Prevalence of HPV and associated factors in a population of women living in southern Brazil.

OBJECTIVE: To determine the prevalence of HPV and investigate factors associated with the infection in women in the city of Francisco Beltrão, southwest Paraná, attending the public health system. METHODS: This cross-sectional study included 324 women, aged between 18 and 65 years, who were attending public health services for routine gynecological consultation. Interviews were conducted to obtain information about socioeconomic, sexual, gynecological, and life habits. After performing the Papanicolaou test, endocervical brush was employed to detect HPV by polymerase chain reaction with the primers MY09-MY11. RESULTS: The prevalence of HPV was 6.8%, out of which 58.3% presented with cytopathologic alterations. And the presence of current cervical alterations can increase the chances of having HPV by almost 33 times (ORadj: 32.688; p < 0.001), recent vaginal infection increased the chances of HPV infection by 2.7 times (ORadj: 2.773; p = 0.04). The non-white ethnicity increased HPV infection chances threefold (ORadj: 3.058; p = 0.039). CONCLUSION: The main finding was low prevalence of HPV infection. Factors that may be linked to HPV infection were cervical alterations, recent vaginal infection, and women's ethnicity.

University Students' Knowledge about the Relation between Human Papillomavirus (HPV) and Head and Neck and Oral Cancers.

INTRODUCTION: Human papillomavirus (HPV) causes the most common sexually transmitted infection (STI) in the world. It affects people regardless of gender and age, causing genital warts and cancer. OBJECTIVE: To evaluate university students' knowledge of HPV and its relationship with head and neck and oral cancers. METHODS: This is a cross-sectional study using an online questionnaire administered to undergraduate students at a public university (n=335). RESULTS: In total, 69.3% of the participants were unaware of the relationship between HPV and head and neck cancers and 34.6% claimed that HPV may not cause oral cancer.  The chances of knowing about the relationship of HPV with head and neck cancers were significant for participants who knew that HPV could be asymptomatic (OR = 9.9; p = 0.029), that might cause genital warts in men (OR = 4.0; p = 0.015), and those aged 24 years or older (OR = 1.9; p = 0.021). However, undergraduate students in the field of health and medicine (OR = 0.419; p = 0.002), who had sex at least twice a week (OR = 0.471; p = 0.017), and were unaware of the target public for the HPV vaccine (OR: 0.222, p<0.001) were less likely to know about the relationship. Students who knew of the relationship between HPV and female (OR = 3.6; p = 0.010) and male genital warts (OR = 3.0; p = 0.005) or were immunized (OR = 1.8; p = 0.020) were more likely to understand the viral interaction with oral cancer. Those who were unaware of the population eligible for HPV vaccine (OR = 0.493; p = 0.017) also showed gaps in their knowledge of this relationship. CONCLUSION: Our findings showed that there were limitations in the knowledge about HPV, its vaccine, and its relationship with head and neck and oral cancers.

GSTT1 and GSTM1 polymorphisms with human papillomavirus infection in women from southern Brazil: a case-control study.

BACKGROUND: Important risk factors for the most common sexually transmitted infection (STI) in the world, human papillomavirus (HPV), include early sexual activity, use of contraceptives, tobacco smoking, and immunological and genetic factors. This study aimed to investigate the relationship between GSTM1 and GSTT1 polymorphisms and HPV infection and associated risk factors in a group of women assisted in the public health system of southwestern Paraná, Brazil. METHODS AND RESULTS: A case-control study was designed with 21 women with HPV matched by age in the case group and 84 women without the virus in the control group. Viral detection was conducted via polymerase chain reaction (PCR) and GSTM1 and GSTT1 genotyping by Multiplex PCR. The results showed that the GSTT1 null allele was a protective factor against infection (ORadj 0.219; 95% CI 0.078-0.618; p = 0.004). No relationship was observed for the GSTM1 gene. Smoking was defined as a risk factor (ORadj 3.678; 95% CI 1.111-12.171; p = 0.033), increasing the chances of HPV by up to 3.6 times. CONCLUSION: This study showed, for the first time, the relationship between GSTM1 and GSTT1 genetic polymorphisms and HPV. We found that this relationship protected women from southern Brazil from viral infection, but not from susceptibility.

Prevalence and factors associated to cervical changes in units from the Single Health System.

OBJECTIVE: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. METHOD: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. RESULTS: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. CONCLUSION: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

Relationship between GSTM1 and GSTT1 polymorphisms and HPV infection: a systematic review.

Human Papillomavirus (HPV) is the most important risk factor for cervical cancer, although not the only one. The allelic polymorphism of enzymes acting on carcinogen metabolism has shown to influence the risk of both intraepithelial lesions and cervical carcinogenesis. Several studies found an association between GSTM1/GSTT1 null genotypes and risk of cancer. This research aimed to review studies addressing the relationship between GSTT1 and GSTM1 and HPV infection in women, with or without cervical pathologies. A database search was conducted in four databases - PubMed, LILACS, SciELO, and Virtual Health Library - using the following descriptors: Glutathione transferase, HPV, and Genetic polymorphism. In total, we found 319 studies. After screening titles and abstracts, 27 articles were selected for full-text read, among which 20 were excluded and 7 were included in the review. No study has exclusively approached the relationship between the virus and GSTM1/GSTT1 variants. However, studies investigating the association between single nucleotide polymorphisms (SNPs) and cervical lesions or cancer found a probable relationship between them and infections with high-risk oncogenic subtypes. Although inconclusive, GSTT1 null alleles were more common in women with more aggressive HPV than GSTM1.

Evidence on Human Exposure to Pesticides and the Occurrence of Health Hazards in the Brazilian Population: A Systematic Review.

Brazil is among the biggest pesticide consumers in the world, with its population severely exposed to tons of such substances, both because of environmental contamination and occupational use. The health consequences of pesticide exposure are well-documented, but still sparse regarding Brazilian population. This study systematically reviewed the Brazilian studies published that address the relationship between exposure to pesticides and health problems in the Brazilian population. Also, information about pesticide use in Brazil is provided. The included studies showed that exposure to pesticides has a relevant impact on the health of the Brazilian population, regardless of age and gender, and on workers in rural areas or not. Most poisoning events seem to result from the continuous use of pesticides, whether occupationally or environmentally, characterizing a public health problem. The major consequences reported in literature were damage to the central nervous system, cancer, deleterious effects on rural workers' health, intoxications, malformations, and endocrine changes. These findings point out the need to understand the impact of chronic exposure to pesticides on severely exposed people and highlight the importance of creating public policies to protect them and avoid disease occurrence.

Prevalence and factors associated to cervical changes in units from the Single Health System / Prevalencia y factores asociados a las alteraciones cervicales en unidades del Sistema Único de Salud / Prevalência e fatores associados às alterações cervicais em unidades do Sistema Único de Saúde

ABSTRACT Objective: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. Method: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. Results: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. Conclusion: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

RESUMEN Objetivo: estimar la prevalencia y los factores de riesgo asociados con las alteraciones citopatológicas en cuello uterino de mujeres atendidas por el Sistema Único de Salud. Método: Estudio transversal realizado con 350 mujeres, entre 14 y 79 años, que se sometieron a una prueba de Papanicolaou en unidades de salud de Francisco Beltrão, Paraná. Se realizó análisis citopatológicos cervicales y se aplicó un cuestionario para obtener informaciones socioeconómicas, ginecológicas, sobre conducta sexual y hábitos de vida. La prueba de chi-cuadrado y la regresión logística con p <0.05 fueron aplicadas para el análisis estadístico. Resultados: La prevalencia de alteraciones cervicales fue del 3,4% y las principales categorías encontradas fueron lesión intraepitelial de bajo grado, lesión intraepitelial de alto grado y atipias de significado indeterminado. De estos, el primero estuvo presente en el 16,6% de las mujeres menores de 25 años. El análisis multivariante señaló asociaciones entre el resultado citopatológico previo (OR = 25.693), el tabaquismo (OR = 7.576) y el consumo de anticonceptivos (OR = 5.265) con el resultado. Conclusión: Las mujeres con antecedentes de alteraciones cervicales previas, uso de anticonceptivos orales, y fumadoras tienen más probabilidades de alterar el cuello uterino.

RESUMO Objetivo: Estimar a prevalência e fatores de risco associados as alterações citopatológicas do colo uterino de mulheres atendidas pelo Sistema Único de Saúde. Método: É um estudo transversal com 350 mulheres de 14 a 79 anos que realizaram exame Papanicolau em unidades de saúde de Francisco Beltrão, Paraná. Realizou-se análise citopatológica e aplicou-se um questionário com informações socioeconômicas, comportamento sexual, ginecológico e hábitos de vida. Para análise estatística foi feito teste Qui-quadrado e regressão logística (p<0,05). Resultados: Prevalência das alterações cervicais foi 3,4%, incluindo Lesão intraepitelial de baixo e alto grau e Atipias de significado indeterminado. Destas, a primeira teve 16,6% de frequência nas mulheres abaixo de 25 anos. A análise multivariada apontou associações entre resultado citopatológico anterior (OR=25,693), hábito de fumar (OR=7,576) e anticoncepcional (OR=5,265) com o desfecho. Conclusão: Mulheres com história de alteração cervical, uso de anticoncepcional e fumantes possuem maiores chances de alterações no colo uterino.