Genital HPV Research Articles

Evaluating different samples & techniques for hr-HPV DNA genotyping to improve the efficiency of risk profiling for oral & cervical cancers in Sikkim, India

Background & objectives Oral and genital HPV infection in men may be a source of cervical diseases in their women partners as well as disease in themselves. This study aimed to evaluate and compare the performance of Hybrid Capture 2 (HC2) in physician-collected cervical samples and qPCR in self-collected urine and oral gargle samples of women and men, respectively, for hr-HPV infection status and genotyping. Methods One thousand and two hundred biological samples were collected from 200 women (urine, oral gargle, and cervical smear) and 200 men (urine and oral gargle) visiting a referral hospital in the remote Himalayan State of Sikkim. The extracted genomic DNA from urine and gargle samples were profiled for hr-HPV genotypes using quantitative polymerase chain reaction (qPCR) and HC2 for cervical samples. Results In women, hr-HPV was detected in 17.5 per cent of cervical samples by HC2, 25.5 per cent of urine, and 7 per cent of gargle samples by qPCR. For men, hr-HPV was detected in 8 per cent urine and 5 per cent gargle samples by qPCR. Among the HPV-positive women, 56 per cent of urine samples and 20 per cent of oral samples showed single-genotype infection, while the remaining had multiple genotypes. Amongst the HPV-positive men, 62.7 per cent of urine samples and 85.7 per cent of oral samples showed single-genotype infection while the remaining had multiple genotypes. Compared to Pap, the area under ROC was good for HC2 (AUC=0.89) and for qPCR (AUC= 0.852). Interpretation & conclusions HC2 for cervical and qPCR-based HPV DNA assay for urine and gargle sample is suitable for risk profiling for cervical cancer (CC) and oral cancer (OC) screening programmes.

Effectiveness of bivalent HPV vaccination against genital HPV DNA-positivity of a catch-up campaign at age 13–16 years compared to routine vaccination at age 12 years: a biennial repeated cross-sectional study

BackgroundThe Netherlands is one of few countries worldwide which has used the bivalent HPV vaccine for girls-only for over a decade. This allows assessment of vaccine effectiveness (VE) against female genital HPV DNA-positivity of this vaccine in an observational post-licencing real-world setting. Additionally, it is unclear whether catch-up vaccination campaigns result in similar VE as routine vaccination. Therefore, type-specific and grouped VE were assessed and compared for women who had been eligible for catch-up vaccination at 13–16 years with those who had been eligible for routine vaccination at 12 years.MethodsPASSYON is a Dutch biennial repeated cross-sectional (2011–2021) study among sexual health clinic clients aged 16–24 years old. Women provided self-collected vaginal samples, questionnaires on demographics and sexual behaviour were administered, and women self-reported HPV vaccination status. Samples were analysed using a PCR-based assay (SPF10-LiPA25). Type-specific and grouped VE estimates, adjusted with propensity score stratification, were assessed against genital positivity for 14 HPV types. VE for targeted and non-targeted genotypes were compared between women who had been eligible for the catch-up and those who had been eligible for routine vaccination.ResultsThe study included 4488 female participants who had been eligible for HPV vaccination and provided genital swabs (1561 eligible for catch-up, 2927 for routine vaccination). Very high VE against genital HPV-16 and HPV-18 was observed (resp. 93.5% and 89.5%) and significant cross-protection against six other genotypes (HPV-31/33/35/45/52/58), varying from 18.0% (HPV-52) to 79.6% (HPV-45). VE estimates were comparable between women who had been eligible for the catch-up campaign and those eligible for routine vaccination: VE HPV-16/HPV-18: 92.2% (95%CI: 87.9–94.9) vs. 91.8% (95%CI: 86.0–95.2).ConclusionsIn real-world settings, the VE of bivalent vaccine is high against targeted genotypes, with cross-protection against 6 other genotypes. Catch-up campaigns up to age 16 years can be as effective as routine vaccination at age 12, although it is recommendable to provide HPV vaccination at an age at which most are likely not sexually active yet. This may inform countries considering catch-up campaigns when introducing or extending the use of HPV vaccination within their national immunisation programmes.

Changes in Genital HPV Prevalence during 12 Years Girls-Only Bivalent HPV Vaccination: Results from a Biennial Repeated Cross-Sectional Study.

From 2009 until 2021, bivalent HPV vaccination was offered only to girls in the Netherlands. We aimed to study the impact of girls-only HPV vaccination on genital HPV prevalence among young adults. PASSYON is a biennial repeated cross-sectional study (2009-21) among sexual health clinic clients aged 16-24 years old. Questionnaires elicited data on demographics, sexual behaviour and HPV vaccination status. Genital samples were collected and analysed using a PCR-based assay (SPF10-LiPA25). Type-specific prevalence trends of 12 high-risk (hr) genotypes were analysed as the adjusted average annual change (aAAC), estimated using Poisson GEE models. The relation between aAAC and phylogenetic distance to HPV-16/18 was assessed by means of regression and rank correlation analysis. Questionnaires and genital samples were collected from 8,889 females and 3,300 heterosexual males (HM). 4,829 females reported to be unvaccinated (54·3%). Among females (irrespective of vaccination status), prevalences of HPV-16/18/31/33/35/45 decreased significantly over time. Increasing trends were observed for HPV-39/52/56. Among both HM and unvaccinated females HPV-16/18 prevalence significantly declined, as did HPV-31 among HM. In contrast, HPV-52/58 increased significantly among HM and unvaccinated females. The type-specific aAAC correlated well with the phylogenetic distance to HPV-16/18. During twelve years girls-only bivalent HPV vaccination in the Netherlands, decreasing trends of the vaccine types and cross-protected types were observed among females. Herd protection of vaccine-types was observed for HM and unvaccinated females, and one cross-protected type for HM. Increasing prevalence trends of HPV types with large phylogenetic distance to the vaccine types might indicate type-replacement.

Clinical Characteristics of Basal Cell Carcinomas of the Scrotum: An Institutional Retrospective Review

Objective. To analyse the clinical and pathologic features, discuss therapeutic strategies, and possibly cause and identify prognostic factors of scrotal basal cell carcinoma (BCC) in Chinese patients. Materials and Methods. Between January 2012 and December 2022, 12 patients with scrotal BCC were diagnosed and treated at our institution. A review was conducted based on the clinical characteristics, pathology slides, and tissues of these patients. Results. The median patient age was 69.26 ± 11.23 years. The skin lesions presented as red papules, blue-grey polypoid nodules, erythematous patches, brownish plaques, and so on. All patients were treated using wide excision, but the margins varied from 0.5 cm to 2 cm. HPV infection was checked in all lesions, with 4 out of 12 testing positive for P16 and 1 for HPV16 DNA. We found mottled positive expression of P16 in the cytoplasm and membrane. One patient developed left inguinal lymph node metastasis and was successfully treated using bilateral inguinal lymphadenectomy. The rest recovered well without relapse. Conclusions. BCC of the scrotum is rare, but long-term surveillance is recommended for BCC patients, and whether genital HPV infection is a noteworthy feature for these patients remains under investigation.

Is an oropharyngeal HPV infection more frequently detectable in women with a genital HPV infection?

If not eliminated by the immune system and persisting over years, oropharyngeal high-risk HPV infection can lead to cancer development in the oropharynx. HPV infection is very commonly found in the genital region and can serve as an HPV reservoir. In this study, we investigate whether women with a genital HPV infection are at a higher risk of harboring an undetected oropharyngeal HPV infection via genital-oropharyngeal transmission. Women presenting for routine gynecological checkups were included in this study. All participants received an HPV brush test from the genital region as well as from the oropharynx. Additionally, probable risk factors for an HPV infection were assessed in a structured questionnaire. 142 women were included in this study. The rate of oropharyngeal HPV infection was low with 2/142 (1,4%) women positive for a low-risk HPV genotype. In the genital brush test, 54/142 (38%) women were tested HPV positive of which 41/142 (29%) were positive for a high-risk HPV genotype. The rate of an oropharyngeal HPV detection in our population was low with 2/142 women harboring a low-risk HPV infection.

Clinical-Epidemiological Characterization of Human anal Papilloma Virus Infection Coloproctology Unit. Central University Hospital Dr. “Antonio Maria Pineda”

AbstractHuman papillomavirus (HPV) infection is one of the most common sexually transmitted viral diseases. A descriptive cross-sectional study was conducted with the purpose of clinically and epidemiologically characterizing anal HPV infection in patients who attended the Benign Orificial Pathology Consultation of the Coloproctological Unit at the Dr. “Antonio María Pineda” Central University Hospital, during the period March 2022 - February 2023, by selecting 288 patients whose average age was 47.09 ± 14.61 years, being the 41-50 years old group (29.17%) and the 51-60 years old group (19.44%) the most affected groups by pathologies of the anal region, with a predominance of male (54.17%). The sociodemographic characteristics with the highest frequency included married (48.61%) and single (47.22%); secondary level of education (44.44%) and traders (18.05%) and housewives (15, 28%) as predominant occupations. The risk factors were represented by onset of sexual intercourse between 16-20 years of age (65.28%), heterosexuality (91.67%), 22.22% reported having anal sex and 5.56% oral sex. Likewise, 5.56% were reported with a history of genital HPV and 4.17% were HIV positive. In addition, 48.61% stated not to use condoms. The initial clinical diagnosis included hemorrhoidal disease (30.55%), anal fistula (25%) and anal fissure (18.05%), and one patient (1.39%) with anal HPV infection. Anal cytology results showed 8.33% flat epithelial cells with cytopathic changes suggestive of HPV infection and 1.39% squamous cells with cytopathic changes suggestive of HPV infection: 50% mild inflammatory negative for malignancy and 33.33% flat epithelial cells without atypia. In conclusion, the anal cytology investigation should continue to determine the actual frequency of anal HPV infection.

Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex.

The oral transmission of HPV and, consequently, the risk of oral cancer has increased in the last years. Oral sex has often been implicated among the risk factors for oral HPV infections, however, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. The present study aimed to evaluate the coexistence of papilloma virus, at the levels of the oral and genital mucosa, in women with a histologically confirmed HPV lesions (and a positive HPV test) at the genital level and a negative HPV control group. We also evaluated how some risk factors, such as smoking, the number of partners, age, and sexual habits can influence the possible presence of the virus itself in the oropharynx of the same women. In total, 117 unvaccinated women aged between 18 and 52 were enrolled. We found that the prevalence of oral HPV infection was high among the women with concomitant genital HPV infection (22%) compared to the HPV-negative women (0%), and the estimated odds ratio was 17.36 (95% CI: 1.02, 297.04). In none of the women with oral HPV did we find any relevant clinical lesions. The potential risk factors for HPV infections in the oropharynx and genitals were analyzed based on questionnaire responses. A multivariate analysis showed that genital HPV infections were significantly associated with a number of sexual partners > 10 (OR 138.60, 95% CI: 6.04-3181.30, p < 0.001), but the data also referred to having between 3-5 or 6-10 partners as being significant, as were a high level of education (OR 6.24, 95% CI: 1.67-4.23.26 p = 0.003), a frequency of sexual intercourse >10 (OR 91.67 95% CI: 3.20-2623.52, p = 0.004), oral sex (OR 6.16, 95% CI: 1.22-31.19, p = 0.014), and >20 cigarettes/day (OR 6.09 95% CI: 1.21-30.61, p = 0.014). Furthermore, being "separate" and having multiple sexually transmitted diseases were also significantly associated with genital HPV infection. In contrast, oral HPV infections were significantly associated with women aged 36 to 50 years (OR 27.38, 95% CI: 4.37-171.37; p = 0.000202) and oral sex (OR 95.5, 95% CI: 5.13-1782.75, p = 0.001126).Additionally, being separate, being cohabitant, lifetime sexual partners of >10, 3-5 lifetime sexual partners, <20 years of age, >10 sexual intercourse per month, occasional and regular anal sex, >20 cigarettes per day, a history of sexually transmitted disease (herpes and multiple), and having a history of genital warts were significant. Screening and early diagnosis are considered to be practically unfeasible for this category of cancer, given the lack of visible lesions; the 9-valent HPV vaccine remains the only means that could help to successfully counter the growing incidence of oral squamous cell carcinoma.

Diversity of Anal HPV and Non-HPV Sexually Transmitted Infections and Concordance with Genital Infections in HIV-Infected and HIV-Uninfected Women in the Tapajós Region, Amazon, Brazil.

The aim of this study was to classify the diversity of anal HPV and non-HPV sexually transmitted infections (STIs) and compare the concordance between anal and genital infections in HIV-infected and uninfected women living in the Tapajós region, Amazon, Brazil. A cross-sectional study was performed with 112 HIV-uninfected and 41 HIV-infected nonindigenous women. Anal and cervical scrapings were collected and analyzed for HPV, Chlamydia trachomatis (CT), Neisseria gonorrheae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), and Human alphaherpesvirus 2 (HSV-2). The Kappa test evaluated the concordance between anal and genital infections. The overall prevalence of anal HPV infection was 31.3% in HIV-uninfected and 97.6% in HIV-infected women. The most frequent anal high-risk HPV (hrHPV) types were HPV18 and HPV16 in HIV-uninfected women and HPV51, HPV59, HPV31, and HPV58 in HIV-infected women. Anal HPV75 Betapapillomavirus was also identified. Anal non-HPV STIs were identified in 13.0% of all participants. The concordance analysis was fair for CT, MG, and HSV-2, almost perfect agreement for NG, moderate for HPV, and variable for the most frequent anal hrHPV types. Thus, a high prevalence of anal HPV infection with moderate and fair concordance between anal and genital HPV and non-HPV STIs was observed in our study.

25-hydroxycholesterol inhibits human papillomavirus infection in cervical epithelial cells by perturbing cytoskeletal remodeling.

Persistent high-risk human papilloma virus (HR-HPV) infection is the main risk factor for cervical cancer, threatening women's health. Despite growing prophylactic vaccination, annual cervical cancer cases are still increasing and show a trend of younger onset age. However, therapeutic approaches towards HPV infection are still limited. 25-hydrocholesterol (25HC) has a wide-spectrum inhibitory effect on a variety of viruses. To explore efficient interventions to restrict HPV infection at an early time, we applied different pseudoviruses (PsV) to evaluate anti-HPV efficacy of 25HC. We tested PsV inhibition by 25HC in cervical epithelial-derived HeLa and C-33A cells, using high-risk (HPV16, HPV18, HPV59), possibly carcinogenic (HPV73), and low-risk (HPV6) HPV PsVs. Then we established murine genital HPV PsV infection models and applied IVIS to evaluate anti-HPV efficacy of 25HC in vivo. Next, with the help of confocal imaging, we targeted 25HC activity at filopodia upon HPV exposure. After that, we used RNA-seq and Western blot analysis to investigate (1) how 25HC disturbs actin cytoskeleton remodeling during HPV infection and (2) how prenylation regulates the cytoskeletal remodeling signaling pathway. Our findings suggest that 25HC perturbs F-actin rearrangement by reducing small GTPase prenylation. In this way, the phenomenon of HPV virion surfing was restricted, leading to failed infection.

Impact of Dietary Quality on Genital Oncogenic Human Papillomavirus Infection in Women.

Most cervical cancers are directly linked to oncogenic or high-risk human papillomavirus (HR-HPV) infection. This study evaluates associations between diet quality and genital HPV infection in women. This study included 10 543 women from the 2003-2016 National Health and Nutrition Examination Survey. The outcome was the genital HPV infection status (HPV-negative, low-risk [LR] HPV, and HR-HPV). Dietary quality was evaluated using the Healthy Eating Index (HEI), in which a higher score indicates a better diet quality. Women who did not consume total fruits (15.8%), whole fruits (27.5%), or green vegetables and beans (43%) had a significantly higher risk of HR-HPV infection than women who complied with the Dietary Guidelines for Americans (HR-HPV odds ratio = 1.76, 1.63, and 1.48 for a HEI score of 0 vs 5, respectively) after adjusting confounding factors. Similar results of these food components on LR-HPV infection were found. In addition, intake of whole grains and dairy was inversely associated with LR-HPV infection. This study showed that women who did not eat fruits, dark-green vegetables, and beans had a higher risk of genital HR-HPV infection. Intake of these food components is suggested for women to prevent HPV carcinogenesis.

MP15-06 REASSESSMENT OF RISK AND VACCINE EFFICACY THROUGH GENOTYPING ANALYSIS OF GENITAL WARTS: ARE GENITAL WARTS TRULY BENIGN?

You have accessJournal of UrologyCME1 Apr 2023MP15-06 REASSESSMENT OF RISK AND VACCINE EFFICACY THROUGH GENOTYPING ANALYSIS OF GENITAL WARTS: ARE GENITAL WARTS TRULY BENIGN? Eun Jae Kim, Jae Chul Lee, Don Hee Lyu, Useok Choi, Kang Sup Kim, Bong Hee Park, Hong Chung, Won Yeol Cho, Chang Hee Han, and Sangrak Bae Eun Jae KimEun Jae Kim More articles by this author , Jae Chul LeeJae Chul Lee More articles by this author , Don Hee LyuDon Hee Lyu More articles by this author , Useok ChoiUseok Choi More articles by this author , Kang Sup KimKang Sup Kim More articles by this author , Bong Hee ParkBong Hee Park More articles by this author , Hong ChungHong Chung More articles by this author , Won Yeol ChoWon Yeol Cho More articles by this author , Chang Hee HanChang Hee Han More articles by this author , and Sangrak BaeSangrak Bae More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003235.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The purpose of this study is to re-evaluate the risk by analyzing the virus that caused genital warts through the genotype analysis of human papillomavirus performed during the treatment of genital warts, and to investigate the possibility of responding to each vaccine type. METHODS: From January, 2020 to June 2021, three urology clinics and hospitals were visited and the results of patients diagnosed with genital warts and HPV genotyping analysis were analyzed. According to the provided results, it was divided into 'high risk' and 'low risk', and if they coexist, it was classified as 'mixed'. Each was analyzed according to the number of lesions and whether or not there was a second recurrence. In addition, it was analyzed whether it was possible to completely cope with each type of vaccine. Analysis was also performed according to the patient's age, site, and recurrence. RESULTS: The analysis results of a total of 692 patients were confirmed. The average age was 33 years, 671 males and 21 females. There were 356 (51.44%) cases in the pure low-risk group, 233 (33.67%) cases in the mixed group, and 103 (14.88%) cases in the pure high-risk group. By major virus, type 6 was the most common with 400 cases (57.8%), and type 11 was identified with 138 (19.94%), 16 with 51 (7.37%), and 52 with 48 (6.94). There were 302 patients who were completely cured by the 4-valent vaccine and 348 patients with 9-valent vaccine, showing an increase in coping ability against additional viruses by 15.2% when changing from 4-valent to 9-valent. Of the 262 recurrence cases, pure low 139 (53.05%), pure high 44 (16.79%), mixed 79 (30.15%), and primary lesion were 430 cases, pure low 217 (50.46%), pure high 59 (12.77%), mixed 154 (33.48%). CONCLUSIONS: Type 6 was the most common type, but in the 20-35 year old group, more than 50% of the genital warts were identified as a mixed. An additional effect of 15.2% can be expected when changing from a quadrivalent to a nine-valent. There was no difference in relapse according to the risk, but in the case of a single lesion, the possibility of the high-risk group was high. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e193 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eun Jae Kim More articles by this author Jae Chul Lee More articles by this author Don Hee Lyu More articles by this author Useok Choi More articles by this author Kang Sup Kim More articles by this author Bong Hee Park More articles by this author Hong Chung More articles by this author Won Yeol Cho More articles by this author Chang Hee Han More articles by this author Sangrak Bae More articles by this author Expand All Advertisement PDF downloadLoading ...

Corelaţii citologice, colposcopice şi histopatologice în diagnosticul neoplaziilor intraepiteliale cervicale

Preinvasive cervical lesions have a long period of evolution towards cervical cancer, therefore their early detection and treatment, along with anti-HPV vaccination, are a necessity in preventing the occurrence of invasive cervical cancer. Genital HPV infection is the most common sexually transmitted infection. The objective of the study was to establish the prediction of the cervicovaginal cyto-tumor examination and the colposcopic examination for cervical dysplastic lesions and the histopathological examination of the fragments obtained by cervical biopsy, as well as the reevaluation of the histopathological diagnosis of certainty of dysplastic lesions, in the context of the increased incidence of cervical cancer in our country. Cervicovaginal cyto-tumor examination and colposcopic examination had a good correlation with the histopathological diagnosis of the biopsied cervical fragment in cases where they were concordant. In case of discordant cytological and colposcopic results, cervical biopsy with histopathological examination establishes the diagnosis of certainty. Since the incidence of cervical cancer is high in our country, the biopsy with histopathological examination is necessary to establish the diagnosis of dysplastic lesions and the subsequent therapeutic behavior.

Genital HPV Prevalence, Follow-Up and Persistence in Males and HPV Concordance Between Heterosexual Couples in Wenzhou, China.

This study aimed to investigate male HPV infection, re-examination rate, clearance rate and relevant influencing factors as well as HPV infection between heterosexual partners in Wenzhou, China. The study enrolled 2359 men who accepted ≥1 HPV detection in the First Affiliated Hospital of Wenzhou Medical University between June 2014 and June 2020. An outpatient follow-up was carried out for collecting HPV re-test results among males who were tested HPV positive. In addition, we collected female sexual partners' HPV infection state through outpatient information system or telephone call. For males who had not re-tested HPV more than half a year after the first HPV positive result, a telephone follow-up would be provided. Male HPV prevalence was 39.39% (928/2359) at baseline, of which the median age was 38.00 years. The percentage of co-infection and HR HPV infection was 35.24% (327/928) and 61.08% (874/1431). Genotype-specific concordance of HPV infection among heterosexual partners was 61.19% (123/201). The most common types were HPV6, HPV52, HPV16, HPV53, HPV11, HPV43 and HPV58. Percentage of males finishing HPV re-examination was low (40.09%). Infection with HR HPV, discomfort or HPV-related diseases and sexual partners with HPV infection were possible motivator for male HPV re-test. The medium time to male HPV clearance was 300.000 (95% CI=274.845-325.155) days. Infection with HR HPV, sexual partners with HPV infection and growth of age might prolong HPV persistence time included. Males are susceptible population for genital HPV infection as well as females. Whereas, males are generally less aware of HPV and its influence on their couples. The study showed that male HPV testing as well as the role of males in the diagnosis and treatment of HPV-associated cervical diseases for females should be popularized and co-treatment of couples was necessary.

Peripheral Blood T-lymphocyte Phenotypes in Mother-Child Pairs Stratified by the Maternal HPV Status: Persistent HPV16 vs. HPV-Negative: A Case-Control Study.

Only few studies exist on the phenotype distribution of peripheral blood lymphocytes concerning persistent oral HPV infection. T-lymphocyte subsets were phenotyped in women who had persistent genital or oral HPV16 infection, using HPV-negative women as a reference group. A subset of 42 mothers and their children (n = 28), were stratified into two groups according to the mothers' HPV status. PBMCs from previously cryopreserved venous samples were immunophenotyped by flow cytometry. Proportions of the CD4+ or CD8+ lymphocytes by their immunophenotype subsets were compared between HPV-positive and -negative mothers and their children. The mean rank distribution of CD8+ memory cells was significantly higher among mothers with persistent genital HPV16 infection. The median levels of both the antigen-presenting CD4+ cells and activated CD8+ cells were significantly lower in mothers with persistent oral HPV16 infection. When oral and genital HPV16-persistors were analyzed as a group, a marker of terminal effector cells was significantly increased as compared to HPV-negative women. Significantly higher levels of activated CD4+, CD8+ and circulating CD8+ memory cells were found among children whose mothers had persistent oral HPV16 infection. Persistent HPV16 infections are associated with changes in peripheral blood T-lymphocyte subsets. The mother's persistent oral HPV16 infection possibly results in immune alterations in her offspring.

Prevalence and Risk Factors of Genital Human Papillomavirus Infections among Women in Lagos, Nigeria.

Regional variations exist in HPV prevalence worldwide despite reports of high prevalence rates among African women. Limited data on genital HPV prevalence necessitated this study with the aim of determining the prevalence of genital HPV and associated risk factors among women in Lagos, Nigeria. Exfoliated cervical cells were collected with consent from 165 women using a cervical brush. Viral DNA was extracted and amplified by nested PCR using two sets of consensus primers (MY09/11 and GP5+/6+). An unconditional logistic regression model was used to identify predictors of HPV positivity. The HPV prevalence was 81.82% in all women and 87.59% in women with normal cytology. The risk of HPV infection was significantly increased among women who had a history of STI (odds ratio (OR) 3.94; 95% confidence interval (CI): 1.51-10.25, p = 0.005) while there was a significantly reduced risk of HPV infection among those who used condoms (odds ratio (OR) 3.94; 95% confidence interval (CI): 0.18-0.91, p = 0.03). The HPV prevalence observed shows an increased transmission of the virus in Lagos, Nigeria. Therefore, there is a need for intense public awareness and the implementation of early detection tests, treatment, and vaccination to prevent an increase in cervical cancer cases in Lagos, Nigeria.

Primary Anal Cancer Screening Results From 381 Women With Human Immunodeficiency Virus.

Women with human immunodeficiency virus (WWH) have an elevated risk for human papillomavirus (HPV)-associated anal cancer. Primary anal cancer screening results from this population could inform practice guidelines. In total, 381 WWH with anal cytology screening, high-risk HPV (hrHPV) testing and genital (cervical or vaginal) cotesting within 6 months were identified during 2012-2019. Those with anal cytology of atypical squamous cells of undetermined significance (ASCUS) or worse underwent high-resolution anoscopy and biopsy. Independent predictors of anal hrHPV, HPV16, and histological anal high-grade squamous intraepithelial lesions (aHSIL) were identified using adjusted logistic regression models. Prevalence of anal hrHPV, HPV16, and ASCUS or worse cytology was 61%, 13%, and 68%. Histological aHSIL was detected in 42% of WWH with ASCUS or worse anal cytology. Prevalence of genital hrHPV, HPV16, and ASCUS or worse cytology was 30%, 4%, and 28%. Genital hrHPV predicted anal hrHPV (odds ratio [OR], 5.05), while genital HPV16 predicted anal HPV16 (OR, 9.52). Genital hrHPV and anal HPV16 predicted histological aHSIL (ORs, 2.78 and 10.9). Anal HPV disease was highly prevalent in this primary screening cohort of WWH. While genital screening results predicted anal disease, rates of isolated anal HPV disease were substantial, supporting universal anal cancer screening for this population.

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

Head and neck cancer, the sixth most common cancer worldwide, account for about 1 out of 20 malignant tumors. In recent years a reduction in the incidence of cervical cancer, but a concomitant major increase in the incidence of HPV-mediated oropharyngeal cancer caused by orogenital HPV transmission has been observed. Consequently, in wealthy countries oropharyngeal squamous-cell carcinomas (OPSCC) is now the most frequent HPV-related cancer, having overtaken cervical cancer. Without effective medical interventions, this incidence trend could continue for decades. As no specific precursor lesion has been consistently identified in the oral cavity and oropharynx, HPV vaccination is the logical intervention to successfully counteract also the rising incidence of OPSCCs. However, HPV vaccine uptake remains suboptimal, particularly in males, the population at higher risk of OPSCC. Alternative primary prevention measures, such as modifications in sexual behaviors, could be implemented based on knowledge of individual genital HPV status. Until recently, this information was not available at a population level, but the current gradual shift from cytology (Pap test) to primary HPV testing for cervical cancer screening is revealing the presence of oncogenic viral genotypes in millions of women. In the past, health authorities and professional organizations have not consistently recommended modifications in sexual behaviors to be adopted when a persistent high-risk HPV cervicovaginal infection was identified. However, given the above changing epidemiologic scenario and the recent availability of an immense amount of novel information on genital HPV infection, it is unclear whether patient counseling should change. The right of future partners to be informed of the risk could also be considered. However, any modification of the provided counseling should be based also on the actual likelihood of a beneficial effect on the incidence of HPV-associated oropharyngeal cancers. The risk is on one side to induce unjustified anxiety and provide ineffective instructions, on the other side to miss the opportunity to limit the spread of oral HPV infections. Thus, major health authorities and international gynecologic scientific societies should issue or update specific recommendations, also with the aim of preventing inconsistent health care professionals’ behaviors.

Consensos em HPV Masculino da Sociedade Portuguesa de Andrologia, Medicina Sexual e Reprodução: Seguimento

Patients with genital HPV lesion, as well as partners, usually present higher psychological stress, than the actual medical consequences of the lesion. Follow-up of these patients should be based on education and counseling. HPV molecular tests are not recommended as a follow-up test, or for screening partners. Development and implementation of protocols, by the centers or units, that follow these patients, are recommended.

Sexual orientation is irrelevant in HPV screening: Infection rates in heterosexual vs. lesbian/bisexual women (135)

Objectives: To evaluate the difference in HPV positive prevalence in heterosexual women compared to lesbian and bisexual women in the United States between 2011 and 2016. Methods: Data on female respondents were obtained from the National Health and Nutrition Examination Survey from 2011 to 2016. Sexual orientation was self-reported by respondents. HPV infection was detected through vaginal swab samples and analyzed using the Roche Linear Array HPV genotyping test. Results: Of 3,656 respondents, 3,461 (94.5%) self-identified as straight/heterosexual and 195 (5.5%) as lesbian or bisexual. A total of 35.7% (n=1,379) of heterosexual women tested positive for any genital HPV compared to 41.6% (n=91) of lesbian or bisexual women (p=0.2). For heterosexual respondents, factors associated with positive HPV status included young age versus old age (40.0% vs 31.6%, p=0.002), more than four lifetime partners (47.1% vs 25.2%, p<0.0001), lower education (41.9% vs 33.2%, p<0.0001), below poverty line and low income versus middle and high income (44.3% and 43.5% vs 33.8% and 28.3%, p<0.0001), and divorced/separated and single versus married/living with partner (57.3% and 48.6% vs 27.8%, p<0.0001). For lesbian or bisexual respondents, the only factor associated with positive HPV was four or more lifetime partners (49.4% vs 29.9%, p=0.02). On multivariate analysis, we found that younger age (OR: 1.52, 95% CI: 1.2-1.93), divorced/separated (OR: 1.71, 95% CI: 1.21-2.43), and more than four lifetime sexual partners (OR: 2.5, 95% CI: 2.04-3.17) were independent predictors for testing positive for genital HPV. There was no difference by self-identified sexual orientation. On intersection analysis, we found that younger women who were divorced/separated and had more than four lifetime sexual partners were at the highest risk, with a prevalence of 72.3% testing positive for any genital HPV and 35.2% for any high-risk HPV. Conclusions: There was no difference in the prevalence of HPV infection based on sexual orientation. Age, marital status, and the number of lifetime sexual partners were independent factors associated with HPV infection. Objectives: To evaluate the difference in HPV positive prevalence in heterosexual women compared to lesbian and bisexual women in the United States between 2011 and 2016. Methods: Data on female respondents were obtained from the National Health and Nutrition Examination Survey from 2011 to 2016. Sexual orientation was self-reported by respondents. HPV infection was detected through vaginal swab samples and analyzed using the Roche Linear Array HPV genotyping test. Results: Of 3,656 respondents, 3,461 (94.5%) self-identified as straight/heterosexual and 195 (5.5%) as lesbian or bisexual. A total of 35.7% (n=1,379) of heterosexual women tested positive for any genital HPV compared to 41.6% (n=91) of lesbian or bisexual women (p=0.2). For heterosexual respondents, factors associated with positive HPV status included young age versus old age (40.0% vs 31.6%, p=0.002), more than four lifetime partners (47.1% vs 25.2%, p<0.0001), lower education (41.9% vs 33.2%, p<0.0001), below poverty line and low income versus middle and high income (44.3% and 43.5% vs 33.8% and 28.3%, p<0.0001), and divorced/separated and single versus married/living with partner (57.3% and 48.6% vs 27.8%, p<0.0001). For lesbian or bisexual respondents, the only factor associated with positive HPV was four or more lifetime partners (49.4% vs 29.9%, p=0.02). On multivariate analysis, we found that younger age (OR: 1.52, 95% CI: 1.2-1.93), divorced/separated (OR: 1.71, 95% CI: 1.21-2.43), and more than four lifetime sexual partners (OR: 2.5, 95% CI: 2.04-3.17) were independent predictors for testing positive for genital HPV. There was no difference by self-identified sexual orientation. On intersection analysis, we found that younger women who were divorced/separated and had more than four lifetime sexual partners were at the highest risk, with a prevalence of 72.3% testing positive for any genital HPV and 35.2% for any high-risk HPV. Conclusions: There was no difference in the prevalence of HPV infection based on sexual orientation. Age, marital status, and the number of lifetime sexual partners were independent factors associated with HPV infection.

Sexual practices and HPV infection in unvaccinated young adults

The present study aimed to evaluate the association of genital and oral HPV infection among different sexual practices in both sexes. In total, 6388 unvaccinated men and women aged 16–25 years from all state capitals of Brazil were enrolled in through primary care services between September 2016 and November 2017. Genital and oral HPV genotyping was performed using the Roche Linear Array. Poisson regression analysis with robust variance was conducted to examine factors associated with overall HPV infection. A higher prevalence of genital HPV was found in women who practiced oral sex (57.85%) and in men who practiced all types of sex (65.87%). However, having more sexual partners and being younger were more important than the type of sex practiced. HPV 6 (7.1%) and 16 (10.5%) were significantly more prevalent in women who practiced oral sex, while HPV 6 (23.96%) and 11 (21.49%) were more prevalent in men who practiced anal sex. The type of sex was not associated with oral HPV prevalence. Genital and oral HPV infection were not associated by different sexual practices in the studied population.