Human Papillomavirus (HPV) DNA Detection Using Self-Sampling Devices in Women Undergoing Long Term Immunosuppressive Therapy.

Gajane Martirosian,Mariusz Sikora,Lidia Rudnicka,Zoulikha Jabiry-Zieniewicz,Miroslaw Wielgos,Magdalena Durlik,Aleksandra Wielgos,Barbara Suchonska,Bronislawa Pietrzak,Jolanta Gozdowska,Urszula Oldakowska-Jedynak

doi:10.3390/v12090962

Gajane Martirosian, Mariusz Sikora + Show 9 more

Open Access

https://doi.org/10.3390/v12090962

Copy DOI

Journal: Viruses	Publication Date: Aug 30, 2020
Citations: 9	License type: CC BY 4.0

Affiliation: Medical University of Warsaw

Abstract

Immunosuppression is a risk factor of persistent human papillomavirus (HPV) infections, which might lead to development of (pre)malignant lesions of the cervix and lower anogenital tract. Results of HPV DNA testing using cervicovaginal self-samples are comparable to those that are clinician-obtained and therefore might be used in cervical screening. The aim of this study was to assess the prevalence of high-risk HPV (hrHPV) infections, their risk factors and the genotypes distribution among women undergoing immunosuppressive therapy. Women undergoing immunosuppressive therapy for at least three months due to solid organ transplantation or autoimmune disorders were asked to self-collect samples for HPV testing using cervicovaginal brushes and complete questionnaires regarding cervical cancer risk factors. HPV DNA detection and genotyping were performed using Genotyping kit HPV GP version 2. hrHPV was detected in 26/90 (28.9%) specimens. Genotyping revealed a broad range of hrHPV, with type 16 being the most common genotype (11/26). The components of bivalent/quadrivalent or nonavalent vaccines cover all genotypes present in 4.4% and 17.8% women, respectively, and occur as a co-infection with other types in 12.2% and 23.3% of women, respectively. The only feature significantly associated with being hrHPV-positive was having at least two lifetime sexual partners. The high prevalence of hrHPV infections among immunosuppressed women emphasizes the need for regular cervical cancer screening with HPV DNA testing, which might be performed on self-collected specimen.

Highlights

Infection with high-risk human papillomavirus is a risk factor of precancerous lesions and cancers of the cervix—cervical intraepithelial neoplasia (CIN) and cervical cancer—as well as Viruses 2020, 12, 962; doi:10.3390/v12090962 www.mdpi.com/journal/virusesViruses 2020, 12, 962 intraepithelial neoplasia and cancers of the vulva, vagina and anus
human papillomavirus (HPV) DNA testing is proclaimed to be a cervical cancer screening method that is superior to cytology because of its higher sensitivity and which should be preferred as a primary screening method
All women were receiving standard immunosuppressive therapy based on combinations of calcineurin inhibitors with mycophenolate mofetil or azathioprine and corticosteroids for at least three months prior to sample collection

Summary

Introduction

Infection with high-risk human papillomavirus (hrHPV) is a risk factor of precancerous lesions and cancers of the cervix—cervical intraepithelial neoplasia (CIN) and cervical cancer—as well as Viruses 2020, 12, 962; doi:10.3390/v12090962 www.mdpi.com/journal/virusesViruses 2020, 12, 962 intraepithelial neoplasia and cancers of the vulva, vagina and anus. Infection with high-risk human papillomavirus (hrHPV) is a risk factor of precancerous lesions and cancers of the cervix—cervical intraepithelial neoplasia (CIN) and cervical cancer—as well as Viruses 2020, 12, 962; doi:10.3390/v12090962 www.mdpi.com/journal/viruses. Immunodeficiency is an established risk factor for persistent HPV—infections which can lead to an increased incidence of CIN in immunocompromised women. The progression of such lesions is more frequent but, in many cases, more rapid. Studies comparing iatrogenically immunocompromised women due to chronic immunosuppressive therapy because of an organ transplant or autoimmune disorders (e.g., systemic lupus erythematosus, systemic sclerosis) with those due to human immunodeficiency virus (HIV) infection revealed that immunodeficiency itself is an independent risk factor for malignancy development, especially those that are virally induced [2]. Cervicovaginal self-sampling for HPV testing has been thoroughly investigated in recent years and is a recognized cervical cancer screening method of accuracy comparable to clinician-collected samples [3,4,5]

Objectives

Methods

Results

Discussion

Conclusion