Genetic diversity of human papillomavirus types 35, 45 and 58 in cervical cancer in Brazil.

In Brazil, most studies of intra-type variants of human papillomavirus (HPV) have focused on HPV16 and HPV18, but other high-risk HPV types have not been studied. Here, we report the prevalence of lineages and variants of HPV35, HPV45 and HPV58 in cervical cancers from the Amazonian and Southeast Brazilian regions. The most frequent sublineages were A1 for HPV35, B2 for HPV45, and A2 for HPV58. The Southeast region had a higher frequency of the B2 sublineage of HPV45, and for HPV35, the genetic and nucleotide sequence diversity were higher in the Southeast region, suggesting that regional factors are influencing the diversity and lineage prevalence.

Estudo dos genótipos do hpv e fatores associados ao diagnóstico do câncer do colo do útero em estádio inicial em mulheres atendidas na unidade de saúde de referência oncológica do estado do pará / [Study of hpv genotypes and factors associated with early stage cervical cancer diagnosis in women treated at the oncology reference health unit in the state of Pará]

A associação do câncer com a infecção pelos tipos de Papilomavírus humano (HPV) considerados oncogênicos está bem estabelecida. Recentemente, vacinas contra os tipos oncogênicos mais prevalentes do HPV foram lançadas no mercado. Em 2014, o Brasil iniciou o programa de vacinação contra os tipos de HPV6, 11, 16 e 18 para meninas de 9 a 13 anos de idade, entretanto o impacto dessa vacina sobre o câncer de colo uterino somente será mensurável nas próximas décadas. Para estabelecer o ponto inicial desse monitoramento, foi desenhado um estudo multicêntrico para conhecer a distribuição dos principais tipos de HPV associados ao câncer do colo do útero em mulheres atendidas em centros de atenção oncológica da rede SUS nos estados do Rio de Janeiro, Pará e Pernambuco. Esta tese apresenta os resultados obtidos no estado do Pará. Além dos tipos de HPV, também foram analisadas as variantes intratipo dos HPV 16 e do HPV 18, o perfil epidemiológico da população de estudo, o conhecimento e as práticas preventivas, assim como o acesso ao diagnóstico da doença. Informações sobre os tipos histológicos dos tumores e o estádio da doença no momento do diagnóstico foram coletadas nos prontuários. O estudo sobre os fatores associados à chegada da paciente ainda com doença em estádio inicial foi realizado com base no modelo de Andersen para uso de serviços de saúde...

The association of cancer and infection by oncogenic Human Papillomavirus (HPV) are well established. Recently, vaccines against most prevalent HPV oncogenic types were launched in the market. In 2014, Brazil started the vaccination program against HPV types 6, 11, 16 and 18 for girls from 9 to 13 years old. However, the impact of the vaccine on the disease burden will only be measurable in the next decades. To establish the starting point of monitoring, it was designed a multicenter study to know the distribution of the HPV types associated with cervical cancer in women treated in the Public Health System care centers (SUS network) in the Brazilian states of Rio de Janeiro, Pará and Pernambuco. This thesis presents the results obtained in the Pará state. In addition to the HPV types, intratype variants of HPV 16 and HPV 18 were also analyzed. It describes the epidemiological profile of the study population, the knowledge and preventive practices, as well as the access to the diagnosis of disease. Information on the histological types of tumors and the disease stage at diagnosis were collected from medical records. The analysis of factors associated with the arrival of the patient with early-stage disease was based on the Andersen model used in health services. The results show that the epidemiological profile of patients treated from 2013 to 2015 are women with low education, low income and high parity, without knowledge of the disease or about preventive practices...