Cause Of Cervical Cancer Research Articles

Turkish mothers' knowledge and attitude about HPV vaccine

BackgroundThe study aimed to evaluate the knowledge and attitude of Turkish mothers about cervix cancer,HPV infection and vaccination. MethodsThis cross-sectional study was conducted the mothers with children aged under 18 years who applied pediatric outpatient clinic.Research data were collected using a face-to-face survey includes sociodemographic characteristics of patients and mothers' knowledge level and attitude about the vaccination for HPV and cervical cancer. ResultsThe rate of mothers who stated that they knew the causes of cervical cancer was 30.3%. Of the 71.5% mothers did not know whether there was a vaccine that protects against cervical cancer.Of the mothers who stated to have heard about the HPV vaccine, 39.2% said that the HPV vaccine is received at 9 years and above, 35.7% said that it could be given to both genders, and 75% knew that the vaccine is not reimbursed. Educational status (p < 0.001), working as a healthcare worker (p < 0.001) and the level of income (p < 0.001), were significantly correlated with the awareness of the causes of cervical cancer in a positive direction. None of the participants vaccinated their child, 91.5% ask for information about HPV and 67.3% stated that they might consider vaccination. ConclusionsThe development of vaccines against HPV has significantly changed the approach used in the treatment of cervical cancer. Healthcare professionals have a great responsibility to inform the public about the HPV vaccine. Practice implicationsHealthcare providers can use the results of this study to identify parents at risk for vaccine hesitancy and initiate individualized education to promote on-time childhood vaccination.

Vaccination with human alphapapillomavirus-derived L2 multimer protects against human betapapillomavirus challenge, including in epidermodysplasia verruciformis model mice

Human alphapapillomaviruses (αHPV) infect genital mucosa, and a high-risk subset is a necessary cause of cervical cancer. Licensed L1 virus-like particle (VLP) vaccines offer immunity against the nine most common αHPV associated with cervical cancer and genital warts. However, vaccination with an αHPV L2-based multimer vaccine, α11–88x5, protected mice and rabbits from vaginal and skin challenge with diverse αHPV types. While generally clinically inapparent, human betapapillomaviruses (βHPV) are possibly associated with cutaneous squamous cell carcinoma (CSCC) in epidermodysplasia verruciformis (EV) and immunocompromised patients. Here we show that α11–88x5 vaccination protected wild type and EV model mice against HPV5 challenge. Passive transfer of antiserum conferred protection independently of Fc receptors (FcR) or Gr-1+ phagocytes. Antisera demonstrated robust antibody titers against ten βHPV by L1/L2 VLP ELISA and neutralized and protected against challenge by 3 additional βHPV (HPV49/76/96). Thus, unlike the licensed vaccines, α11–88x5 vaccination elicits broad immunity against αHPV and βHPV.

Audio-Visual Training Improves Awareness and Willingness of Cervical Cancer Screening among Healthy Indian Women: Findings from a Survey.

Priya GaneshkumarObjectives We evaluated the impact of a standardized, simple audio-visual (AV) training video developed in regional languages on cervical cancer awareness among apparently healthy women and their willingness to undergo regular cervical cancer screening. Materials and Methods This cross-sectional noninterventional multicentric survey was conducted in 69 centers across 14 states in India and one center in UAE among women aged between 18 and 88 years attending clinics for a variety of indications. Using a short questionnaire, cervical cancer awareness and willingness to undergo cervical cancer screening were assessed before and after the AV training. Statistical Analysis In addition to descriptive analysis, improvement in awareness after the AV training was assessed using McNemar's test, and comparison of responses between subgroups was performed using Pearson chi-squared test. Results The survey was completed by 3,188 apparently healthy women (mean age: 36.8 ± 11.3 years). Before AV training, correct answers were given to only 4/6 questions by majority of the participants; most participants were unaware about the main cause of cervical cancer (1,637/3,188, 51.4%), availability of cervical cancer screening tests (1,601/3,188, 50.2%), and cervical cancer vaccines (1,742/3,188, 54.6%). Only 576 women (18.1%) had undergone cervical cancer screening in the past. After the AV training, the proportion of women correctly responding to all six questions improved significantly (p < 0.05), and 84.4% (2691/3188) women showed willingness to undergo periodic cervical cancer screening. Compared to unmarried and professional women, although married women and home-makers had lower awareness scores, the latter subgroups had more often undergone previous cervical cancer screening. Conclusion It is possible to improve cervical cancer awareness among healthy women, and to enhance their willingness to undergo regular cervical cancer screening tests using a simple, six minute-long, standardized AV training material.

High prevalence of and factors associated with human papillomavirus infection among women attending a tertiary hospital in Gauteng Province, South Africa

BackgroundPersistent high-risk (hr) human papillomavirus (HPV) infection is a necessary cause of cervical cancer. Cervical cancer is a major public health problem in Sub-Saharan Africa including South Africa. This study investigated the prevalence of and factors associated with hr-HPV infection among women attending a tertiary hospital in Gauteng Province, South Africa.MethodsCervical samples were collected from 526 participants aged ≥ 18 years using a Cervex Brush® Combi and tested for hr-HPV types on the Abbott m2000 analyzer using the Abbott RealTime HR HPV assay. Samples that tested hr-HPV deoxyribonucleic acid (DNA)-positive were further tested for hr-HPV E6/E7 messenger ribonucleic acid (mRNA) using the APTIMA® HPV assay on the Panther system (Hologic, Inc.). Sociodemographic data were collected using a self-administered questionnaire. Binomial regression analysis was used to assess factors associated with hr-HPV infection.ResultsOverall hr-HPV DNA prevalence was 48.1% (95%CI: 43.8–52.4%). Of the hr-HPV DNA-positives, 24.5% (95%CI: 19.3–30.1) had HPV-16; 12.3% (95%CI: 8.5–16.9) had HPV-18 and 87.4% (95%CI: 82.6–91.2) had other 12 h-HPVs. Of the samples positive for hr-HPV DNA, 84.2% (95%CI: 79.1–88.5) (213/253) were positive for hr-HPV E6/E7 mRNA. Advanced age was an important factor linked to hr-HPV E6/E7 mRNA positivity. Based on multivariate binomial regression analysis, unemployment (PR: 1.50; 95%CI: 1.23–1.83) and being married (PR: 0.61; 95%CI: 0.47–0.81) were identified as statistically significant (p < 0.0001) predictive and protective factors, respectively, for hr-HPV infection.ConclusionsThe prevalence of hr-HPV infection was high. Furthermore, hr-HPV DNA-positive samples had a high hr-HPV E6/E7 mRNA prevalence. The presence of hr-HPV E6/E7mRNA indicates active infection and thus a greater risk of developing the cervical disease. Therefore, HPV mRNA testing could be a better test to monitor women who are positive with Pap smear before colposcopy is performed to reduce the burden of referrals.

Knowledge, Acceptance and Uptake of HPV Vaccine Among OB/ GYN Patients (447)

Objectives: Human papillomavirus (HPV) is the leading cause of cervical cancer. This study aimed to explore patients’ knowledge about the HPV vaccine. Secondary objectives were to understand factors and potential barriers to vaccination in a safety-net hospital system. Methods: A 28-item survey was developed using Likert scale survey questions to assess patient agreement with statements regarding HPV and the HPV vaccine. The surveys were then administered to patients in the Obstetrics/Gynecology outpatient clinics of a safety- net hospital. Patients had to be 18 years and older, able to read English, Spanish or Haitian Creole, and were able to self-complete survey. Survey responses were recorded in REDCap (Research Electronic Data Capture) for further analysis. Descriptive statistical analysis was performed to evaluate frequency, range, mean and median values. Results: Two hundred and fourteen patients completed surveys from May through July of 2021. The mean age of respondents was 34 years. Fifty-two percent of respondents were identified as Caucasian, 21% African American, 8% Haitian, and 18% others. Seventy-two percent identified as Hispanic, and 28% identified as non-Hispanic. Thirty- one percent reported not knowing how HPV was transmitted, and 38% reported that they did not know the health consequences of HPV. Forty-four percent of respondents reported cancer as a possible health outcome of HPV infection. The majority of patients (70%) reported that a medical professional had never discussed HPV vaccination. Sixty-four percent of patients did not know the earliest age at which the HPV vaccine could be administered, and 84% did not know the oldest age at which the HPV vaccine could be administered. Fifty- nine percent of respondents were unsure whether men could receive the HPV vaccine, whereas 72% of respondents did not know how many injections were required as part of the HPV series. Seventy-six percent of respondents reported that the HPV vaccine was not available for receipt the same day when offered. Fifty percent of patients reported that they were unaware that they were eligible to receive the vaccine. Conclusions: Our study demonstrated significant gaps in knowledge regarding HPV and HPV vaccination among our clinic population. Less than half of patients knew that HPV causes cancer. Nearly half of our patients had not received the vaccine, and the majority reported that a medical professional had never discussed vaccination with them. Healthcare providers have significant opportunities to provide education and counseling to increase knowledge and uptake of HPV vaccine for cancer prevention. Objectives: Human papillomavirus (HPV) is the leading cause of cervical cancer. This study aimed to explore patients’ knowledge about the HPV vaccine. Secondary objectives were to understand factors and potential barriers to vaccination in a safety-net hospital system. Methods: A 28-item survey was developed using Likert scale survey questions to assess patient agreement with statements regarding HPV and the HPV vaccine. The surveys were then administered to patients in the Obstetrics/Gynecology outpatient clinics of a safety- net hospital. Patients had to be 18 years and older, able to read English, Spanish or Haitian Creole, and were able to self-complete survey. Survey responses were recorded in REDCap (Research Electronic Data Capture) for further analysis. Descriptive statistical analysis was performed to evaluate frequency, range, mean and median values. Results: Two hundred and fourteen patients completed surveys from May through July of 2021. The mean age of respondents was 34 years. Fifty-two percent of respondents were identified as Caucasian, 21% African American, 8% Haitian, and 18% others. Seventy-two percent identified as Hispanic, and 28% identified as non-Hispanic. Thirty- one percent reported not knowing how HPV was transmitted, and 38% reported that they did not know the health consequences of HPV. Forty-four percent of respondents reported cancer as a possible health outcome of HPV infection. The majority of patients (70%) reported that a medical professional had never discussed HPV vaccination. Sixty-four percent of patients did not know the earliest age at which the HPV vaccine could be administered, and 84% did not know the oldest age at which the HPV vaccine could be administered. Fifty- nine percent of respondents were unsure whether men could receive the HPV vaccine, whereas 72% of respondents did not know how many injections were required as part of the HPV series. Seventy-six percent of respondents reported that the HPV vaccine was not available for receipt the same day when offered. Fifty percent of patients reported that they were unaware that they were eligible to receive the vaccine. Conclusions: Our study demonstrated significant gaps in knowledge regarding HPV and HPV vaccination among our clinic population. Less than half of patients knew that HPV causes cancer. Nearly half of our patients had not received the vaccine, and the majority reported that a medical professional had never discussed vaccination with them. Healthcare providers have significant opportunities to provide education and counseling to increase knowledge and uptake of HPV vaccine for cancer prevention.

Overexpression of miR-3653 is Associated with HPV Infection and Serves as a Biomarker in Patients with Cervical Cancer.

BackgroundHuman papillomavirus (HPV) is a major cause of cervical cancer (CC) occurrence. This study aimed to explore whether abnormal microRNA (miR)-3653 is associated with HPV infection and to investigate the clinical value of miR-3653 in the diagnosis and prognosis of CC.MethodsTumor tissues and adjacent non-cancerous tissues were collected from 136 patients with CC. Cervical tissues from 101 patients with uterine fibroids were collected as controls. The expression of miR-3653 was measured by quantitative real-time PCR. The ability of miR-3653 to discriminate between HPV positive (HPV+) and HPV negative (HPV-) CC patients, and to discriminate patients from controls was assessed by receiver operating characteristic analysis. Kaplan–Meier curves and Log rank tests were used to evaluate the relationship of miR-3653 with survival of CC patient. Whether miR-3653 could function as a prognostic indicator was evaluated by univariate and multivariate Cox analyses.ResultsmiR-3653, highly expressed in CC tissues, was associated with HPV infection, tumor diameter, International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis in CC patients. Additionally, miR-3653 was increased in HPV+ controls, CC patients and CC cells. Moreover, miR-3653 could screen HPV+ controls, screen HPV+ patients and screen CC patients. Furthermore, miR-3653 was associated with the survival of CC patients (log-rank P < 0.001) and could serve as an independent prognostic indicator for CC patients.ConclusionmiR-3653, increased in CC, is related to HPV infection and may serve as a diagnostic and prognostic biomarker for CC patients.

A qualitative exploration of perceived causes of cervical cancer in Busia and Trans Nzoia, Western Kenya (416)

<b>Objectives:</b> The Primary Integrated Care for Four Chronic Diseases (PIC4C) is an initiative implemented by the Kenyan Ministry of Health and Moi Teaching & Referral Hospital to pilot screening, referral, treatment integration for diabetes, hypertension, breast cancer, cervical cancer in Busia and Trans-Nzoia counties, western Kenya. A major aspect of the qualitative phase of PIC4C sought to determine how localized knowledge affects perceptions of cervical cancer causes in the two counties and to use this information to develop targeted interventions. <b>Methods:</b> A total of 174 participants were included in 18 focus group discussions (FGDs), engaging patients, community members (CHVs), and health care providers (HCPs). A total of 14 patients with cervical cancer were included in the patient FGDs. The group sessions were facilitated by trained moderators and captured using audio recorders and field notes. Two analysts independently coded and analyzed the data using NVivo 12. Data were translated from Kiswahili to English as appropriate. <b>Results:</b> Overall, patients, CHVs, and HCPs perceived cervical cancer to be a chronic disease that could be treated but inevitably led to death. Several factors were implicated in causing cervical cancer among the three groups of participants (Table 1). All 174 participants alluded to sexual behavior etiologies, including multiple sexual partners, contracting sexually transmitted infections, and early engagement in sexual activities. Patients and CHVs cited unhealthy diet and use of selected family planning methods, while HCPs and CHVs added complications during delivery as causative. Only patients cited commercial sex, lack of vitamin B17, bacterial infections, smoking as factors. Additionally, CHVs added female circumcision, genetics, abortion, intercourse with men with long penises as causes. <b>Conclusions:</b> This study reports how localized knowledge affects perceptions of cervical cancer causes in Busia and Trans-Nzoia, western Kenya. Our study shows that misconceptions and inadequate knowledge about cervical cancer causes persist in these two counties. Our findings suggest a need for improved screening and treatment via dedicated health education campaigns, treatment resources, training for CHVs and HCPs to ensure communities receive accurate information. Eliciting local perceptions about cervical cancer ensures informed programming creation and implementation. Community interventions with buy-in from patients, CHVs, HCPs are essential to improve cervical cancer prevention, screening, treatment in western Kenya.

Association between common vaginal and HPV infections and results of cytology test in the Zhoupu District, Shanghai City, China, from 2014 to 2019

BackgroundHPV (human papillomavirus) is an important cause of cervical cancer. Cervical-vaginal infection with pathogens, such as herpes simplex virus (HSV), bacterial vaginosis Trichomonas vaginalis and vaginal candidiasis could be a cofactor. This study aimed to assess the relationship between vaginal infection with HPV genotype and cytology test results and analyze the relationship between vaginal and HPV infections and cervical cancer.MethodsWe performed a district-based study to elucidate the relationship among the vaginal and HPV infections and cervical cancer. We collected the cervical exfoliation data of 23,724 women admitted to the Shanghai Zhoupu Hospital and received ThinPrep cytology test (TCT) and HPV detection between 2014 and 2019.ResultsTotal vaginal infection rate was 5.3%, and the HPV-positive group had a slightly higher vaginal infection rate than the HPV-negative group (P < 0.01). The incidence rate of cervical intraepithelial neoplasia or cervical cancer with vaginal infection was higher than without vaginal infection (P < 0.001).ConclusionHPV/vaginal infection-positive women tended to have abnormal results of TCT. Women with vaginal infection were more likely to develop HPV infection. HSV combined with HPV infection was noted as a causal factor for HSIL.

Knowledge and Attitude of Iranian University Students toward Genital Warts.

Human papillomavirus (HPV) is one of the well-known causes of cervical cancer and one of the most prevalent sexually transmitted diseases (STDs). Since cervical cancer is one of the most common causes of morbidity and mortality in women, this study was performed to investigate Iranian medical students' knowledge and attitudes towards genital warts. This cross-sectional study assessed the perception and attitudes of 385 students at Babol University of Medical Sciences using a preconceived questionnaire. The participants' mean age was 23.70 ± 3.27 years, with a range of 20-50 years. Evaluation of these students' level of general information about HPV showed that 7 (1.8%) students had inadequate general information, 34 (8.8%) had moderate knowledge, and 344 (89.4%) had good general knowledge in this regard. There was also a significant association between students' general knowledge of HPV and their field of study. Based on our results, the knowledge of the majority of Babol University of Medical Sciences students about genital warts was in a good range, and their knowledge about HPV routes of transmission was of moderate level. Moreover, the majority had an appropriate attitude to interact with people infected with HPV.

Prophylactic and Therapeutic HPV Vaccines: Current Scenario and Perspectives.

Persistent human papillomavirus (HPV) infection is recognized as the main cause of cervical cancer and other malignant cancers. Although early detection and treatment can be achieved by effective HPV screening methods and surgical procedures, the disease load has not been adequately mitigated yet, especially in the underdeveloped areas. Vaccine, being regarded as a more effective solution, is expected to prevent virus infection and the consequent diseases in the phases of both prevention and treatment. Currently, there are three licensed prophylactic vaccines for L1-VLPs, namely bivalent, quadrivalent and nonavalent vaccine. About 90% of HPV infections have been effectively prevented with the implementation of vaccines worldwide. However, no significant therapeutic effect has been observed on the already existed infections and lesions. Therapeutic vaccine designed for oncoprotein E6/E7 activates cellular immunity rather than focuses on neutralizing antibodies, which is considered as an ideal immune method to eliminate infection. In this review, we elaborate on the classification, mechanism, and clinical effects of HPV vaccines for disease prevention and treatment, in order to make improvements to the current situation of HPV vaccines by provoking new ideas.

A Technical Comparison of Human Papillomavirus Genotyping Assays from a Population-Based Cervical Cancer Screening in South Central Ethiopia.

PurposeHigh-risk Human Papillomavirus (HPV) is the most important cause of cervical cancer. The highest burden of disease is seen in Low- and Low-Middle-Income Countries (LMIC). Several new HPV screening assays have been developed for high-risk HPV (hr-HPV) testing. We compared the performance and adequacy of three HPV genotyping assays on samples from a population of rural women in south-central Ethiopia.Patients and MethodsOne hundred and ten cervical swabs from rural women screened for HPV were assayed. HPV DNA was tested using MPG-Luminex Assay, Anyplex II HPV HR Detection, and EUROArray HPV. MPG-Luminex Assay was used as a reference method to compute the sensitivity and specificity of the two commercial assays in detecting hr-HPV infections.ResultsOf the 110 samples, MPG-Luminex Assay found 18.2% positive for the 14 hr-HPV and 7.3% for the probable hr-HPV genotypes. Anyplex™ II HPV HR Detection assay and EUROArray HPV Assay identified 21.82% and 12.7% samples, respectively, for the 14 hr-HPVs and both 7.3% for the probable hr-HPV genotypes (κ=0.734). Among the 14 hr-HPV genotypes, the genotype-specific agreement of the three HPV genotyping assays was moderate or better for HPV16, 31, 35, 39, 52, 56, 66 and 68. The aggregated sensitivity in detecting the 14 hr-HPV infections of Anyplex™ II HPV HR Detection and EUROArray HPV assays was high, 100% and 70%, respectively. The specificities of Anyplex™ II HPV HR Detection and EUROArray HPV were 95.6% and 100%, respectively.ConclusionThe three evaluated assays showed similar analytical performance in the detection of hr-HPV infections and moderate or better concordance in HPV genotyping. This study is part of the ongoing cluster-randomized trial that has been registered in clinicaltrials.gov (NCT03281135) on September 13, 2017.

Prevalence of Anti-Human Papillomavirus IgG Antibody among Students of a Private Tertiary Institution in Ado-Ekiti, Nigeria

Background: Human Papillomavirus (HPV) is an oncogenic sexually transmitted virus. It is the leading cause of cervical cancer, penile, vulva, vaginal and anal high-grade dysplasia. Infections are usually asymptomatic only to manifest after several years, implying that most adults with symptoms must have been infected at their young ages. The risky sexual behavior of subjects at ages 16-24 makes then vulnerable. Objectives: This study evaluates the prevalence of anti-human Papillomavirus IgG antibody among students of a tertiary institution in Ado-Ekiti, Nigeria. Methods: One hundred and fifty (150) blood samples were collected from consenting students (100 females and 50 males) age 16-24 in Ado-Ekiti. A structured questionnaire was administered concurrently. Sera were assayed using the anti-HPV-IgG antibody ELISA Kit (Melsin Medical Co. Limited). Data was analyzed using Epi-Info 7.2 Version Software and Excel. Ethical approval was obtained for the study. Results: Sixty eight (45%) of the total subjects were seropositive for anti-HPV-IgG antibody. Twenty six (52%) males and 42 (41%) females were seropositive. There was no significant difference (p&gt;0.05) in seropositivity across the ages and among the gender. Fifty nine (60%) of sexually active subjects were seropositive for anti-HPV-IgG antibody (p˂0.05). Thirty five (97%) non-condom users were seropositive (p&lt;0.05) while fifty four (75%) of subjects who have had unprotected sex at one point in their lives were seropositive (p&lt; 0.05). Only three of the subjects had been vaccinated. Conclusion: The high rate of seropositivity to anti-HPV-IgG antibody in the population is a cardinal pointer to high rate of exposure to HPV and a likely exposure to the high-risk serotype.

Cohabitation of tuberculosis and human papillomavirus-positive infections in the development of cervical cancer

Tuberculosis (TB) has been implicated in the pathogenesis of malignancies and may interfere with their diagnosis. TB and cancer frequently coexist and the relative immunosuppression caused by cancer or its treatment may lead to the reactivation of latent TB infections, leading to increased morbidity and mortality. Human papillomavirus (HPV) infection causes cervical cancer, particularly HPV 16 and 18 strains account for 75% of these cases. Although it is difficult to determine the exact chronology of events using data from reported diagnoses of infections, it is possible to draw preliminary conclusions regarding the relationship between co-infections and HPV infection, HPV persistence, and the development of CIN3+. This review highlights the underappreciated overlap of the cohabitation of TB and HPV + ve infection in the cause of cervical cancer.

New Perspectives in Therapeutic Vaccines for HPV: A Critical Review.

Human Papillomavirus is the main cause of cervical cancer, including squamous cell carcinoma of the oropharynx, anus, rectum, penis, vagina, and vulva. In recent years, considerable effort has been made to control HPV-induced diseases using either prophylactic or therapeutic approaches. A critical review of the literature about the therapeutic Human Papillomavirus vaccine was performed to analyze its efficacy in the treatment of female lower genital tract lesions and its possible perspective application in clinical practice. The most important medical databases were consulted, and all papers published from 2000 until 2021 were considered. We retrieved a group of seven papers, reporting the role of anti HPV therapeutic vaccines against the L2 protein in the order of their efficacy and safety in female lower genital tract disease. In addition, the immune response due to vaccine administration was evaluated. The development of therapeutic vaccines represents an interesting challenge for the treatment of HPV infection of the lower genital tract. Literature data underline that the L2 protein may be an interesting and promising target in the development of therapeutic HPV vaccines, but the possible strengths and the unclear longevity of L2 immune responses are factors to be considered before clinical use.

A Straightforward HPV16 Lineage Classification Based on Machine Learning.

Human Papillomavirus (HPV) is the causal agent of 5% of cancers worldwide and the main cause of cervical cancer and it is also associated with a significant percentage of oropharyngeal and anogenital cancers. More than 60% of cervical cancers are caused by HPV16 genotype, which has been classified into lineages (A, B, C, and D). Lineages are related to the progression of cervical cancer and the current method to assess lineages is by building a Maximum Likelihood Tree (MLT); which is slow, it cannot assess poor sequenced samples, and annotation is done manually. In this study, we have developed a new model to assess HPV16 lineage using machine learning tools. A total of 645 HPV16 genomes were analyzed using Genome-Wide Association Study (GWAS), which identified 56 lineage-specific Single Nucleotide Polymorphisms (SNPs). From the SNPs found, training-test models were constructed using different algorithms such as Random Forest (RF), Support Vector Machine (SVM), and K-nearest neighbor (KNN). A distinct set of HPV16 sequences (n = 1,028), whose lineage was previously determined by MLT, was used for validation. The RF-based model allowed a precise assignment of HPV16 lineage, showing an accuracy of 99.5% in the known lineage samples. Moreover, the RF model could assess lineage to 273 samples that MLT could not determine. In terms of computer consuming time, the RF-based model was almost 40 times faster than MLT. Having a fast and efficient method for assigning HPV16 lineages, could facilitate the implementation of lineage classification as a triage or prognostic marker in the clinical setting.

Current Status of Human Papillomavirus Infection and Cervical Cancer in the Philippines.

Cervical cancer is estimated to cause 341,831 deaths each year, with 9 of 10 deaths occurring in developing countries. Over the past decade, there has been a significant increase in cervical cancer incidence among women in the Philippines. Persistent infection with high-risk human papillomavirus (HPV) is the well-established necessary cause of cervical cancer. Based on limited studies conducted in the Philippines, the prevalence of infection with any HPV genotype was 93.8% for cervical squamous cell carcinoma and 90.9% for cervical adenocarcinomas. HPV types 16 and 18 were the most common HPV genotypes among Filipino patients with cervical cancer. On the other hand, the incidence of HPV infection among Filipino women with normal cervices was 9.2%. The World Health Organization has launched a global agenda of eliminating HPV infection by 2030. One of its key milestones is to vaccinate 90% of girls with the HPV vaccine by 15 years. However, the HPV vaccination rate among Filipino women remains to be unsatisfactory. HPV vaccination has only been included in the Philippine Department of Health's community-based National Immunization Program in 2015. Despite these efforts, the Philippines currently ranks last on HPV program coverage among low-middle income countries, with coverage of only 23% of the target female population for the first dose and 5% for the final dose. The principal reason for the non-acceptance of HPV vaccines was the perceived high cost of vaccination. The low utilization of available cervical cancer screening tests such as Pap smear and visual inspection with acetic acid hampered the Philippines' control and prevention of HPV infection and cervical cancer. Among those diagnosed with cervical cancer in the Philippines, only an estimated 50% to 60% receive some form of treatment. To this end, we summarize the burden of HPV infection and cervical cancer on Filipinos and the risk factors associated with the disease. We present the current screening, diagnostics, treatment, and prevention of HPV-related diseases in the Philippines. Lastly, we also propose solutions on how each building block in health systems can be improved to eliminate HPV infection and reduce the burden of cervical cancer in the Philippines.

RG2-VLP: a Vaccine Designed to Broadly Protect against Anogenital and Skin Human Papillomaviruses Causing Human Cancer.

The family of human papillomaviruses (HPV) includes over 400 genotypes. Genus α genotypes generally infect the anogenital mucosa, and a subset of these HPV are a necessary, but not sufficient, cause of cervical cancer. Of the 13 high-risk (HR) and 11 intermediate-risk (IR) HPV associated with cervical cancer, genotypes 16 and 18 cause 50% and 20% of cases, respectively, whereas HPV16 dominates in other anogenital and oropharyngeal cancers. A plethora of βHPVs are associated with cutaneous squamous cell carcinoma (CSCC), especially in sun-exposed skin sites of epidermodysplasia verruciformis (EV), AIDS, and immunosuppressed patients. Licensed L1 virus-like particle (VLP) vaccines, such as Gardasil 9, target a subset of αHPV but no βHPV. To comprehensively target both α- and βHPVs, we developed a two-component VLP vaccine, RG2-VLP, in which L2 protective epitopes derived from a conserved αHPV epitope (amino acids 17 to 36 of HPV16 L2) and a consensus βHPV sequence in the same region are displayed within the DE loop of HPV16 and HPV18 L1 VLP, respectively. Unlike vaccination with Gardasil 9, vaccination of wild-type and EV model mice (Tmc6Δ/Δ or Tmc8Δ/Δ) with RG2-VLP induced robust L2-specific antibody titers and protected against β-type HPV5. RG2-VLP protected rabbits against 17 αHPV, including those not covered by Gardasil 9. HPV16- and HPV18-specific neutralizing antibody responses were similar between RG2-VLP- and Gardasil 9-vaccinated animals. However, only transfer of RG2-VLP antiserum effectively protected naive mice from challenge with all βHPVs tested. Taken together, these observations suggest RG2-VLP's potential as a broad-spectrum vaccine to prevent αHPV-driven anogenital, oropharyngeal, and βHPV-associated cutaneous cancers. IMPORTANCE Licensed preventive HPV vaccines are composed of VLPs derived by expression of major capsid protein L1. They confer protection generally restricted to infection by the αHPVs targeted by the up-to-9-valent vaccine, and their associated anogenital cancers and genital warts, but do not target βHPV that are associated with CSCC in EV and immunocompromised patients. We describe the development of a two-antigen vaccine protective in animal models against known oncogenic αHPVs as well as diverse βHPVs by incorporation into HPV16 and HPV18 L1 VLP of 20-amino-acid conserved protective epitopes derived from minor capsid protein L2.

Abstract 2229: Targeted locus amplification based sequencing for mapping viral integration sites in human papillomavirus positive head and neck squamous cell carcinomas

Abstract Background: Human papillomavirus (HPV) infections are the principal cause of cervical cancers, subsets of anogenital and head and neck cancers (HNC). During persistent infection, viral DNA integration into the host genome may occur, which is suggested to affect carcinogenesis. One of the most critical limitations of currently used HPV integration detection techniques (PCR-based or NGS-based) is their application to FFPE material, because of DNA fragmentation. The aim of this study was to assess HPV integration in HPV-positive HNSCC cell lines and FFPE tissue comparing the new Targeted Locus Amplification (TLA) technology with previously used PCR technology (APOT/DIPS). Methods: Seven HPV-positive cell lines and FFPE material of 10 HPV-positive HNSCC were used for HPV integration detection by TLA, a proximity ligation-based next-generation sequencing technique. Crosslinked DNA is digested with restriction enzymes, and re-ligated into chimeric DNA molecules. For cell lines, a PCR based HPV16 target enrichment is performed, and for FFPE material a capture-based target enrichment is performed for HPV16 and HPV18 sequences, both followed by Illumina sequencing. Results: TLA was able to sequence up to 100 kb around the target, detecting exact HPV integration loci, structural variants, and chromosomal rearrangements. In all cell lines, one or more integration sites were identified, in accordance with APOT/DIPS PCR data and the literature. In the FFPE tissue samples, TLA identified integrated HPV in 6 out of 10 tumors, with simple and complex integration patterns. In general, TLA confirmed PCR data and detected additional integration sites. Conclusion: TLA provides the opportunity for reliable and robust detection of HPV integration in HNSCC cell lines and FFPE tissue. This new sequencing technology could be a useful tool for further research on HPV integration in disease and patient outcome and eventually in clinical diagnostics. Citation Format: Imke Demers, Harini Balaji, Harma Feitsma, Irinia Sergeeva, Joost Swennenhuis, Nora Wuerdemann, Steffen Wagner, Bernd Kremer, Christian Huebbers, Jens Peter Klussmann, Ernst-Jan Speel. Targeted locus amplification based sequencing for mapping viral integration sites in human papillomavirus positive head and neck squamous cell carcinomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2229.

Computational Drug Design Study of Curcuma longa L. Compound as HPV-16 Antiviral Candidate Against Cervical Cancer

Human papillomavirus (HPV) is one of the causes of cervical cancer in women. These viruses have DNA-type genetic material, are not enveloped, and are divided into two types based on their ability to trigger cancer. High-risk HPV is the type of HPV that often causes cervical cancer cases, this is due to the high expression of oncoprotein E6. E6 works through the inhibition and degradation of p53 to trigger cancer. HPV drugs tend to be expensive and must use alternative solutions such as the herbal Curcuma longa L. Curcuma longa L. is an herbal plant that is widely used by the public for their daily needs, for example as an antiviral, antioxidant, and anti-inflammatory. This study aims to predict the molecular mechanism and screening of drug candidate compounds in Curcuma longa L. to inhibit the activity of the HPV E6 protein through a bioinformatics approach. This study used in silico methods such as docking simulations and molecular interaction analysis to identify potential antiviral candidate compounds. Curcuma longa L. can act as an antiviral through the binding activity of Curcumin compounds in preventing the E6-p53 complex through the specific domains and stable because it have a many number of hydrogen bonds. We recommend the E6-binding domain for further research as a target for HPV drug design and the results of this study are yet to be verified through wet lab testing

Knowledge Attitude and Practice of Postpartum Parturients Towards Cervical Cancer and Cervical Cancer Screening; Is Lack of Knowledge the Misleading Scapegoat?

Objective:The aim of this study was to assess knowledge, attitude, and practices towards cervical cancer screening among postpartum subjects. Study design:This cross-sectional study was conducted at inpatient obstetrics ward at Thammasat University Hospital (TUH), Thailand. The period of study was between July 2020 and July 2021. Subjects were term Thai pregnant women who had age between 20 and 45 years old and delivered at TUH. Demographic characters, knowledge, attitude and practices regarding cervical cancer screening were collected. Results:A total of 388 parturient was recruited into the study. Average age was 31 years old. Around 90 percent of subjects knew that every woman age between 21and 65 years old with or without children should be screened for cervical cancer despite having only 46.6 percent (181/388) of subjects that underwent postpartum cervical cancer screening. Almost half of the participant agreed that risky sexual behavior of both genders was not the cause of cervical cancer. Despite the availability of the HPV vaccine throughout the country, only 74.2 percent acknowledged that HPV was the cause and only 70.4% heard about the HPV vaccine. The mean attitude about the cervical cancer was relatively high with the mean of 3.19±0.46. Although the higher the score the better the attitude toward the statement, there were several correlations of having such attitude. Conclusion: Attention to postpartum cervical cancer screening was quite low even though high knowledge of cervical cancer and screening. Scant knowledge was not all of the troubles that we believed long time ago.