Human Papillomavirus Infection Research Articles

Effect of a multi-ingredient coriolus-versicolor-based vaginal gel in women with HPV-dependent cervical lesions: the PAPILOBS real-life prospective study

Human papillomavirus (HPV) is responsible for virtually all cervical cancers in women. HPV infection and persistency may lead to different-grade squamous intraepithelial lesions that can result in high-grade lesions and cancer. The objective was to prospectively evaluate the results of using a Coriolus-versicolor-based vaginal gel (Papilocare®) on HPV-dependent low-grade cervical lesion repair in a real-life scenario. HPV-positive women _ 25 years with ASCUS/LSIL cervical cytology results and concordant colposcopy images were included, receiving the vaginal gel one cannula/day for 21 days (first month) + one cannula/alternate days (five months). A 6-month second treatment cycle was prescribed when needed. Repair of the cervical low-grade lesions through cytology and colposcopy, HPV clearance, and level of satisfaction, and tolerability were evaluated. In total, 192 and 201 patients accounted for the total and safety analyses, respectively, and 77.1% repaired cervical lesions at 6 or 12 months (76.0% for high-risk HPV). Additionally, 71.6% achieved HPV clearance throughout the study’s duration (70.6% for high-risk HPV). Satisfaction level was rated 7.9 and 7.5 out of 10 at 6 and 12 months, respectively. Only three mild–moderate product-related adverse events were reported, and all of them were resolved by the end of the study. In our study, we observed higher regression rates of low-grade cervical lesions in women treated with Papilocare® vaginal gel than spontaneous regression rates reported in the literature.

Systemic administration of a potent mouse monoclonal antibody provides multisite protection against HPV16 infection

Although preventive vaccines for Human Papillomaviruses (HPV) are available, a definitive cure for the viral infection itself is currently lacking. There is a sizable population that remains inaccessible to HPV vaccination due to reasons such as high costs or lack of availability of the vaccines. Therefore, there remains a significant population susceptible to HPV infection. Persistent multisite infections with high-risk HPV types can cause cancer at several different anatomic sites.Especially HPV16 is a key etiologic factor for cervical, other ano-genital and oropharyngeal cancers. Therefore, it is imperative to develop pharmaceutical interventions for the treatment of viral infections. In this study, a panel of 9 neutralizing antibodies was screened using the hybridoma technique, with 20F6 being identified as the representative antibody. The purified 20F6 exhibited an IC50 of 0.0011 μg/ml against HPV16, demonstrating potent viral inhibitory activity. Moreover, it displayed cross-neutralizing efficacy towards other Alphapapillom 9 subtypes including HPV31, HPV33, HPV52, and HPV58 with respective IC50 values of 2.0 μg/ml, 7.3 μg/ml, 1.7 μg/ml, and 3.0 μg/ml. 20F6 recognizes the linear epitope MSLW, the first four amino-acids located at the very N-terminus of the HPV16 L1 protein. Administration of 20F6, 24 h prior to and following HPV16 pseudo-virion (PSV) challenge, conferred protection against infection in mice at doses as low as 1 mg/kg. Following intraperitoneal administration of 20F6, neutralizing antibodies were consistently detected at both oral and vaginal sites, indicating that prophylactic systemic administration of 20F6 may confer efficient protection against multiple susceptible mucosal sites.

MHealth interventions to improve public knowledge of HPV-associated oropharyngeal cancer in the UK

In the United Kingdom (UK), the current prevalence rates of oropharyngeal cancer linked to human papillomavirus (HPV) are 6.29% and 2.04% in men and women, respectively. Over the years, the burden of this disease has increased in the UK, and this is mainly due to the rising prevalence of HPV infection in the UK. Research evidence has shown that over 70% of oropharyngeal cancers in the UK are linked to HPV. Oral sex is the major route of transmission of HPV, and over 63% of UK young adults are found to have a positive history of oral sex practice. However, only a minority of the UK population are aware of HPV-associated oropharyngeal cancer; this therefore calls for more public health efforts to increase awareness and knowledge on HPV-associated oropharyngeal cancer in the UK. While the use of technology-based, clinic-based, and community-based interventions have been employed to improve public awareness and knowledge on the role of HPV-associated oropharyngeal cancer, mobile health (mhealth) interventions have not been seriously explored despite existing robust evidence on the effective roles of mhealth in improving awareness and knowledge in diverse diseases. This article therefore calls for the adoption and use of mhealth interventions in educating the UK’s population on HPV-associated oropharyngeal cancer. The use of mhealth interventions in this regard is highly viable as its implementation closely aligns with the country’s National Health Service (NHS) commitment towards the digital transformation of the UK’s healthcare system.

Upregulation of Apoptosis Related Genes in Clinically Normal Tongue Contralateral to Squamous Cell Carcinoma of the Oral Tongue, an Effort to Maintain Tissue Homeostasis

PurposeThe field cancerization concept indicates the presence of pre-cancerous changes in clinically normal tissue surrounding the tumor. In squamous cell carcinoma of the oral tongue (SCCOT) which is infrequently linked to human papillomavirus infection, we have previously reported that clinically normal tongue contralateral to tumor (NTCT) is molecularly abnormal. Here, combining our transcriptomic and genomic data, we aimed to investigate the contribution of molecular changes in NTCT to cancer development.MethodsMicroarray gene expression data of 14 healthy controls, 23 NTCT and 29 SCCOT samples were investigated to characterize transcriptional profiles in NTCT. Whole exome sequencing and RNA-sequencing data of paired NTCT and tumor samples from 15 SCCOT patients were used to study correlation between copy number variation and differential gene expression.ResultsUsing supervised multivariate partial least squares discriminant analysis, a total of 61 mRNAs that distinguish NTCT from healthy tongue were selected. Functional enrichment analysis of the 22 upregulated genes showed increased “positive regulation of nitrogen compound metabolic process” in NTCT. All 12 genes involved in this process have roles in apoptosis (anti- and/or pro-apoptotic). Compared to healthy controls, Zinc Finger Protein 395 (ZNF395), a pro-apoptotic tumor suppressor located on chromosome 8p, was the only gene showing increased mRNA level in NTCT whereas decreased in SCCOT. Given the frequent loss of chromosome 8p in SCCOT, the impact of ZNF395 copy number variation on gene expression was further examined, revealing a positive correlation between copy number and mRNA level (correlation coefficient = 0.572, p < 0.001).ConclusionNTCT is susceptible to malignant transformation, where tissue homeostasis is maintained at least partly through regulation of apoptosis. Loss of the pro-apoptotic gene ZNF395 could thus initiate cancer development.

HPV and Lung Cancer: A Systematic Review

This systematic review aims to explore the diagnostic criteria, epidemiology, etiology, and prognosis of Human Papillomavirus (HPV) infection in lung cancer. This PRISMA-guided review searched the PubMed® and EmbaseTM databases for “lung cancer AND HPV” on 10 June 2023, filtering human subject papers. A total of 97 studies encompassing 9098 patients worldwide, revealing varied HPV infection rates in lung cancer, ranging from 0% to 69%, were analyzed. While HPV16/18 was predominant in some regions, its association with lung cancer remained inconclusive due to conflicting findings. Studies from Asia reported lower HPV infection rates compared to Western populations. Some studies suggested a limited role of HPV in lung carcinogenesis, particularly in non-smokers. However, intriguing associations were noted, including HPV’s potential role in lung adenocarcinoma and squamous cell carcinoma. Discrepancies in HPV detection methods and sample sources highlight the need for further research with standardized methodologies to elucidate HPV’s role in lung carcinogenesis and its clinical implications. Overall, this systematic review offers insights into HPV’s role in lung cancer epidemiology and clinical characteristics. Despite inconclusive evidence, intriguing associations between HPV and lung adenocarcinoma and squamous cell carcinoma have emerged. Further research with standardized methodologies and larger cohorts is needed for clarity.

A population-based study on the associations of thyroid cancer with chronic periodontitis.

Emerging concerns link periodontitis to an array of cancers, notably thyroid cancer, though investigations into these associations are still in the nascent stages. This population-based study aimed to investigate the association of thyroid cancer with chronic periodontitis using Taiwan's Longitudinal Health Insurance Database 2010 (LHID2010). This case-control study utilized LHID2010, selecting 2,775 patients diagnosed with thyroid cancer, matched with 8,325 controls based on age, sex, income, and the presence of diabetes, hypertension, hyperlipidemia, human papillomavirus infection, and tobacco use disorder using propensity-score matching. Multivariate logistic regression models were used to evaluate the association of thyroid cancer with chronic periodontitis. A chi-squared analysis demonstrated a significant disparity in the prevalence of chronic periodontitis between those diagnosed with thyroid cancer and the controls, with prevalence rates of 38.5% and 24.1% respectively, and a p-value less than 0.001. The odds ratio (OR) for having prior chronic periodontitis among patients with thyroid cancer compared to controls was 1.991, with a 95% confidence interval (CI) of 1.816-2.184 and a p-value less than 0.001. The association was similar between sexes, yielding adjusted ORs of 1.991 (95% CI=1.816∼2.184) for men and 1.962 (95% CI=1.765-2.182) for women, indicating a statistically significant higher prevalence of chronic periodontitis in both male and female patients diagnosed with thyroid cancer compared to their control counterparts. The findings highlight chronic periodontitis as a potential risk factor for thyroid cancer, underscoring the importance of integrated health surveillance and preventive strategies that encompass oral health. This study aimed to explore the link between thyroid cancer and chronic periodontitis. Using Taiwan's Longitudinal Health Insurance Database 2010 (LHID2010), we selected 2,775 patients with thyroid cancer and matched them with 8,325 individuals without the disease based on age, sex, income, and other health conditions such as diabetes, hypertension, high cholesterol, HPV infection, and smoking habits. The study used statistical models to examine the relationship between thyroid cancer and chronic periodontitis. The findings showed that 38.5% of thyroid cancer patients had chronic periodontitis, compared to 24.1% of the control group. The odds of having chronic periodontitis were nearly twice as high in thyroid cancer patients. This pattern was consistent for both men and women. The study underscores the strong connection between chronic periodontitis and thyroid cancer, emphasizing the importance of raising public awareness about the potential risks of periodontitis.

Prevalence of 14 high-risk human papillomavirus subtypes among volunteers of cervical cancer screening by Papanicolaou smear cytology from a tertiary care institute of Assam, India

Abstract: BACKGROUND: In India, cervical cancer is the second most prevalent cancer among women, constituting 18.3% of all cases. Persistent high-risk human papillomavirus (HPV) infection is a well-established risk factor for cervical cancer. OBJECTIVES: This study aimed to assess the prevalence of 14 high-risk HPV subtypes and their association with abnormal cytology among women in Upper Assam. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted from February 2022 to April 2023 at a tertiary care center in Assam. A total of 100 women aged 23-72 years underwent cervical sample collection for HPV DNA analysis via real-time polymerase chain reaction and cytological examination of Papanicolaou (PAP) smears. RESULTS: The overall HPV prevalence was 13%, with 10% testing positive for HPV 16/18 and 6% for other high-risk subtypes. Coinfection with HPV 16/18 and other subtypes was found in 3% of cases. The mean age of HPV-positive participants was 46 years. Cytology results showed 87% normal, 11% inflammatory changes, and 2% epithelial cell abnormalities. The Chi-square analysis (α = 0.05) showed no significant association between age (P = 0.24), religion (P = 0.49), or education (P = 0.57) and HPV positivity, but the study showed a significant association of HPV infection with menstrual cycle (P = 0.04). The study also showed a significant association between cervical cytology and HPV positivity (P = 0.0087). DISCUSSION: The present study’s findings on the prevalence of all 14 high-risk HPV subtypes contribute new insights to the existing literature, although the slightly lower prevalence may be attributed to the sample size and demographic factors. The findings emphasize the need for regular screening by PAP smear as well as by HPV DNA detection, as cytological abnormalities were detected even in those without HPV infection. CONCLUSION: Along with 16/18 HPV subtypes, a longitudinal study may offer important insights into the development of coinfections and the other 12 subtypes of HPV infection, as well as the spectrum of dysplasia and in situ cervical cancer.

Determination of Women's Belief Levels Regarding Human Papilloma Virus Infection and Vaccine and Hesitations towards Vaccination

Objective: To determine women's belief levels regarding Human Papilloma Virus (HPV) infection and vaccine and their hesitation towards the vaccine. Methods: The study is a cross-sectional research type. The sample of the study consisted of 504 women who met the inclusion criteria. The data was collected between 10.04.2023-10.07.2023 by face-to-face interview method. Introductory Information Form, Health Belief Model Scale for Human Papilloma Virus and its Vaccination, and Scale of Vaccine Hesitancy were used to collect data. Results: The average age of women is 34.82±7.857 and 57.2% do not want to get HPV vaccine for themselves, 56% for their daughters and 79.8% for their sons. None of the women had received HPV vaccination and 83.3% had not received information about HPV infection and vaccination before. Health belief scale model regarding HPV infection and vaccine benefit perception mean score is 7.12±2.330, susceptibility perception mean score is 12.76±2.499, seriousness perception mean score is 4.39±1.374 and obstacle perception mean score is 9.95±2.733. 'Stop. The total score average of the Scale of Vaccine Hesitancy is 32.03±7.598, the lack of confidence score average is 24.92±6.924, and the risks score average is 7.11±1.416. Conclusion: Women's knowledge levels about HPV infection and vaccination are low, their perception of susceptibility to health beliefs regarding HPV infection and vaccination is high, and their perception of benefits, seriousness and obstacles is low. Women's hesitations and lack of confidence in the HPV vaccine are at a moderate level, and the opinion that the vaccine has risks is at a high level.

Entangled Connections: HIV and HPV Interplay in Cervical Cancer-A Comprehensive Review.

Cervical cancer (CC) remains a prevalent malignancy and a significant global public health concern, primarily driven by persistent human papillomavirus (HPV) infections. The infectious nature of HPV underscores the preventability of CC through vaccination and screening programs. In addition to HPV, factors such as age, parity, smoking, hormonal contraceptives, and HIV co-infection elevate the risk of CC. HIV-associated immunodeficiency exacerbates susceptibility to infections and cancers, making CC a defining condition for acquired immune deficiency syndrome (AIDS) and one of the most commonly diagnosed cancers among women living with HIV (WLWH). These women face higher risks of HPV exposure due to sexual behavior and often encounter economic, social, and psychological barriers to screening. HIV and HPV co-infection can potentially accelerate CC carcinogenesis, with WLWH typically being diagnosed with CC earlier than their HIV-negative counterparts. Antiretroviral therapy (ART), which reduces AIDS-related mortality, also lowers the risk of invasive CC. The interaction between HIV and HPV is intricate and bidirectional. This summary reviews current evidence on HPV infection and CC in WLWH, highlighting the connections across pathogenesis, prevention, diagnosis, and treatment.

Clinical and immunological characteristics of post-covid patients with infectious immunopathology syndrome

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has caused global morbidity and high mortality worldwide. Today it is known that, despite recovery from COVID-19, confirmed by both laboratory and instrumental diagnostic methods, many patients, regardless of the severity of the disease, suffer from a significant deterioration in health and increased exacerbations of chronic diseases. During examinations by attending physicians, they note fatigue, an increase in cases of acute respiratory viral infections per year, an increase in relapses of skin diseases such as furunculosis, pyoderma, exacerbation of pulmonary pathologies, pathologies of the urinary tract of inflammatory origin, as well as chronic infectious diseases such as herpesvirus and human papillomavirus infections, which occur for the first time or are characterized by frequent relapses no less than six months after recovery from acute COVID-19. Such persistent post-infectious consequences are known as post-COVID syndrome. SARS-CoV-2 infection is accompanied by damage to both the acquired and innate immune systems. In previous work, we determined the role of B cells, cytotoxic T lymphocytes, natural killer cells and the regulatory properties of CD46, as well as its involvement in the processes of viral entry into the cell. In this study, we studied the relationship of immune disorders of these factors of innate and acquired immunity with the clinical manifestations of post-COVID infectious syndrome in this category of patients and the severity of lung damage in these patients during the acute period of COVID-19. The results of the study showed that in some patients more than six months after suffering from COVID-19, the following was revealed: in patients who had a coronavirus infection without lung damage, no violations of the innate and acquired parts of the immune system were detected. In addition, significant differences were identified between clinical manifestations of diseases with increasing cases of relapses or newly identified after clinical recovery from an acute COVID-19 infection, depending on the phenotype of immune status disorders.

Stratified Mucin-producing Lesions of the Anus

Primary anal cancers are rare and typically driven by high-risk human papillomavirus (HPV) infection. Though squamous cell carcinoma is most common, a spectrum of HPV-related nonsquamous anogenital neoplasms with similarities to cervical stratified mucin-producing carcinoma has been reported. In this study, we mined our institutional archives to characterize the clinicopathologic features of this emerging entity. Six cases were identified from the files at 2 institutions, including 4 cases of invasive stratified mucin-producing carcinoma and 2 stratified mucin-producing intraepithelial lesions (SMILE). Four patients were women, and the mean age was 70 years. Patients presented with rectal/anal mass or polyp, rectal bleeding or pain, weight loss, or at the time of screening colonoscopy. Tumors displayed histologic features as described in the gynecologic tract. Cases of invasive stratified mucinous carcinoma showed infiltrative tumor nests with variable intracytoplasmic mucin, peripheral palisading, prominent apoptosis, and neutrophilic infiltrate. One invasive stratified mucinous carcinoma associated with high grade glandular dysplasia, whereas 1 SMILE was next to conventional low-grade squamous intraepithelial lesion. All lesions stained with p16 showed block-like p16 expression. HPV in situ hybridization was performed in 5 cases, 4 of which were positive; one was interpreted as equivocal. Follow-up information, available in 4 patients, revealed 1 local recurrence followed by death due to unrelated causes in a patient with invasive stratified mucin-producing carcinoma. We report the first series of HPV-associated primary anal stratified mucin-producing neoplasms analogous to those seen in the gynecologic tract, further broadening the spectrum of HPV-related anal neoplasia.

Natural small molecule compounds targeting Wnt signaling pathway inhibit HPV infection

BackgroundHigh-risk human papillomavirus (HPV) infection is a major risk factor of HPV-related tumors, especially cervical cancer. To date, there is no specific drug for the treatment of HPV infection. PurposeTo explore the role of canonical Wnt signaling pathway in HPV16 infection and to screen inhibitors against HPV16 infection from natural small molecule compounds targeting the canonicalWnt pathway. MethodsWnt pathway inhibitor IWP-2 and FH535 were used to inhibit Wnt/β-catenin signaling pathway. HPV16-GFP pseudovirus infectivity were analyzed by fluorescence microscopy and fluorescence activated cell sorting. A small molecule screening of a total of CFDA-approved 29 natural compounds targeting the Wnt pathway was performed. ResultsWnt signaling pathway inhibitor suppressed HPV16-GFP pseudovirus infection in HaCat cells. Natural small molecule compounds screening identified 6-Gingerol, gossypol, tanshinone II2A, and EGCG as inhibitors of HPV16-GFP pseudovirus infection. ConclusionWnt signaling pathway is involved in the process of HPV infection of host cells. 6-Gingerol, gossypol, tanshinone II2A, and EGCG inhibited HPV16-GFP pseudovirus infection and suppressed Wnt/β-catenin pathway in HaCat cells.

Abstract C082: Descriptive study of the vaginal microbiome in Hispanic populations in Houston and Puerto Rico with high-risk normal and cervical dysplasia

Abstract Objective Cervical cancer is a leading cause of cancer-related deaths in women worldwide, leading to over 340,000 deaths in 2022. The majority of cervical cancers are caused by the persistent infection of high-risk human papillomavirus (HPV). In the United States, Hispanic women are at increased risk of cervical cancer development and are more likely to die of the disease in certain geographical locations. Furthermore, prior research implicated an association between the vaginal microbiota and the risk of HPV infection and cervical dysplasia. This descriptive study aims to explore the vaginal microbiome profiles of Hispanic or Latino women at risk for HPV-induced cervical dysplasia or with cervical dysplasia residing in Houston and in Puerto Rico. MethodsCervical swab samples were collected from Hispanic patients in Houston IRB 2019-1059 (N = 93) and Puerto Rico IRB 1050411 (N = 118) during routine clinical visits on a prospective collection protocol. Swabs were acquired at the patient’s initial visit and subjected to 16S V4 rRNA gene sequencing for microbiome profiling. Through HPV genotyping via PCR, patients were categorized into three groups: having HPV 16, other high-risk HPV types (18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), and “other”, comprised of low-risk HPV types, HPV negative, or unknown HPV status. Alpha and beta diversity were assessed using QIIME2. Microbiome composition was evaluated across different locations, HPV status, and disease status, followed by exploring alpha diversity between locations and disease status. The taxa species classification was performed using a custom classifier trained via a cervicovaginal-specific database. Samples were assigned to vaginal community state types (CSTs) using VALENCIA. Results Within the study cohort, 72% (N = 152) were classified as high-risk normal, and 28% (N = 59) had cervical dysplasia. HPV 16 was detected in 12% (N = 26), other high-risk HPV types in 33% (N = 70), while 55% (N = 115) of patients were classified as “other”. At the species level, the vaginal microbiota is dominated by Lactobacillus crispatus, Lactobacillus iners, and Trichomonas vaginalis as the top three abundant, regardless of the patient’s location, HPV status, and disease status. Alpha diversity between locations was 2.2 (1.4) for Houston and 1.6 (1.3) for Puerto Rico, as demonstrated by the Shannon Diversity Index. Alpha diversity was also observed between disease status, with a mean Shannon Diversity Index of 1.9 (1.4) for high-risk normal and 1.9 (1.1) for cervical dysplasia. The top three vaginal community state types were IV-B (32%), I (27%), and III (23%) for Houston, while the top three for Puerto Rico were III (34%), IV-B (31%), and I (21%). Conclusion The study examines the vaginal microbiome profiles of Hispanic women in Houston and Puerto Rico who are at risk for HPV-induced cervical dysplasia or already have cervical dysplasia. These findings provide insights into the vaginal microbiome composition, which plays a crucial role in cervical cancer development. Citation Format: D'Shaunique Walters, Molly El Alam, Timothy Harris, Tatiana Cisneros, Nadim Ajami, Jagannadha Sastry, Josefina Romaguera, Filipa Godoy-Vitorino, Stephanie Dorta-Estremera, Ann Klopp, Lauren Colbert. Descriptive study of the vaginal microbiome in Hispanic populations in Houston and Puerto Rico with high-risk normal and cervical dysplasia [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C082.

Fibroblasts Regulate the Transformation Potential of Human Papillomavirus-positive Keratinocytes.

Persistent human papillomavirus (HPV) infection is necessary but insufficient for viral oncogenesis. Additional contributing co-factors, such as immune evasion and viral integration have been implicated in HPV-induced cancer progression. It is widely accepted that HPV+ keratinocytes require co-culture with fibroblasts to maintain viral episome expression, yet the exact mechanisms for this have yet to be elucidated. Here we present comprehensive RNA sequencing and proteomic analysis demonstrating that fibroblasts not only support the viral life cycle, but reduce HPV+ keratinocyte transformation. Our co-culture models offer novel insights into HPV-related transformation mechanisms.

Abstract B078: Tailoring human papillomavirus (HPV) vaccine outreach for rural and Hispanic communities in Washington state: A modified Boot Camp Translation approach

Abstract Introductory sentences indicating the purposes of the study: Using a modified version of Boot Camp Translation (BCT), a validated community participatory approach, we co-created locally relevant and culturally appropriate human papillomavirus (HPV) vaccination materials and messages for parents and caregivers of HPV vaccine-eligible children in Washington state. Brief description of pertinent experimental procedures: The HPV vaccine, recommended for children starting at age 9, reduces the risk of HPV infection and HPV-related cancers. However, HPV vaccine rates are significantly lower in rural regions compared to urban areas. In partnership with Kaiser Permanente Center for Health Research, the Huntsman Cancer Institute, and Sea Mar Community Health Centers, a large federally qualified health center in Washington state, we used a modified BCT approach to elicit input from parents and caregivers of HPV-vaccine eligible children to develop materials and messages that motivate parents to vaccinate their children. Eligible participants were parents or caregivers of children between the ages of 9-15 who had at least one vaccination, spoke English or Spanish, and were able to participate in the entire BCT process. Two BCT sessions were conducted (one in English and one in Spanish), both consisting of three meetings over a four-month period. The sessions included a five-hour in-person meeting in Aberdeen, Washington (English) and Bellingham, Washington (Spanish), and two one-hour follow-up virtual calls for each language. The in-person meetings included HPV vaccine education by Sea Mar providers and an expert in HPV research, discussions on HPV knowledge, perceptions, and barriers to vaccination, and small group discussions to generate HPV messages and materials. The follow-up calls gathered feedback on drafted materials and messages. Summary of the new unpublished data: Eight parents or caregivers participated in the English session and nine participated in the Spanish session. Key themes identified to incorporate in messages and materials included: stressing the benefits of vaccination, highlighting research on the vaccine’s safety and efficacy, including statistics and images of both girls and boys, reporting local statistics, spelling out HPV in materials, and emphasizing the words “prevent” and “protection” from cancers/infections later in a child’s life. The preferred materials and dissemination methods included: fact sheets and brochures (available in the clinic, mailed home, or in school nurses’ offices), posters (displayed in the clinic lobby and exam rooms), and animated videos (played on the clinic lobby TV and texted to parents’ phones). Participants also requested live phone calls from Sea Mar to discuss the importance of the vaccine and assist with vaccine scheduling. Final materials will be showcased.Statement of conclusions: We used a modified BCT approach to incorporate participant feedback to develop HPV vaccine messages and materials and identified preferred dissemination channels for rural communities in Washington state. Citation Format: Priyanka Gautom, Jamie H. Thompson, Jennifer S. Rivelli, Ludy Villegas, Anna C. Edelmann, Katherine Vaughn, Becca Slagle, Stephen Gubler, Kaila Christini, Amanda F. Petrik, Gloria D. Coronado, Deanna Kepka. Tailoring human papillomavirus (HPV) vaccine outreach for rural and Hispanic communities in Washington state: A modified Boot Camp Translation approach [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B078.

Abstract A112: The seroprevalence of nine human papillomavirus types included in the nonavalent vaccine in unvaccinated women living in Puerto Rico

Abstract Introduction Human papillomavirus (HPV) surveillance is lacking in Puerto Rico (PR). We aim to estimate the seroprevalence of the HPV types included in the nonavalent vaccine (9vHPV) in women and explore associations. Methodology A population-based cross-sectional study of socio-demographic, clinical [including, sexually transmitted infections (STIs)], and behavioral characteristics of sexually active women (16-64 years) was conducted in PR from 2010-2013. Blood samples from 524/566 (92.6%) HPV unvaccinated women were included in this sub- analysis. Antibody responses to 9vHPV types (HPV-6/11/16/18/31/33/45/52/58) were analyzed using M9ELISA by the U.S. Centers for Disease Control and Prevention (CDC). A self-collected cervical and anal sample from all 524 women were also tested using L1 consensus primer (MY09/MY11) PCR followed by dot hybridization to detect 40 HPV types. Statistical analyses included Pearson’s chi-square and logistic regression models. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were reported. Results The mean age of participants was 42.4 years ± 0.6 standard deviations (SD), 52.5% were married/cohabited, and 9.7% were uninsured. About half (51.3%) had between 3-9 lifetime sexual partners, 15.9% had history of STIs, and 40.3% had a current anogenital HPV infection. Overall, 65.8% were seropositive to at least one of the 9vHPV types (1.0% to all 9vHPV types), 59.9% to any of the seven oncogenic types (HPV-16/18/31/33/45/52/58) and 49.1% to any of the quadrivalent vaccine (4vHPV) types. The seroprevalence for specific HPV types ranged between 10.7%-28.1% [HPV-33 (10.7%), 11 (11.6%), 45 (11.8%), 58 (15.8%), 18 (18.7%), 31 (25.0%), 6 (26.2%), 52 (26.9%), and 16 (28.1%)]. In bivariate analysis, significant associations between 9vHPV types were observed with marital status, age at sexual debut, lifetime sexual partners, anal sex, history of STIs and anogenital HPV infection (p&amp;lt;0.05). In the multivariate model, divorced/separated/widowed women (aOR: 2.2, 95%CI: 1.2-4.3) had higher odds of seropositivity to any of the 9vHPV types than single women. Women with 3-9 (aOR: 2.4, 95%CI, 1.5-3.8) and with &amp;gt;10 (aOR: 3.1, 95%CI, 1.6-5.8) lifetime sexual partners had higher odds of seropositivity than women with 1-2 partners. Women with a history of STIs (aOR: 2.1, 95%CI, 1.1-4.0) and with an anogenital HPV infection (aOR: 1.9, 95%CI, 1.2-2.9) had higher odds of HPV seropositivity than their counterparts. In this model, no differences were observed by age, education, healthcare coverage, age at sexual debut or anal sex. Conclusion Before implementation of the HPV nonavalent vaccine, the seroprevalence of at least one of the 9vHPV types among women in PR was high (65.8%). However, less than 1% of women were seropositive for all nine HPV types, indicating this population would benefit from HPV vaccine implementation. Acknowledgements Study funded by the National Institute of Allergy and Infectious Diseases Grant (Grant #1SC2AI090922-01) of the National Institutes of Health. Citation Format: Angeline Cruz, Jeslie M. Ramos-Cartagena, Gitika Panicker, Elizabeth Unger, Ana P Ortiz. The seroprevalence of nine human papillomavirus types included in the nonavalent vaccine in unvaccinated women living in Puerto Rico [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A112.

Abstract A163: Factors associated with human papillomavirus vaccination uptake among a clinic-based sample in Puerto Rico

Abstract BACKGROUND: Human papillomavirus (HPV) vaccine can protect against several cancers such as anal, cervical, vulvar, vagina, penis, and oropharyngeal. HPV vaccination is recommended for individuals, regardless of sex-at-birth, aged 9 through 26 years old. In addition, patient-physician clinical decision-making is recommended for individuals up to the age of 45. HPV vaccination can protect against the most common HPV genotypes that cause cancer and is the only preventive strategy for HPV infection. Therefore, this study aims to assess factors associated with HPV vaccination uptake among patients from the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (ANC-UPRCCC). Methods: Data from baseline visit of individuals aged ≥18 years of age who received services at the ANC- UPRCCC were used for this analysis (N=1,170). During this visit, all patients completed a questionnaire given by the clinic physicians, which collects information on sociodemographic, clinical, and lifestyle characteristics. HPV vaccination uptake was defined as having ≥1doses. Pearson chi-square and generalized regression models were used to evaluate factors associated with HPV vaccination uptake. Results: Most participants were men (66.9%), aged ≥46 years old (50.7%), and people living with human immunodeficiency virus (PLWH) (72.0%). Although HPV vaccine uptake was 15.7%, only 8% of participants reported vaccine completion (3 doses). Higher uptake was seen among younger people, men who have sex with men, people with a history of sexually transmitted infections (STIs), people without HIV, and people with anal pap uptake history (p&amp;lt;0.05). Given that a statistically significant interaction with age was observed, logistic regression models were stratified by age. On multivariable analysis, we observed higher odds of HPV vaccine uptake among persons with a history of STIs aged 27-45 (OR27-45:1.12, 95% CI: 1.01, 1.26) and ≥46 years (OR≥46:1.06, 95% CI: 1.01,1.11) in comparison to those without a history of STIs. Higher HPV vaccine uptake was also observed among people aged ≥46 with anal pap uptake history (OR≥46:1.09, 95% CI:1.01-1.19) in comparison to their counterparts. PLWH had lower odds of HPV vaccine uptake than people without HIV across all age groups (OR18-26:0.73, 95% CI:0.57-0.93; OR27-45:0.77, 95% CI:0.71-0.83; OR≥46:0.93, 95% CI:0.89-0.98). Conclusions: Despite their increased high-risk for HPV-related cancers, our results showed lower HPV vaccination uptake for PLWH across all age groups. This is concerning and highlights the importance of including educational materials about the HPV vaccine during consultation with healthcare providers, especially among individuals at high-risk for HPV-related cancers, such as PLWH. Citation Format: Jeslie M. Ramos-Cartagena, Maribel Tirado, Miriam Matos, Keimari Méndez, José Torres-Russe, Gabriela Pisiellos-Echevarria, Cristina Muñoz, Karen Del Valle, Humberto M. Guiot, Ana Patricia Ortiz. Factors associated with human papillomavirus vaccination uptake among a clinic-based sample in Puerto Rico [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A163.

Interaction of High- and Low-Risk Human Papillomavirus Genotypes is Associated with a Reduced Risk of Developing Cervical Cancer.

Cervical cancer is among the most common types of cancer in women and is associated with human papillomavirus (HPV) infection. The association between cervical cancer and high-risk HPV infection has been well documented. However, the effect of simultaneous infection with high- and low-risk HPV or low-risk HPV alone on the risk of developing cervical malignancy remains unanswered in guidelines. We investigated the association of high and low-risk HPVs (HR or LR) genotypes with cervical carcinoma risk and pathological and cytological information in cases recruited from a population-based cohort study of 790 patients. Correlation matrix and t-test were used for analysis. The percentage of HR+LR and HR-HPV16/18 were 9.30% and 11.20% in class II, 7.15% and 7.10% in class IV, and 7.15% and 5.80% in As-CUS smears. Interestingly, concurrent infection with HR-HPV and LR-HPV types led to a significant reduction in the risk of developing malignancy compared to the high-risk group (OR=0.3 (0.098-0.925), pvalue=0.04). The percentage of individuals with cervical malignancy was 10.2% and 28.2% within the co-infected and the HR-HPV participants. Our findings suggest that simultaneous infection with high- and low-risk HPV may reduce the risk of cervical malignancy.

An investigation into the human papilloma virus (HPV) vaccination among undergraduate medical students (A prospective cross-sectional KAP survey)

Introduction: The most common sexually transmitted infection worldwide is the human papillomavirus (HPV) infection. It is believed that over 80% of sexually active women have contracted the virus at some point in their lives. About 11 million women in Saudi Arabia who are aged 15 to 44 years are at risk of having HPV-related cervical cancer. Aim: To assess the awareness and knowledge of undergraduate medical students (males and females) about the human papilloma virus (HPV) vaccination and to pinpoint the major factors influencing their attitudes towards it. Subjects and methods: A prospective, cross-sectional online survey included 411 undergraduate medical students (males and females) across different grades during three months, from January 1st to March 31st, 2024, at the Batterjee Medical College, Jeddah City, Saudi Arabia. We statistically analyzed the collected data using Microsoft Office®, Excel® 2016, and IBM's Statistical Package for Social Studies (SPSS®) version 26.0. IBM is located in Chicago, Illinois, USA. Results: The majority of participating students were of young age, 20–25 years old (233, 56.69%), female (393, 95.62%), and of Saudi nationality (260, 63.26%). The most common recruited students were from the preparatory year (124, 30.17%), while the fewest were from the M6 grade (6, 1.46%). We implemented "Kamel's scoring system for students' awareness", which yielded the following scores: not acceptable (124, 30.17%), fairly acceptable (101, 24.57%), moderately acceptable (95, 23.11%), acceptable (71, 17.27%), and highly acceptable (20, 4.87%). Next, we implemented "Kamel's scoring system for students' knowledge", which yielded the following scores: very low (130, 31.63%), low (110, 26.76%), moderate (90, 21.90%), high (50, 12.17%), and very high (31, 7.54%). We implemented "Kamel's scoring system for students' attitude" to assess the students' attitude towards HPV vaccine utilization. We interpreted the calculated scores as inadequate or poor (136, 33.09%), reasonable or fair (100, 24.33%), sufficient or good (80, 19.46%), remarkable or very good (70, 17.03%), and outstanding or excellent (25, 6.08%). results were of statistical significance (the P-value is &lt;0.00001). Conclusion: The estimated degree of awareness and knowledge about the HPV vaccination among undergraduate medical students at the Batterjee Medical College (BMC) was poor. This results in low motivation and utilization of the available vaccine.

Anal carcinoma - exploring the epidemiology, risk factors, pathophysiology, diagnosis, and treatment.

Anal carcinoma is a relatively rare tumor that accounts for approximately 2% of gastrointestinal malignancies and less than 7% of anorectal cancers. Most anal tumors originate between the anorectal junction and the anal verge. Risk factors for the disease include human papillomavirus infection, human immunodeficiency virus, tobacco use, immunosuppression, female sex, and older age. The pathogenesis of anal carcinoma is believed to be linked to human papillomavirus-related inflammation, leading to dysplasia and progression to cancer. Squamous cell carcinoma is the most common type of anal tumor, with an annual incidence of approximately 1 to 2 per 100000 persons. Treatment regarding anal cancer has emerged over time. However, chemoradiation therapy remains the mainstay approach for early localized disease. Patients with metastatic disease are treated with systemic therapy, and salvage surgery is reserved for disease recurrence following chemoradiation. This article aims to provide background information on the epidemiology, risk factors, pathology, diagnosis, and current trends in the management of anal cancer. Future directions are briefly discussed.