello uterino según el sistema Bethesda 2001, de las cuales 3651 (94,0 %) eran citologías normales. Se usó PCR/RFLP para la detección y tipificación de virus de papiloma humano. Resultados: La edad promedio de las pacientes fue de 34,8 ± 12,20 años (rango: 13 a 89). La prevalencia general de la infección fue de 28,5 % (1038/3651). En 31,9 % se detectó virus de papiloma humano de alto riesgo oncogénico y en 21,2 % de bajo riesgo oncogénico. El virus de papiloma humano 6 (57,7 %) fue el genotipo de mayor prevalencia, seguido de secuencias desconocidas del virus (45,4 %). El virus de papiloma humano 16 fue el más comúnmente encontrado (28,09 %) entre los de alto riesgo, seguido del 18 (17,5 %) y el 31 (14,2 %) (p<0,000). También se detectó 33 (4,8 %), 52 (4,2 %), 53 (3,6 %) y 58 (3,1 %). A medida que aumentó la edad, disminuyó la positividad para la infección por el virus de papiloma humano (p<0,000) y la mayor prevalencia viral se presentó en menores de 25 años (35,1 %). Conclusiones: La prevalencia de virus de papiloma humano en pacientes con citologías negativas es elevada y heterogénea en este medio, observándose una mezcla de virus de alto y bajo riesgo.

Objective: To examine the prevalence of human papillomavirus infection in patients with negative cervical cytology in a cervical cancer screening program of the Barrio Adentro Mission in Venezuela. Methods: A total of 3,883 conventional cervical cytology samples were analyzed according to the Bethesda 2001 system, of which 3651 (94.0%) were reported normal cytology. PCR / RFLP were used for the detection and typing of human papilloma virus. Results: The mean age of the patients was 34.8 ± 12.20 years (range: 13 to 89). The overall prevalence of infection was 28.5% (1038/3651). In 31.9% of cases high oncogenic risk human papillomavirus were detected and 21.2% of HPV low oncogenic risk. Human papillomavirus 6 (57.7%) was the most prevalent genotype, followed by unknown virus sequences (45.4%). Human papillomavirus 16 was the most commonly found (28.09%) among high risk, followed by 18 (17.5%) and 31 (14.2%) (p <0.000). We also detected 33 (4.8%), 52 (4.2%), 53 (3.6%) and 58 (3.1%). As age increased, the positivity for human papillomavirus (p <0.000) decreased, and the highest viral prevalence occurred in women’s under 25 (35.1%). Conclusions: The prevalence of human papilloma virus in patients with negative cytology is high and heterogeneous in this medium, with a mixture of high and low risk viruses.

Prevalence of Human Papilloma Virus DNA in HIV Positive Women in Lagos University Teaching Hospital (LUTH) Lagos, Nigeria.

Introduction: HIV-infected women have a high prevalence of Human Papilloma virus (HPV) infection and are more likely to be infected with high risk genotypes with the potential of progressing to cervical cancer. There is paucity of data regarding the prevalence of sexually transmitted HPV infection among HIV positive women in Nigeria. Aims: The objective of this cross-sectional prospective study was to determine the prevalence of high risk HPV among HIV positive and negative women in LUTH, Lagos, Nigeria and to relate HPV genotypes in the study population to commercially available HPV vaccine types that would be or not be appropriate for implementation of vaccination programs in Lagos State. Place and Duration of Study: AIDS Prevention Initiative In Nigeria (APIN) clinic as well as the Gynecologic outpatient clinic of LUTH, Lagos between August 2011 and August 2012. Methodology: A combination of PCR and flow through hybridization method was used in the genotyping of HPV from samples obtained from 98 HIV positive and 97 HIV negative women. Data was analyzed using Epi info 3.5.6. Non parametric variables were compared with chi-square or Fisher exact test as appropriate. The differences in mean for parametric variables were compared using student T test. P value <0.05 were considered significant. Results: The prevalence of HPV among HIV positive women was 44.9% while the prevalence of high risk types was 37.5%. The commonest high risk types seen were types 31, 52, 53 and 35. The prevalence of HPV among the HIV negative women was 11%. The commonest high risk types seen were types 18, 16, 52 and 56. Conclusion: In view of the high prevalence and diversity of HPV genotypes among the HIV positive women, adequate screening protocols should be put in place for screening this category of women. Studies should also be carried out to determine the efficacy of existent HPV vaccines on this group of patients.

High prevalence of oncogenic HPV-16 in cervical smears of asymptomatic women of eastern Uttar Pradesh, India: A population-based study.

In developing countries like India, occurrence of Human papillomavirus (HPV) in cervical cancer as well as in the asymptomatic population was observed to be very high. Studies on HPV prevalence have been conducted in different parts of the country but no data were available from the eastern region of Uttar Pradesh (UP). The present study aimed to determine the status of HPV prevalence and its association with different socio-demographic factors in this population. Prevalence of HPV was investigated in a total of 2424 cervical scrape samples of asymptomatic women. Primer sets from L1 consensus region of viral genome were used to detect the presence of HPV, and the positive samples were genotyped by sequencing. Univariate binary logistic regression analysis was used to evaluate association of socio-demographic factors with HPV. 9.9% of the clinically asymptomatic women were found to be infected with HPV comprising 26 different genotypes. Among HPV-positive women, 80.8% showed single infection, while 15.4% harboured multiple infections. HPV-16 (63.7%) was the most prevalent, followed by HPV-31 (6.7%), HPV-6 (5.4%), HPV-81 (4.6%) and HPV-33 (4.2%). Significant association of HPV with non-vegetarian diet (P<0.05) and rural residential areas (P<0.01) were observed. High prevalence of HPV-16 in asymptomatic women of this population, a frequency comparable to invasive cervical cancers, highlights an urgent need for a therapeutic HPV vaccine covering HPV-16 and other high-risk types to provide protection against the disease.