Role of human papillomavirus 6 & 11 in condyomata acuminata in Indian patients.

BACKGROUND: Condylomata acuminata, commonly known as genital wart is a sexually transmitted disease caused by Human Papillomavirus (HPV). The positivity of HPV6/11 in condylomata acuminata in western literature varies from 80-90% however, there is a paucity of Indian literature. AIM: The aim of the present study was to determine the role of HPV 6 & 11 in Condylomata acuminata in Indian patients. METHODS: A total of 22 formalin fixed parafilm embedded (FFPE) tissue was collected from the cases of condylomata acuminata which was histologically diagnosed and was used to detect HPV 6 and 11 by PCR. RESULTS: Of these 14/22 patients (63.6%) were positive for HPV 6 or 11; HPV 6 alone in eight (36.3%) and HPV 11 in six (27.2%). CONCLUSION: The high HPV 6 and 11 PCR positivity suggests their definitive role in causation of condylomas cases. This important HPV infection is preventable by prophylactic vaccination.

Prevalence and sociodemographic correlates of anogenital Human Papillomavirus (HPV) carriage in a cross-sectional, multi-ethnic, community-based Asian male population.

BACKGROUND: Addressing the burden of HPV-associated diseases among men is increasingly becoming a public health issue. The main objective of this study was to determine HPV prevalence among a healthy community-based Malaysian men. METHOD: This was a cross-sectional study that recruited 503 healthy males from 3 community-based clinics in Selangor, Malaysia. Genital and anal samples were collected from each participant for 14 high risk and 2 low risk HPV DNA detection and genotyping. All participants responded to a set of detailed sociodemographic and sexual behaviour questionnaire. RESULTS: The median age at enrolment was 40 years old (IQR: 31-50). The anogenital HPV6/11 prevalence was 3.2% whereas high risk HPV prevalence was 27.1%. The genital HPV prevalence for HPV6/11 was 2.9% while high risk HPV was 18.8%. HPV6/11 prevalence in the anal canal was 1.6% and high risk HPV was 12.7%. HPV 18 was the most prevalent genotype detected in the anogenital area. There was a significant independent association between genital and anal HPV infections. CONCLUSION: Anogenital HPV infection is common among Malaysian men. These findings emphasize the ubiquity of HPV infection and thus the value of population-wide access to HPV prevention.

El virus del papiloma humano y su relación con la patología de la cavidad oral / Relationship of human papillomavirus with diseases of the oral cavity

Durante las últimas décadas la infección por virus del papiloma humano (VPH) ha emergido como una nueva epidemia y se ha convertido en un problema de salud debido a su asociación con diversos cánceres localizados en el cuello uterino, región anogenital y orofaringe. En esta revisión pretendemos entender y explicar las características distintivas de los carcinomas escamosos de orofaringe) relacionados con el VPH, en términos de epidemiología, factores de riesgo, topografía específica, subtipos de VPH más frecuentemente involucrados, técnicas de detección del VPH, comportamiento clínico, pronóstico, tratamiento y prevención. También se discutirá la relación del VPH con el desarrollo de otros cánceres de cabeza y cuello y con la patología benigna de la cavidad oral

Over the last few decades, the human papillomavirus (HPV) infection has emerged as a new epidemic and become a health issue due to its involvement in several cancers affecting the cervix, the anogenital region and the oropharynx. In this review, we aim to understand and explain the distinctive features of HPV-related oropharyngeal squamous cell carcinoma based on its epidemiological data, risk factors, specific topography, HPV subtypes most frequently involved, HPV-status diagnosis, clinical behaviour, prognosis, treatment, and preventive measures. In addition, the relationship of HPV with the development of other head and neck carcinomas and benign lesions of the oral cavity will also be discussed

Comparative analysis of human papillomavirus type 6 complete genomes originated from head and neck and anogenital disorders.

It is increasingly recognized that fundamental differences exist between high-risk and low-risk human papillomavirus (HPV) genotypes regarding interactions with the host. This study aims to join the recently emerging efforts to uncover these differences at the complete genome level and to study how they may influence the disease caused. Sixteen samples of thirteen patients with various HPV6-mediated benign mucosal disorders (nine recurrent respiratory papillomatoses with 2-8 recurrences, one condyloma acuminatum and three premalignant lesions of the genital mucosa) were sampled to determine the complete virus genomes. We collected the 197 HPV6 complete genomes deposited in the GenBank for cluster analysis to determine (sub)lineages. Genome polymorphisms were determined against the reference sequences of the (sub)lineages. Genome polymorphisms of the long control region (LCR) were tested for putative transcription factor binding sites; their functional analysis was performed by transient transfection of cloned whole LCRs into HEp-2 cells using a luciferase reporter system. Genomes from the same patients were always identical. Three, nine and one patients carried HPV6 lineage A, sublineage B1 and B2 variants, respectively. The three lineage A sequences were highly similar to each other, but distinct from the reference genome. A unique non-synonymous single nucleotide polymorphism (SNP) was found in the E5a open reading frame (ORF). Sublineage B1 genomes were more diverse, exhibited unique non-synonymous SNPs in the LCR and the E2/E4, L1, L2 ORFs. LCR activity of lineage A and sublineage B1 differed significantly; activity of one sublineage B1 LCR exhibiting two unique SNPs was significantly higher than that of other B1 LCR variants, close to the mean of LCR activities of lineage A variants. Different HPV6 lineages showed marked differences in variability patterns of the different genome regions. This may be involved in the differences in their distribution in different diseases or patient populations.

Implication of low risk human papillomaviruses, HPV6 and HPV11 in laryngeal papillomatosis in Burkina Faso.

PURPOSE: Laryngeal papillomatosis is the most common benign tumor of the larynx of children. It is characterized by the development of exophytic proliferative lesions in the mucosa of the airways. Human papillomavirus (HPV) has been recognized as a causal agent among which HPV types 6 and 11 are the most frequently implicated. This disease affects the vocal cords and other important functions of the child. The difficulty of treatment is related to the high recurrence of papilloma growth after surgical removal. The objective of this study was to describe the implication of HPV6 and HPV11 in cases of laryngeal papillomatosis histologically confirmed in Ouagadougou. MATERIALS AND METHODS: This was a descriptive cross-sectional study based on histologically diagnosed archival tissue; obtained in the last ten years (2007 to 2017) in the anatomy and cyto-pathology laboratories in Burkina Faso. These fixed and paraffin-embedded tissues were deparaffinized with xylene before HPV DNA extraction; then HPV6 and HPV 11 were identified by real-time multiplex PCR. RESULTS: The prevalence of low-risk HPV infection (HPV-LR) was 54.84% in histologically confirmed laryngeal papillomatosis in Ouagadougou. Among the HPV-LR positive samples, HPV6 and HPV11 genotype prevalence's were respectively 41.17% and 35.3% while the HPV6 / HPV11 co-infection was 23.53%. CONCLUSIONS: The results show the implication of HPV6 and HPV11 in laryngeal papillomatosis in Burkina Faso with a high prevalence.

Human Papillomavirus-Associated Invasive Condylomas in a Man with Immunosuppressive Comorbidities.

Human papilloma virus (HPV) infections are one of the most common sexually transmitted diseases. We present the case of a 77-year-old Caucasian male with enormous genital warts of the penis, scrotum, groins and anus. Lesions were excised by electrosurgery. The histological examination revealed Condylomata gigantea as well as an invasive perianal squamous cell carcinoma. Mucosal "low-risk" HPV type 6 was detected. The patient had a history of an immunosuppressing disease. During the 4-year follow-up, multiple relapses occurred. Thus, particularly in immunosuppressed patients, early prophylactic HPV vaccination seems to be indicated for use in the prevention of HPV-associated mutilating and life-threatening disease. Vaccination should also protect from "low-risk" HPV.

P16INK4a expression in patients with penile cancer.

BACKGROUND: Infection with human papillomavirus (HPV) is reported to be present in 30-50% of penile cancer cases. The immunohistochemical test for p16INK4a is used as an indicator of the presence of HPV and as a prognostic marker for squamous cell carcinomas in various sites. However, the role of this marker in penile carcinoma has not yet been completely elucidated. The aim of this study was to analyze whether the expression of p16INK4a is associated with the presence of HPV, histological parameters, and survival in penile cancer. METHODS: A study was conducted from 2014 to 2016 that included 55 patients with penile carcinoma. HPV DNA was detected through PCR using fresh tumor tissue, and immunohistochemistry was performed for analysis of p16INK4a protein using paraffin-embedded tissue. Evaluation of histological parameters was performed following complete embedding of the tumor tissue in paraffin. RESULTS: HPV DNA (low-risk and high-risk genotypes) was found in 49 (89.1%) cases, and 46/49 (93.9%) showed high-oncogenic risk HPV (HR-HPV). Of the 22 cases positive for p16INK4a, HR-HPV DNA was present in 21 (95.5%) (p = 0.032). Regarding histological parameters, p16INK4a and HR-HPV were significantly associated only with tumor subtype (p = 0.036 and p = 0.032, respectively); all carcinomas with basaloid characteristics were positive for p16INK4a. Although HPV+ patients had a higher disease-free survival (p <0.001), p16INK4a expression was not associated with patient survival. CONCLUSIONS: Our study, using fresh tissue samples, showed the highest incidence of HPV compared to that observed in the literature. Expression of the p16INK4a protein was significantly associated with the presence of HR-HPV and this expression may serve as a marker for the presence of the virus. The p16INK4a protein was not associated with the histological prognostic parameters, with the exception of tumor subtype, nor with patient survival. In the results, we showed that the objective of the present study was reached.

Development of a human papillomavirus type 6/11 vaccine candidate for the prevention of condyloma acuminatum.

Condyloma acuminatum (CA) represents a significant human papillomavirus (HPV) disease burden worldwide, resulting in substantial healthcare costs and loss of life quality in both genders. To address this problem, we tried to develop a bivalent HPV6/11 virus-like particle (VLP) vaccine targeting CA. HPV6/11 VLPs were generated in Hansenula polymorpha, and a disassembly and reassembly (D/R) treatment was further conducted to improve the stability and monodispersity of the VLPs. The HPV6/11 VLPs were identified by transmission electron microscopy (TEM), high performance liquid chromatography (HPLC), mass spectrum (MS) and dynamic light scattering (DLS), and were evaluated for their immunogenicity in both mice and cynomolgus monkeys. The results showed that the HPV6/11 L1 proteins were correctly expressed and assembled into HPV6/11 VLPs, and the HPV6/11 VLPs formulated with aluminum phosphate induced vigorous production of specific neutralizing antibodies against HPV6/11 VLPs in mice and cynomolgus monkeys. These data indicated that the Hansenula polymorpha-derived HPV6/11 VLPs could be formulated into a bivalent vaccine used in prevention of CA.

Case of rapidly progressing condylomatous squamous cell carcinoma of the uterine cervix associated with low-risk human papillomavirus type 6.

Condylomatous, or warty squamous cell carcinoma (SCC) of the uterine cervix, is a rare variant of invasive SCC. Here, we describe a case of aggressive condylomatous SCC of the uterine cervix. A 43-year-old woman was monitored for 3 years for suspected low-grade squamous intraepithelial lesion. A whitish papillary mass occupied the cervix, and the colposcopic diagnosis was condyloma acuminatum. A cervical biopsy revealed papillary proliferating thick squamous epithelium, which consisted of koilocytes and atypical cells with enlarged nuclei. Hysterectomy specimens showed a thick layer of atypical squamous epithelium with koilocytosis invading the stroma. Immunohistochemistry revealed negative p16 expression. Hysterectomy specimens tested positive for low-risk human papillomavirus type 6, but negative for other high-risk human papillomavirus types. The bilateral pelvic and para-aortic lymph nodes were positive for metastases. In spite of adjuvant chemotherapy, the case relapsed with multiple lymph nodes and lung metastases shortly after the operation.

Human Immunodeficiency Virus Status Differentially Associated With Genital and Anal Human Papillomavirus Infection Among Chinese Men Who Have Sex With Men: A Cross-Sectional Survey.

BACKGROUND: Little is known about human papillomavirus (HPV) infection and genotypes when considering both anatomic site and human immunodeficiency virus (HIV) status among men who have sex with men (MSM) in low- and middle-income countries. METHODS: A cross-sectional study was conducted among MSM in Beijing, China. HIV serostatus was determined, and genital and anal HPV genotyping were performed from respective swabs. RESULTS: Of 1155 MSM, 817 (70.7%) had testing for genital (611; 52.9%) and/or anal (671; 58.1%) HPV. Preference for insertive anal sex (adjusted odds ratio [aOR], 2.60; 95% confidence interval [CI], 1.42-4.75) and syphilis (aOR, 1.50; 95% CI, 1.01-2.23) were associated with genital HPV. Inconsistent condom use during receptive anal sex (aOR, 1.82; 95% CI, 1.17-2.84), and HIV seropositivity (aOR, 2.90; 95% CI, 1.91-4.42) were associated with anal HPV. Among 465 (40.3%) MSM with specimens from both anatomic sites, anal HPV (68%) was more common than genital HPV (37.8%). Prevalence of anal HPV was higher among HIV-infected than uninfected MSM (P < 0.01). Some oncogenic HPV types were more commonly found at the anal site of HIV-infected MSM (P < 0.01). CONCLUSIONS: Human papillomavirus is highly prevalent among Chinese MSM. Anal HPV was more common than genital HPV, and HIV seropositivity was associated with oncogenic HPV types at the anal site.

Recurrence of Human Papillomavirus External Genital Wart Infection Among High-Risk Adults in Montréal, Canada.

OBJECTIVES: The incidence of recurrent genital warts is not well characterized; this is especially true in a post-human papillomavirus (HPV) vaccination era. The objectives of this study were to assess the incidence of subsequent HPV-related external genital warts (EGW) episodes in high-risk male and female adults, as well as ascertain patient profile and disease characteristics, in a real-world Canadian sexual health clinical setting. METHODS: Retrospective chart review study conducted at Clinique médicale l'Actuel, a sexual health clinic in Montréal, Québec, Canada. Eligible patients were 18 to 45 years of age with a first diagnosis of EGW associated with a HPV infection between July 1, 2006, and June 30, 2012. RESULTS: A total of 400 first-episode EGW cases were identified. Up to 6 subsequent episodes were documented, with 194 (48.5%) patients reporting at least 1 subsequent EGW episode. Median time to first subsequent EGW episode was 3.97 years, and the incidence density rate for all subsequent episodes was 0.18/100 patient-years. Over 90% of patients reported clearance of the first subsequent episode, with median time to clearance of 0.30 years. Regardless of subsequent episode number, greater than 95% of patients received treatment, primarily cryotherapy, with high-risk sexual behavior reducing as number of episodes increased. CONCLUSIONS: Overall, a high rate of subsequent EGW episodes was observed in this high-risk population, despite high treatment rates and improvement in high-risk sexual behavior. These data, assessed in a prevaccination Québec health care system, may be compared with future EGW rates to assess the impact of a governmentally-funded HPV vaccination program.

Human papillomavirus prevalence in South African women and men according to age and human immunodeficiency virus status.

BACKGROUND: Both cervical cancer and human immunodeficiency virus (HIV) are major public health problems in Sub-Saharan Africa. The objectives of the study were to investigate human papillomavirus (HPV) prevalence according to age, HIV status and gender. METHODS: Participants were 208 HIV-negative women, 278 HIV-positive women, 325 HIV-negative men and 161 HIV-positive men between the ages of 18-66 years. HPV types were determined in cervical and penile cells by Roche Linear Array HPV genotyping assay. RESULTS: HPV prevalence was 36.7 % (76/207; 95 % confidence intervals (CI): 30.4-43.4 %) in HIV-negative women, with the highest prevalence of 61.0 % (25/41; 95 % CI: 45.7-74.4 %) in women aged 18-25 years. HPV prevalence was 74.0 % (205/277; 95 % CI: 68.5-78.8 %) in HIV-positive women, with the highest prevalence of 86.4 % (38/44; 95 % CI: 72.9-94.0 %) in women aged 18-25 years. HPV prevalence was found to decrease with increasing age in HIV-negative women (P = 0.0007), but not in HIV-positive women (P = 0.898). HPV prevalence was 50.8 % (159/313; 95 % CI: 45.3-56.3 %) in HIV-negative men, with the highest prevalence of 77.0 % (27/35; 95 % CI: 60.7-88.2 %) in men aged 18-25 years. HPV prevalence was 76.6 % (121/158; 95 % CI: 69.2-82.9 %) in HIV-positive men, with the highest prevalence of 87.5 % (7/8; 95 % CI: 50.8-99.9 %) in men 18-25 years of age. HPV prevalence was found to decrease with increasing age in HIV-negative men (P = 0.004), but not in HIV-positive men (P = 0.385). HIV-positive women had a significantly higher prevalence of one or more HPV type(s) in the bivalent (HPV-16/18: 20 % 55/277, 9 % 12/207; P <0.001), quadrivalent (HPV-6/11/16/18: 26 % 71/277, 12 % 24/207; P = 0.001) and nonavalent vaccine (HPV-6/11/16/18/31/33/52/56/58: 65 % 181/277, 24 % 50/207; P <0.001) compared to HIV-negative women. Similar observation were observed in men for bivalent (20 % 32/158, 10 % 30/313; P = 0.001), quadrivalent (35 % 56/158, 13 % 41/313; P <0.001) and nonavalent vaccine (75 % 119/158, 28 % 87/313; P <0.001). CONCLUSIONS: This study demonstrated high HPV prevalence among HIV-positive women and men in all age groups. The high prevalence of HPV types found in bivalent, quadrivalent and nonavalent vaccines in South African HIV-positive and HIV-negative women and men demonstrate that this population will greatly benefit from current HPV vaccines.

Disfonía infantil precoz como síntoma de alerta de la papilomatosis laríngea juvenil / Early infantile dysphonia as an alert symptom of juvenile laryngeal papillomatosis

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Next generation prophylactic human papillomavirus vaccines.

The two licensed bivalent and quadrivalent human papillomavirus (HPV) L1 (the major papillomavirus virion protein) virus-like particle (VLP) vaccines are regarded as safe, effective, and well established prophylactic vaccines. However, they have some inherent limitations, including a fairly high production and delivery cost, virus-type restricted protection, and no reported therapeutic activity, which might be addressed with the development of alternative dosing schedules and vaccine products. A change from a three-dose to a two-dose protocol for the licensed HPV vaccines, especially in younger adolescents (aged 9-13 years), is underway in several countries and is likely to become the future norm. Preliminary evidence suggests that recipients of HPV vaccines might derive prophylactic benefits from one dose of the bivalent vaccine. Substantial interest exists in both the academic and industrial sectors in the development of second-generation L1 VLP vaccines in terms of cost reduction-eg, by production in Escherichia coli or alternative types of yeast. However, Merck's nonavalent vaccine, produced via the Saccharomyces cerevisiae production system that is also used for their quadrivalent vaccine, is the first second-generation HPV VLP vaccine to be available on the market. By contrast, other pharmaceutical companies are developing microbial vectors that deliver L1 genes. These two approaches would add an HPV component to existing live attenuated vaccines for measles and typhoid fever. Prophylactic vaccines that are based on induction of broadly cross-neutralising antibodies to L2, the minor HPV capsid protein, are also being developed both as simple monomeric fusion proteins and as virus-like display vaccines. The strong interest in developing the next generation of vaccines, particularly by manufacturers in middle-to-high income countries, increases the likelihood that vaccine production will become decentralised with the hope that effective HPV vaccines will be made increasingly available in low-resource settings where they are most needed.

Vacunas frente al VPH / No disponible

Esta revisión se centra en publicaciones de los ensayos clínicos de fase II y III llevados a cabo con dos vacunas profilácticas frente al VPH: Gardasil(R) (Merck & Co., Inc., Whitehouse Station, NJ, Estados Unidos), una vacuna cuadrivalente que contiene partículas similares a virus (VLPs) de la región L1 de los tipos del VPH 6, 11, 16 y 18, y CervarixTM (GlaxoSmithKline Biologicals, Rixensart, Bélgica), una vacuna bivalente que contiene VLPs de los tipos del VPH 16 y 18. En la actualidad, los análisis de fin de estudio de los ensayos clínicos de fase III de estas vacunas ya se han completado y se dispone de un amplio tiempo de seguimiento desde su inicio en los años 2000-1. La evidencia científica sobre el perfil de seguridad, inmunogenicidad y eficacia de las dos vacunas VPH está bien establecida. Ambas vacunas obtuvieron resultados excelentes de seguridad. Los efectos adversos más frecuentes fueron reacciones leves a moderadas en el lugar de la inyección sin diferencias significativas en la aparición de efectos adversos sistémicos graves y no graves en los grupos vacunados respecto a los grupos control. Altamente inmunogénicas, ambas vacunas inducen títulos elevados de anticuerpos en virtualmente todos los vacunados y constantes a lo largo de los años. Ambas vacunas han demostrado ser altamente eficaces y presentar eficacias similares para prevenir un amplio abanico de variables clínicas en mujeres jóvenes (15 a 26 años): desde infecciones persistentes cervicales hasta CIN3 en mujeres naïve para el tipo de VPH correspondiente en el momento de la vacunación. Hasta la fecha no hay signos de disminución de la protección a lo largo del tiempo. Ambas vacunas también presentan protección cruzada parcial frente a infección y enfermedad causadas por un número limitado de VPHs no vacunales relacionados filogenéticamente. La infección por un tipo de VPH vacunal no inhibe la prevención para el resto de tipos de VPH vacunales. Sin embargo, las vacunas no tienen acción terapéutica para inducir regresión o prevenir la progresión de infecciones ya establecidas. Gardasil(R) también ha demostrado alta protección frente a verrugas genitales y neoplasia vulvar/vaginal asociada a los tipos de VPH vacunales. En otros ensayos, Gardasil(R) ha demostrado también protección frente a infección incidente y CIN en mujeres de 25 a 45 años. Gardasil(R) también ha demostrado protección en hombres frente a infección incidente, verrugas genitales y AIN por los tipos de VPH vacunales. Por su lado, Cervarix(R) también ha demostrado protección frente a infecciones anales y de la cavidad oral por los tipos de VPH incluidos en la vacuna. Los estudios puente de immunogenicidad y seguridad en niñas y niños adolescentes muestran excelentes respuestas immunitarias y de seguridad. Estos resultados de noinferioridad de respuesta a las mujeres jóvenes prevén una gran efectividad para los programas de vacunación adolescente. Los excelentes resultados de estos estudios han llevado a las agencias reguladoras nacionales de numerosos países a autorizar el uso de Gardasil(R) y Cervarix(R) y a la financiación pública de amplias campañas de vacunación en mujeres preadolescentes y en algunos países en mujeres adolescentes, adultas jóvenes y/o hombres. Los primeros datos de impacto poblacional nos presentan un futuro muy optimista. Las vacunas VPH han presentado una efectividad muy alta frente a las verrugas genitales en países que han implementado programas de vacunación sistemática con altas coberturas. Las verrugas genitales son el primer resultado clínico evaluable debido al intervalo corto de tiempo entre infección incidente y progresión a enfermedad clínica. Sin embargo, todavía faltan unos años para poder evaluar completamente la efectividad de esta intervención y en todo el espectro de enfermedad relacionada con el VPH. Múltiples estudios post-autorización están en curso y el seguimiento de las cohortes vacunadas en los grandes ensayos de fase III continúa

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Infección por papiloma virus humano y carcinoma escamocelular bucal, diversas técnicas moleculares para detectar su presencia / Human papillomavirus infection. Relationship with oral squamous cancer, several techniques for detecting its presence

El cáncer bucal (CB) es una neoplasia maligna de comportamiento agresivo, que comprende el 4 al 5 % de todos los tumores, con una alta tasa de mortalidad, la gran mayoría son carcinomas escamocelulares (90%). Entre los factores de riesgo asociados al CB se describen el tabaquismo, predisposición genética, alcohol y últimamente se menciona algunos virus con el virus de papiloma humano (VPH) entre otros. El objetivo del presente artículo es revisar los reportes de literatura que dan cuenta de la relación que existe entre CB y VPH, específicamente se describe el comportamiento molecular de los VPH de alto riesgo, el mapa genómico del virus y su posible relación con CB. La evidencia científica muestra que entre el 15 al 30% de los CB están relacionados con HPV, específicamente el subtipo 16 considerado de alto riesgo oncogénico y que los individuos con presencia de VPH bucal tienen dos veces mayor riesgo de desarrollar un CB que aquel que no está expuesto al virus (AU)

Oral cancer (BC) is an aggressive malignancy that includes 4 to 5% of all tumors with a high mortality rate, the vast majority are squamous cell carcinomas (90%). Among the factors risk associated with CB are described smoking, genetic predisposition, alcohol and recently mentioned some virus papilloma virus (HPV) among others. The aim of this paper is to review literature reports that account for the relationship between CB and HPV, specifically describing the molecular behavior of HPV high risk, the genome map of the virus and its possible relationship with CB. The Scientific evidence shows that between 15 to 30% of CB are related to HPV, specifically the subtype 16 considered high risk oncogenic and that individuals with oral HPV presence are twice increased risk of developing a CB who is not exposed to the virus (AU)

Number of external anogenital warts is associated with the occurrence of abnormal cervical cytology.

BACKGROUND: Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. OBJECTIVES: To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. MATERIALS AND METHODS: Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. RESULTS: A total of 191 women were eligible, with a mean age of 27.0±8.9 years; and a mean body mass index of 20.6±8.9 kg/m2. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ≥ 5 was the only factor associated with LSIL+ (aOR 2.65, 95%CI 1.11-6.29, p 0.027). CONCLUSIONS: LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.

Quadrivalent HPV vaccine efficacy against disease related to vaccine and non-vaccine HPV types in males.

A small number of HPV types are related to a majority of HPV-related neoplastic lesions in humans. High-risk types such as HPV 16 and 18 are most often implicated, although other oncogenic and non-oncogenic HPV types can cause disease in men. The efficacy of the quadrivalent HPV vaccine (qHPV) against external genital lesions and intra-anal disease related to HPV in men has been demonstrated. This report examines the vaccine's efficacy against disease due to 10 additional non-vaccine HPV types, as well as efficacy regardless of HPV detection. The data presented suggest that vaccinating males against HPV 6, 11, 16 and 18 protects them against most vaccine HPV-type related anogenital disease. However, significant efficacy against disease due to non-vaccine HPV types was not seen. In addition, the data do not provide any evidence that vaccination with qHPV vaccine will increase the likelihood of disease caused by non-vaccine types in the short term.