Human Papillomavirus Strains Research Articles

Trends in HPV and HPV Vaccine Awareness among Gay and Bisexual Males in the U.S.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (US). It is often discussed within the context of women’s sexual health due to its association with cervical cancer. However, HPV is also associated with other cancers and conditions which affect men. Gay and bisexual males (GBM) in the US have higher risks of HPV infection and a higher incidence of HPV-associated anal cancer than heterosexual males. In addition, GBM in the US have a higher prevalence of some high-risk strains of HPV than in other regions. HPV vaccination is highly effective at preventing HPV-associated cancers and genital warts. Several resources have been directed towards improving HPV awareness in the US over the past couple of years to improve vaccination rates. Given the low rates of HPV vaccination among GBM in the US, this study aimed to assess the trends in HPV and HPV vaccine awareness using a nationally representative sample of GBM. We found an overall increase in HPV and HPV vaccine awareness between 2017 and 2020. However, the sociodemographic differences in awareness levels highlight the need for more interventions to improve vaccination rates, especially in this high-risk population.

Assessment of Oral Human Papillomavirus Prevalence in Pediatric and Adult Patients within a Multi-Ethnic Clinic Population.

Introduction: Human papillomavirus (HPV) encompasses a large family of oncogenic viruses responsible for increasing rates of both cervical and oral cancer, particularly among minority and low-income populations. Although this represents an increasingly significant public health risk, few studies have screened for oral HPV within Nevada. Based upon this information, the primary objective of this study was to provide a temporal analysis of oral HPV screening among a primarily low-income, minority patient population. Methods: This retrospective analysis was reviewed and approved by the Institutional Review Board (IRB). In brief, unstimulated saliva samples were previously obtained from clinical patient volunteers who provided informed consent and pediatric assent (if applicable). DNA was isolated and screened using spectrophotometry for quality (A260:A280 ratio > 1.70) and quantity (concentration > 100 ng). Validated qPCR primers were used to screen repository samples for high-risk HPV strains HPV16 and HPV18. Results: A total of N = 930 samples were identified for this study, which involved n = 555 samples from adults and n = 375 from pediatric patients treated between 2011 and 2019. A demographic analysis revealed nearly equal distribution between males and females with most derived from non-White (minority) patients. A qPCR screening revealed an overall increase in high-risk HPV of 3.17-fold from 5.7% in 2011 to 18.1% in 2019 and a coefficient of determination or R2 = 0.764, suggesting a strong, positive correlation between more recent sample years and HPV-positive results, which was observed among both pediatric (R2 = 0.671) and adult (R2 = 0.971) patients. In addition, although the average age among adult patients increased over time, a significant decrease was observed among pediatric patients from an average of 16.0 years to 14.81 years. Conclusions: These data suggest temporal changes and positive increases in the prevalence of oral HPV among both the pediatric and adult patient samples taken from this clinic population. These data are important as considerations are made regarding which HPV vaccination education and awareness programs are introduced and the specific populations most likely to benefit from these interventions.

Effects of Religious Practice and Teachings about Sexual Behavior on Intent to Vaccinate against Human Papillomavirus.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Most infections are mild and clear without treatment in 1 to 2 years. Some HPV strains result in persistent infection, which can cause various cancers, including cervical, penile, anal, mouth, and throat cancers. Vaccines have been developed that provide protection against the highest risk HPV strains. Despite HPV vaccines having been proven to be safe and effective, uptake has been low. Religiosity has been negatively correlated with HPV vaccine uptake in some studies. It is hypothesized that religiosity and Christian religious affiliation could impact parents’ decision to vaccinate their children against HPV via teachings and beliefs about sexual behaviors. A survey was distributed to participants to determine what factors, including religiosity and views about sex, impacted HPV vaccination. The survey results (n = 442) were analyzed using confirmatory factor analysis, structural equation modeling, and univariate factor analysis. The association between religious practice and vaccine attitudes were complex, with religious practice slightly positively correlated with pro-vaccine attitudes and vaccine knowledge, but also with the belief that religious adherence to expectations surrounding sexual behavior will protect children from HPV infection, as well as more negative views towards vaccines, in general.

Successful Treatment of Condyloma Acuminata Using Office-Made Topical 60% Betel Leaf Extract

BACKGROUND: Condyloma acuminata (CA), also known as anogenital warts, is a predominantly sexually transmitted disease caused by the Human Papillomavirus (HPV). The most common strains of HPV that causes anogenital warts are Type 6 and 11. This vdisease affects the mucous membrane as well as skin of the external genitalia and perianal areas. There are several therapeutic modalities for CA such as destructive and surgical therapies; however, these therapies can pose side-effects mostly tissue destruction. Alternative modalities such as using betel leaf can be atreatment option for CA. CASE REPORT: In this paper, we report a 31-year-old female with CA who experienced clinical improvement after 3 weeks of office-made 60% topical betel leaf extract therapy, prompting more thorough research on the possible use of herbal treatments for treating CA. CONCLUSION: Office-made betel leaf extract therapy is a promising topical therapy for CA and is relatively simple to prepare. The plant has various mechanisms such as anti-proliferative and cytotoxic properties that can be studied further to prove its efficacy in the treatment of CA to prevent adverse events caused by other conventional destructive treatment modalities.

Cervical cancer, geographical inequalities, prevention and barriers in resource depleted countries.

Cervical cancer (CC) remains a current global issue, with >90% of cervical cancer cases being attributed to human papilloma virus (HPV). The highest burden of cervical cancer is reported in resource-depleted geographical areas with a high incidence of HPV infection. Recent developments in primary prevention include vaccinations against specific strains of HPV and the psychoeducation of the public. Yet, despite the availability of vaccinations, there is high incidence of both HPV and cervical cancer in developing countries, which is attributed to a multitude of barriers including inaccessibility to expensive vaccines. With regards to secondary prevention, progress is actively being made to develop more effective methods of screening and to specifically address the needs of low-income countries. In the past few years, more novel screening methods, such as self-assessment kits, immunohistochemistry and methylation marker analysis, have been developed. Barriers to screening in resource-depleted countries include limited financial resources and infrastructure to develop screening programmes, a lack of screening programmes that are accessible to populations, inadequate training of healthcare teams and stigma related to medical examinations performed as part of screening. Developing primary and secondary prevention programs, as well as addressing the barriers involved in countries with low socioeconomic levels, can drastically reduce morbidity and mortality rates associated with cervical cancer, thus reducing the burden associated with this gynaecological malignancy.

An Update on Human Papilloma Virus Vaccines: History, Types, Protection, and Efficacy.

Human papillomavirus (HPV) is the most common sexually transmitted agent worldwide. Early prevention with HPV vaccination is a safe and effective method against this disease. HPV vaccines provided more protection against several oncogenic HPV strains. Three prophylactic HPV vaccines have been approved to target high-risk HPV types and protect against HPV-related disorders. These existing vaccines are based on the recombinant DNA technology and purified L1 protein that is assembled to form HPV empty shells. The prophylactic vaccines are highly immunogenic and can induce production of specific neutralizing antibodies. However, therapeutic vaccines are different from these prophylactic vaccines. They induced cell-mediated immunity against transformed cells, instead of neutralizing antibodies. The second generation of prophylactic HPV vaccines, made from alternative viral components using cost-effective production strategies, is undergoing clinical evaluation. The purpose of this review is to provide a complete and up-to-date review of the types of HPV vaccines and the efficiency of each of them for readers.

Comparison of Effectiveness and Safety of Immunotherapy of Warts with Intralesional Versus Subcutaneous MMR Vaccine: An Open Label Randomized, Parallel Group, Clinical Trial.

Common wart, also known as verruca vulgaris is characterized by focal proliferation of keratinocytes caused by multiple strains of human papilloma virus (HPV). Conventional treatments like chemical cautery, cryotherapy, electro-cautery, etc often fail to cure verruca satisfactorily. The present work was a randomized, parallel-group, non-inferiority clinical trial with an objective of comparing the effectiveness and safety of subcutaneous MMR versus intralesional MMR vaccine in the treatment of multiple warts.Method:Consenting patients of both sexes of 18-65 years age, who have viral warts and did not receive anti-wart treatment in the last 4 weeks and devoid of any active bacterial or viral skin diseases were included in the study.Interventions:Eligible patients were randomized into either group A (receiving 0.3 ml of intralesional MMR) or group B (receiving 0.5 ml of subcutaneous MMR). A total of three injections were administered at two weeks interval.Outcome Measure:The response was considered complete if there was disappearance of the wart(s) and return of the normal skin markings, partial if the wart(s) was regression in size by 50-99% and no response if there was be 0-49% decrease in wart size.Results:Thirty patients were recruited in each group; 5 of group A and 3 of group B were lost to follow up. Modified intention to treat analysis was performed, so, the last observation of such patients was carried forward and all 60 participants were analysed. Number of warts and size of the largest wart were declined significantly (P < 0.001 and P = 0.001 respectively) in both the treatment arms. No significant difference between two groups were seen. Complete clearance including distant lesions was achieved in 22 patients; 12 (48%) in group A and 10 (37.04%) in group B, but the final outcome at the end of the study showed no significant difference between the two t groups. (P = 0.64).Adverse Events:Only one patient had developed mild fever with tender, enlarged parotid gland after first injection of subcutaneous MMR which resolved within two weeks.Conclusion:Efficacy and safety profile of Subcutaneous and intralesional MMR were almost same. Both can be considered as safe and cost effective treatment of warts while the subcutaneous route may be easier to administer.

Prevalence and Genotyping of Human Papillomavirus among Women in the Departments of Niari and Bouenza, Republic of the Congo

Human papillomaviruses (HPV) are at the origin of many mucosal, benign or malignant skin pathologies. Some so-called high-risk genotypes, especially types 16 and 18, are involved in the genesis of cervical cancer, one of the most common cancers in women. To determine the prevalence of HPV infections and to identify oncogenic genotypes circulating in the departments of Niari and Bouenza. A total of 207 cervical samples collected between 2019 and 2020 were studied. Cervico vaginal smears were performed on all samples for cytological analysis, and HPV DNA detection and genotyping were performed on GeneXpert. The average age of the women who participated in this study was 43.67 ± 12.31 years in Niari and 38.29 ± 10.52 in Bouenza with age intervals ranging from 18 to 80 years. Cytological analysis of these samples reported the following prevalences: Normal diagnosed in 89.58% (186/207) cases, ASCUS in 5.31% (11/207) cases, LSIL in 2.89% (6/207) cases, and ICC in 1.93% (4/207) cases. The prevalence of HPV infection was detected in 83.54% (66/186) of women without lesions, 6.32% (5/11) of ASCUS women and 10.12% (8/10) of women with cytological abnormalities [5.06% (4/6) LSIL, and 5.06% (4/4) ICC]. In total, 79 of the 207 women in our study tested positive for one or more HPV-HR types, or 38.16%. In the department of Niari 37.5% (48/128) women tested positive for HPV, and in the department of Bouenza 39.24% (31/79) tested positive for HPV. Multiple infections ranged from two to more than three strains of HPV. No statistically significant association was observed between socio-demographic characteristics and genotyping (p > 0.05). On the other hand, HPV-HR prevalence varied significantly according to cervical cytology (p = 0.001). The results obtained show the predominance of HPV 16 in women in these two departments of Congo.

HPV prevention in women aged 30-65 in Istanbul: Effect of early diagnosis of cervical cancer.

OBJECTIVEEarlier detection and timely interventions against cancers are well known to reduce the morbidity and mortality. Screening programs provide opportunity to detect cancers as early as precancerous stages. Cancers of cervix of uterus are one of the cancers that have widely applicable screening methods and are one of the three cancer types that have population-based screening program in Turkiye. In this article, it is aimed to evaluate cervical cancer screenings in Istanbul.METHODSThe study methodology for cervical cancer screening conducted between 2015 and 2020 in Istanbul, Turkiye’s largest city, was introduced. The results obtained in the first round of screening of 723,068 women with the human papillomavirus (HPV) method as a new methodology are discussed.RESULTSAs a summary of results, the HPV positivity ratio was found to be 6.5% and the positivity rate was higher in younger women. The results also show that majority of the subjects with positive result were infected with more than 1 strains of HPV. Most prevalent subtypes detected were HPV16, HPV51, HPV31, HPV52, and HPV66, respectively. Total detection rate for any of the high-risk HPV subtypes was 29.95%.CONCLUSIONAlthough HPV-16 is the highest subtype to be infected and total percentage of infection with any high-risk strains is approximating to one-third of the total positivity, cytological results revealed only 8.1% meaningful results.

Isolated Fungating Axillary Lymph Node Metastasis in Anal Canal Carcinoma – A Rare Case Report

Anal canal cancer is the least common malignancy of the gastrointestinal tract. Main risk factors include infection with human papillomavirus strains, immunosuppression, multiple sexual partners, and receptive anal intercourse. We present a rare case of anal canal carcinoma with fungating right axillary lymph node metastasis. A 65-year-old farmer had presented to the surgical department with complaints of bleeding per rectum and ulceration around the anus for 6 months. He also gives a history of fecal incontinence and right axillary swelling. On examination, there was an ulcer around the anus circumferentially with everted edges and indurated base. There were multiple enlarged bilateral inguinal lymph nodes and fungating right axillary lymph node. Magnetic resonance imaging of the pelvis revealed features suggestive of neoplastic etiology of anal canal. Biopsy of ulcer margin and axillary lymph node was suggestive of squamous cell carcinoma. Positron emission tomography/computed tomography (PET/CT) of the whole body revealed no other site metastatic foci. The patient underwent diversion sigmoid colostomy and was started on chemoradiation (Nigro regimen). The patient had very good response to the regimen, and follow-up PET/CT scan showed no active uptake in the tumor foci.

High-risk human papillomavirus enhances theexpression ofCOX-2 VEGF, EGFR, ProEx-C, and TERT proteins in human papillomavirus-related multiphenotypic sinonasal carcinoma through activation ofPI3K/Akt, pRb, and TERT signalling pathways.

Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is anew type ofsinonasal tumour that frequently drops out ofaccurate diagnosis. Human papillomavirus related multiphenotypic sinonasal carcinoma was previously known as HPV-related sinonasal carcinoma with adenoid cystic characteristics, and it is connected to high-risk HPV (HR-HPV) strains whose prognosis is unknown. We aim to evaluate PI3K/Akt, pRb, and htelomerase reverse transcriptase (TERT) signalling pathway activation through theexpression ofproteins cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), ProEx-C, and TERT and their prognostic and clinicopathological value in HMSC patients. Sections ofthe40 paraffin blocks ofHMSC were recovered, and all samples were evaluated for thepresence ofacocktail ofHR-HPV, and theabsence ofMYB, NFIB, and MYBL1 fusions using fluorescence in situ hybridization; thepresence ofmyoepithelial markers; S100, actin; thepresence ofsquamous differentiation markers; calponin, p40, and p63 using PCR-based assays; and COX-2,VEGF, ProEx-C, and TERT using immunohistochemical staining. All patients were monitored for around 54 months, until death, or thelast known surviving data (range 20-60 months). Astatistically significant relationship exists between COX-2 expression was significantly related to theold age group, tumour extent, relapse, mortality, and poor DFS; (p = 0.001), (p = 0.01), (p = 0.002), and (p = 0.035), respectively. While VEGF, ProEx-C, and TERT expression with theold age group, tumour extent, lymph node metastasis, advancedstaging, relapse, mortality, poor disease free survival (DFS), and overall survival (p = 0.001). Human papillomavirus-related multiphenotypic sinonasal carcinoma is aunique sinonasal neoplasm with astrong link to HR-HPV strains. Expression ofCOX-2, VEGF, EGFR, ProEx-C, TERT was linked to poor prognosis, survival, and aggressive malignant behaviours such as proliferation, local recurrence, and lymph node metastasis, making them novel beneficial biomarkers and targeted therapies for HMSC patients.

Abstract P011: B cell subsets that correlate with anti-PD-1 resistance in a preclinical model of HPV+ oropharyngeal cancer

Abstract A subset of head and neck squamous cell carcinomas (HNSCC) is associated with infection with oncogenic strains of human papillomavirus (HPV) and its prevalence continues to rise in the US. Cancer progression has been associated, in part, with an impaired immunity. Because of this, immunotherapies such as immune checkpoint blockade (ICB) have been FDA approved to treat different types of cancers, including HNSCC. The ICB targeting the molecule programmed death cell-1 (PD-1) is used as treatment for HPV-related HNSCC, however, only around 30% of patients respond. Most studies have focused on characterizing T cell responses, however, B cells, are also present in the tumor microenvironment of HPV-positive HNSCC. Interestingly, different B cell subsets with differential functions that may promote or prevent an effective anti-tumor response are present in tumors and tumor-draining lymph nodes. Therefore, fine regulation of anti-tumor and tumor-promoting B cell subsets may be necessary to promote an effective anti-tumor response and therefore prevent tumor progression. However, the B cells that may be associated with responsiveness to anti-PD-1 in HPV+ oropharyngeal cancer remain undefined. By using the preclinical model for HPV+ oropharyngeal cancer (named mEER) we have determined that tongue-implanted tumors are sensitive to anti-PD-1, where around 50% of the mice clear the tumors, whereas flank-implanted tumors are completely resistant to these treatments. By using this in vivo model, we were able to characterize B cell subsets in anti-PD-1 sensitive and anti-PD-1 resistant tumors. First, we compared B cell subsets in untreated mice between tongue (anti-PD-1 sensitive) and flank-implanted (anti-PD-1 resistant) tumors by flow cytometry. Interestingly, flank-implanted tumors contained more PD-1-expressing B cells, which have been identified as an immunosuppressive population in hepatocellular carcinoma. The presence of immunosuppressive B cells on flank tumors was also supported by our finding that flank implanted tumors grew at a slower rate in B cell-deficient mice compared to wild-type mice. When we compared tongue-bearing tumor mice that responded or not responded to anti-PD-1, we observed that mice that did not respond to anti-PD-1 had a higher frequency of antibody-secreting cells in tumor-draining lymph nodes compared to responders. Lastly, when we cultured naïve B cells with tumor cell supernatant from mEER cells, B cells upregulated PD-1 and were able to produce the immunosuppressive cytokine IL-10. Our data suggest that HPV+ oropharyngeal tumors modulate B cell functions and that a differential infiltration of B cell subsets into tumors and tumor-draining lymph nodes correlates with responsiveness to anti-PD-1 therapy in a preclinical model of HPV+ oropharyngeal cancer. These results will aid in our long-term goal to elucidate novel mechanisms for the modulation of anti-tumor responses by B cells and the development of novel B cell-specific therapies for HPV-related cancers and, therefore, improve clinical outcomes in these patients. Citation Format: Pamela A. Merheb, Daniel L. Castañón, Michael Rivera, Jorge Galán, Stephanie M. Dorta-Estremera. B cell subsets that correlate with anti-PD-1 resistance in a preclinical model of HPV+ oropharyngeal cancer [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2021 Oct 5-6. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(1 Suppl):Abstract nr P011.

Characterization of the High-Affinity Fuzzy Complex between the Disordered Domain of the E7 Oncoprotein from High-Risk HPV and the TAZ2 Domain of CBP.

The intrinsically disordered N-terminal region of the E7 protein from high-risk human papillomavirus (HPV) strains is responsible for oncogenic transformation of host cells through its interaction with a number of cellular factors, including the TAZ2 domain of the transcriptional coactivator CREB-binding protein. Using a variety of spectroscopic and biochemical tools, we find that despite its nanomolar affinity, the HPV16 E7 complex with TAZ2 is disordered and highly dynamic. The disordered domain of HPV16 E7 protein does not adopt a single conformation on the surface of TAZ2 but engages promiscuously with its target through multiple interactions involving two conserved motifs, termed CR1 and CR2, that occupy an extensive binding surface on TAZ2. The fuzzy nature of the complex is a reflection of the promiscuous binding repertoire of viral proteins, which must efficiently dysregulate host cell processes by binding to a variety of host factors in the cellular environment.

Mechanism of a new photosensitizer (TBZPy) in the treatment of high-risk human papillomavirus-related diseases

BackgroundHigh-risk human papillomavirus infection is closely related to the development of several diseases, including cervical cancer and condyloma acuminatum. We recently designed a new photosensitizer, 1-triphenylaminebenzo[c][1,2,5]thiadiazole-4-yl)styryl)-1-methylpyridin-1-ium iodide salt (TBZPy), which shows good photodynamic properties. In this study, we explored the mechanism of action of the TBZPy photosensitizer and its potential application in the treatment of high-risk human papillomavirus-related diseases. MethodsHeLa cells (infected by the high-risk human papillomavirus strain HPV18) were treated with TBZPy-photodynamic therapy (PDT). Cell viability, production of reactive oxygen species, apoptosis, and mitochondrial membrane depolarization were evaluated using cell counting kit-8, immunofluorescence, and flow cytometry assays, respectively. Expression levels of the anti-apoptotic proteins Bcl-2 and Bcl-XL; pro-apoptotic proteins Bax, cytochrome C, cleaved caspase 3, and cleaved caspase 9; and the mitochondrial stress protein heat shock protein 60 were examined by western blotting. ResultsTBZPy-PDT inhibited the viability and promoted reactive oxygen species production, lactate dehydrogenase release, and apoptosis of HeLa cells in vitro. TBZPy-PDT also promoted the loss of mitochondrial membrane potential, downregulated the expression of anti-apoptotic proteins, and upregulated the expression of pro-apoptotic proteins. Moreover, TBZPy-PDT downregulated the expression of the human papillomavirus E6 and E7 proteins. ConclusionOur study demonstrates the effectiveness of TBZPy-PDT against human papillomavirus-related diseases. These findings provide a foundation for using this novel photosensitizer to treat diseases associated with high-risk human papillomavirus infection.

Repurposing the Hybrid Capture 2 (HC2) screening test for whole-genome sequencing of human papillomaviruses.

Simple and standardized approaches for genome analysis of human papillomavirus (HPV) by next-generation sequencing are needed. The aim of the study was to develop a protocol for direct deep sequencing of high-risk (hr) HPV strains, based on the widely used commercial Hybrid Capture 2 (QIAGEN) test, without any additional probe design. This protocol was applied to 15 HPV-positive and two HPV-negative cervical samples or cell lines and validated at the genotype level by comparing the sequencing results to those obtained using a commercial genotyping kit. The performance of our protocol, presented in this proof-of-principle study, supports its use for accurate characterization of genetic variants of hrHPV.

Prevalence of high-grade dysplasia in cytology-negative, HPV-positive cervical cancer screening.

This study has two aims: determine the prevalence of CIN3 + in patients with discordant cotesting, defined as negative cytology and positive human papillomavirus (HPV) testing, and identify factors (including HPV strain) associated with CIN3 + , defined as cervical intraepithelial neoplasia (CIN) 3 or cancer within this population. We conducted a retrospective chart review of women age 30-65 with intact cervices who had discordant cotesting results between January 1, 2013 and September 1, 2018, at an academic medical center. We used the t test for continuous variables and the Chi-square test for categorical variables to compare women with and without CIN3 + . To identify factors associated with CIN3 + , we performed univariate and multivariate logistic regression. The primary outcome was the prevalence of CIN3 + based on pathologic diagnosis following biopsy or excisional procedure. Among 375 patients with discordant co-testing, the mean age was 43.8years, 58.4% were parous, and 84.8% were white. Overall, 43/375 (12.0%) had CIN3 + and 7/375 (1.9%) had AIS. On logistic regression, only parity ≥ 1 (p = 0.04, adjusted OR = 2.23, CI = 1.06-4.68) was significantly associated with CIN3 + . HPV-18 was less likely to be associated with CIN3 + (p = 0.02, adjusted OR 0.08, CI 0.01-0.65) but was present in 43% of AIS cases. HPV16 and other HR-HPV strains were highly associated with CIN3 + . Women with discordant cotesting are at significant risk for CIN3 + . We recommend that biopsy be performed at the time of indicated colposcopy for all patients with discordant cotesting to assess for high-grade dysplasia.

Human Papillomavirus and Oral Lesions: What is the Best Diagnostic Method?

Oropharyngeal squamous cell carcinoma is the most common neoplasm of head and neck cancers related to the presence of human papillomavirus (HPV). in the dental, maxillofacial and ENT fields, the finding of mediated HPV lesions is quite common. The diagnostic techniques currently available are different and can be more or less invasive depending on the type of lesion and the need for the clinician. In this study, two clinical cases subjected to a double diagnostic technique were considered in order to exclude any possible risk of false negatives. The polymerase chain reaction (PCR) technique showed a lower sensitivity or in any case dictated by a limited number of HPV strains analyzed. Histological examination nowadays turns out to be the best diagnostic method despite requiring a surgical phase.

Epidemiological Study of Various HPV Strains in Cervical Fluid Samples in South-Eastern Iran, 2018-2020.

Uterine cervical malignancy is one of the commonly detected malignancies related to the human papillomavirus (HPV) and is increasing incidentally in developing countries. Therefore, the use of an efficient diagnostic method is required as an effectual step for cervical cancer prevention and treatment. The purpose of the study was to diagnose various types of HPV in the cervical cytology specimens in the South-East of Iran. This cross-sectional study was performed on 1079 cervical fluid cytology specimens referred for two years, between 2018-2020. Polymerase chain reaction (PCR) and hybridization (INNO-LiPA HPV Genotyping EXTRA II assay) were used to determine HPV DNA and their genotypes, respectively. HPV was positive in 37.7% (407 of 1079) patients with a mean age of 34.62 ± 8.82. Among positive cases, 252 (62%) had only one HPV genotype and 155 (38.05%) had multiplex HPV genotypes, which included 94 (60.7%), 38 (24.6%), 18 (11.6%) and 5 (3.2%) cases with two, three, four and five or more genotypes, respectively. The samples with multiple strains revealed 31 HPV genotypes with the four most prevalent being HPV6 (14.7%), HPV16 (10.9%), HPV53 (9.6%) and HPV51 (5.9%). HPV infection is the main health challenge for women that requires improved health service programs and appropriate epidemic vaccination.

Type Specific Human Papilloma Virus Prevalence and Distribution in Women with Abnormal Cervical Cytology: A Single Centre Retrospective Observational Study in the Emirate of Abu Dhabi

Background: Human papillomavirus (HPV) infection is a major cause of cervical cancer and premalignant dysplasia. The prevalence and distribution of different high-risk HPV genotypes can affect HPV vaccination strategies and the design of cervical cancer prevention programs. Objective: Here, we aimed to determine the prevalence of different HPV genotypes in women with abnormal Cervical cytology in the United Arab Emirates (UAE), evaluate correlations between HPV genotypes and the degree of cervical dysplasia, and observe distributions of HPV genotypes across age groups. Methods: The study included 442 women who underwent HPV genotyping at our institution between January 2018 and September 2019. A retrospective chart review was conducted for all 442 cases, and data were collected from hospital records. Results: The overall HPV positivity rate was 56.1%. The prevalence of high-risk HPV was 48%; 35.4% of patients had multiple high-risk HPV strains, whereas 64.6% had a single high-risk HPV strain. The most common high-risk HPV genotype was HPV-16 (15.2%), followed by HPV-31 (11.7%), HPV-53 (8.9%), HPV-66 (8.6%), and HPV-51 (8.3%). The prevalence of HPV-18 was only 3.8%. The high-risk HPV positivity rate Increased from 39% in women with Atypical Squamous Cells of Undetermined Significance (ASCUS) to 81% in women with Low-grade Squamous Intraepithelial Lesions (LSILs), 81.3% in women with atypical squamous cells cannot rule out High-Frade Lesions, and 80% in women with High-Grade Squamous Intraepithelial Lesions (HSILs). The multiple high-risk HPV strain positivity rate increased from 32.4% in ASCUS to 44.7% in LSIL and 62.5% in HSIL. Increased HPV positivity rates and prevalence of HPV-16 were noted with increasing severity of cervical dysplasia. Decreased HPV positivity was observed with increasing age. Conclusion: Overall, because the prevalence and distribution of different high-risk HPV genotypes affect HPV vaccination strategies, our findings may be useful for the design of cervical cancer prevention programs.

Predictors of human papillomavirus persistence or clearance after 5-aminolevulinic acid-based photodynamic therapy in patients with genital warts

BackgroundNumerous studies have confirmed that 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) is an effective treatment for human papillomavirus-associated diseases. In this study, we evaluated the variables associated with human papillomavirus (HPV) persistence or clearance after ALA-PDT in patients with genital warts. MethodsWe performed a retrospective chart review of all patients with genital warts or subclinical HPV infection who received ALA-PDT treatment between January 2019 and December 2020 at Nanfang Hospital and Dermatology Hospital of Southern Medical University and analyzed the predictors of HPV persistence or clearance. HPV genotype and viral load assays were analyzed before treatment and after each session of photodynamic therapy. ResultsMultiple sexual partners, a history of recurrent HPV infection, and severe pain response during photodynamic therapy were associated with higher odds of viral persistence after three rounds of ALA-PDT. Infection with single strains of HPV, and mucosal and subclinical infection were more likely to be cleared after three rounds of photodynamic therapy. ConclusionOur findings suggest that patients with multiple sexual partners, a history of recurrent infections, and severe pain response during photodynamic therapy should undergo close surveillance and monitoring, and may need additional photodynamic therapy sessions. Infection with a single strain of HPV, and mucosal or subclinical infections are more likely to be cleared after three courses of ALA-PDT treatment. These findings may improve the efficiency of ALA-PDT in clinical practice.