Incidence Of Human Papillomavirus Infection Research Articles

Healthy lifestyle and HPV infection risk: results from a cross-sectional study.

Human Papillomavirus (HPV) infection constitutes a significant global public health challenge despite the widespread implementation of vaccination programs, with infection rates persistently high. Recent studies suggest that lifestyle factors including diet quality (DQ) and physical activity (PA) could play a pivotal role in the mitigation of HPV infections. This investigation explored the influence of DQ, PA, and a healthy lifestyle on the incidence of HPV infection in adult women. Data from 5,308 women aged 20-59 from the National Health and Nutrition Examination Survey (NHANES) 2007-2016. DQ and PA were measured using the Healthy Eating Index (HEI-2015) and the Global Physical Activity Questionnaire (GPAQ), respectively, creating four lifestyle groups based on how well they matched dietary and activity guidelines. The associations between key factors and HPV infection were explored using multivariate logistic regression, trend tests, and interaction tests. Fully adjusted multivariable logistic regression models revealed an inverse association between the risk of HPV infection and higher levels of PA (OR = 0.914; 95% CI: 0.854-0.979) as well as DQ (OR = 0.993; 95% CI: 0.989-0.998). Individuals in the highest tertile of DQ displayed a reduced risk of HPV infection relative to those in the lowest tertile (OR = 0.846; 95% CI: 0.726-0.986). Belonging to the third quintile of PA was linked to a lower risk of HPV infection than the lowest quintile (OR = 0.823; 95% CI: 0.681-0.995). Subgroups adhering to a healthy DQ were linked to a lower risk of HPV infection irrespective of PA meeting guideline recommendations. Our findings underscore the importance of a healthy diet in conjunction with appropriate PA in preventing HPV infection, offering new insights for public health policies and interventions.

Cost-Effectiveness of 9-Valent HPV Vaccination for Patients Treated for High-Grade Cervical Intraepithelial Neoplasia in the UK

Patients who have been treated for high-grade cervical intraepithelial neoplasia (CIN grade ≥2) are at a high risk for subsequent CIN and other cancers and diseases related to human papillomavirus (HPV). HPV vaccination can reduce the risk of subsequent disease in patients surgically treated for grade 2 or greater CIN; however, there is no formal recommendation for prophylactic HPV vaccination in this high-risk population, and the cost-effectiveness is unknown. To assess the incremental lifetime outcomes, costs, and cost-effectiveness of integrating peritreatment 9-valent HPV (9vHPV) vaccination in combination with posttreatment surveillance for the prevention of cervical cancer and other HPV-attributable diseases in patients surgically treated for grade 2 or greater CIN vs posttreatment surveillance alone from a UK payer perspective. This economic evaluation used 3 independent Markov model structures. Model inputs for vaccine efficacy, utilities, and costs were obtained from published sources, and cervical cancer screening data were obtained from the National Health Service Cervical Screening Program. Costs were adjusted to 2022 to 2023 reference years. Data were analyzed from October 2022 to September 2023. Peritreatment vaccination with 9vHPV in combination with posttreatment surveillance compared with posttreatment surveillance alone. Clinical outcomes included grade 1, 2, or 3 CIN; cervical cancer; vaginal cancer; vulvar cancer; anal cancer; head and neck cancer; genital warts; and recurrent respiratory papillomatosis. Incremental cost-effectiveness ratios (ICERs) using a willingness-to-pay threshold (WTP) of £20 000 (US $26 200) per quality-adjusted life-year (QALY) were estimated. Deterministic sensitivity analysis and probabilistic sensitivity analysis were performed. Vaccination with 9vHPV in conjunction with posttreatment surveillance was cost-effective, with a favorable ICER of £13 789.07 (US $18 064.68) per QALY gained (ie, below the WTP of £20 000 per QALY) vs posttreatment surveillance alone. The resulting ICER was £52 358.01 (US $68 588.99) per HPV-related cancer averted and £64 090 (US $83 958.18) per HPV-related cancer death averted. The ICER was most sensitive to discount rate, incidence of HPV infection, vaccine price, and age at initial treatment for grade 2 or greater CIN. Results of the probabilistic sensitivity analysis showed peritreatment 9vHPV vaccination was cost-effective at the WTP recommended by the UK's Joint Committee on Vaccination and Immunisation (90% of iterations <£30 000 [US $39 300] per QALY) in 100% of iterations. These findings suggest that peritreatment prophylactic 9vHPV vaccination is a cost-effective option for preventing subsequent HPV-attributable diseases in patients surgically treated for grade 2 or greater CIN.

The Human Papillomavirus Enigma: A Narrative Review of Global Variations in Oropharyngeal Cancer Epidemiology and Prognosis.

Oropharyngeal cancers (OPCs) in Asia account for 42% of the global burden and over 50% of related deaths. Human papillomavirus (HPV) is involved in over 70% of OPC cases in the Western hemisphere, but its role in the Eastern hemisphere is unclear. This study reviews OPC epidemiology, including prevalence, etiological factors (such as smokeless tobacco and HPV), and their interaction. Among the SEAR countries, India had the highest incidence of HPV-related OPCs at 38.4%, while data were unavailable for most African countries, with only a 14% incidence reported. Conversely, the American region exhibited one of the highest HPV positivity rates, reaching up to 65% in different states of the USA, while Brazil reported an incidence of up to 38%. In the European Union, the UK had the highest incidence of HPV-associated OPC, reaching up to 52%. In the Western Pacific region, New Zealand demonstrated the highest incidence at up to 78%. Smokeless tobacco consumption was higher in SEAR countries, which had a relatively lower incidence of HPV infection, suggesting a negative correlation between the two. Based on our literature search, the most common detection methods used globally are immunohistochemistry for p16 and polymerized chain reaction. OPCs are a global health concern, and proper identification and classification are vital. HPV-driven cancers have better survival rates, emphasizing the need for focused research on specific problem areas based on the burden of HPV-positive or HPV-negative cancers.

High incidence of HPV infection in minors with oral squamous cell carcinoma

BackgroundOral squamous cell carcinoma in minors is considered to be a distinct entity from OSCC in older patients, with an uncertain etiology. Human papillomavirus (HPV) infection may trigger the initiation and promote the progression of OSCC, but these roles have not been firmly established.We aimed to explore the correlation between HPV infection and the development of oral squamous cell carcinoma in minors and know the characteristics of OSCC in young patients more thoroughly.MethodFrom January 2013 to December 2022,6 cases of OSCC aged < 15 years were selected from the Department of Oral Pathology, Peking University School of Stomatology, Beijing, China. All cases underwent testing for high-risk HPV mRNA infection using the RNA scope technique, and immunohistochemical staining was performed to investigate the expression of p16, pan-cytokeratin (CK), CK5/6, CK7, CK8/18, epidermal growth factor receptor (EGFR), p53, and Ki-67. Furthermore, we reviewed the literature on OSCC in patients aged < 21 years.ConclusionsMinors OSCC is associated with HPV infection, and that p16 can serve as an immunohistochemical marker of HPV positivity.

Factors associated with HPV-associated sexual risk behaviors among sexually active college students.

High-risk sexual behavior is the primary risk factor for the acquisition and persistence of human papillomavirus (HPV) infection and the development of HPV-associated diseases including cancer. Incidence of HPV infection is high among individuals in their late teens and early 20s. Thus, college students represent a historically high-risk group for HPV infection yet are also a group with the ability to independently access HPV vaccination for HPV prevention. To inform future interventions, we examined factors associated with HPV-associated risky sexual behaviors among sexually active college students. Data (N = 741) were from an anonymous online survey distributed to students at a public Midwestern university in 2021. The outcomes were HPV-associated sexual risk behaviors-number of oral orvaginalsexual partners [high (≥ 5) or low (< 5)] and age of oral or vaginalsexual debut [early (< 18years) or late (≥ 18years)]. Multivariable logistic regression models estimated the association between HPV-associated risky sexual behaviors and several predictors including age, gender, relationship status, academic level, country of birth, and rural-urban status. Among sexually active students, approximately 47% and 41% had a high number of lifetime vaginal and oral partners, respectively. Among the same group, 60% and 64% had early vaginal and oral sexual debut. Students who were single and dating (aOR = 1.93; 95% CI = 1.21, 3.08) or single and not dating (2.11; 1.28, 3.48) were more likely to have a high number of vaginal lifetime partners compared with married students. Single (vs. married) students were also about twice as likely to have a high number of oral lifetime partners. Relative to graduate students, freshmen/sophomores were more likely to have an early vaginal (2.44; 1.45, 4.11) and oral (2.14; 1.26, 3.63) sexual debut. Interventions tailored to college freshmen/sophomores and unmarried students should encourage students to receive the HPV vaccine for prevention of future HPV-associated diseases.

Association between dietary folate intake and HPV infection: NHANES 2005-2016.

Recent studies have established a correlation between folate levels and the incidence of cervical cancer. Given that Human Papillomavirus (HPV) infection is a primary etiological factor in the development of cervical cancer, the nature of the relationship between dietary folate intake and HPV infection remains an area of ongoing investigation. To investigate the association between dietary folate intake and HPV infection, this study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2016. Multivariate logistic regression analysis was employed to examine the potential associations. Furthermore, the use of restricted cubic splines (RCS) facilitated the exploration of any non-linear correlations. Additionally, subgroup analyses were used to explore this correlation in different populations. The study encompassed a total of 6747 women aged between 18 and 59 years. For every one mcg increase in folate intake, the incidence of HPV infection is reduced by 1% (OR = 0.99, p<0.05). Besides, folate intake was categorized into quartiles as follows: Q1 (<211 mcg/day), Q2 (211-311 mcg/day), Q3 (311-448 mcg/day), and Q4 (>448 mcg/day). The adjusted odds ratios (OR) for the different folate levels were as follows: Q2: 0.94 (95% CI: 0.76-1.16), Q3: 0.84 (95% CI: 0.67-1.04), and Q4: 0.63 (95% CI: 0.49-0.81). The RCS analysis confirmed a nonlinear relationship between dietary folate intake and HPV infection risk. Notably, a significant inverse association was observed when dietary folate intake exceeded 193.847 mcg/day. In conclusion, the findings of this study indicate a negative association between dietary folate intake and the risk of HPV infection. This association demonstrates a nonlinear pattern, particularly evident at higher levels of folate consumption.

Morphology Basis of Cervical Cancer

Background: Cervical cancer is a cancer that occurs in the cells of the cervix–the lower part of the uterus that connects it to the vagina and represents a global public health problem. For many years, we have known that the main cause of preinvasive lesions and cervical cancer is the human papilloma virus (HPV). HPV infection is most common in young, sexually active women under the age of 25, but cervical cancer is more common in older women. In developing countries, this prevalence is higher and describe most frequent clinical manifestations in the praxis. Objective: The aim of this study was to analyze and describe morphology basis of cervical cancer. Methods: This is cross-sectional study based on meta-analysis of the facts published in scientific literature stored in indexed databases about morphology basis of the cervical cancer with description of clinical manifestations and its consequences describing morbidity and mortality rate in the population worldwide. Results and Discussion: The development of cervical cancer is associated with persistent infection with oncogenic types of HPV. The most common oncogenic types of HPV worldwide are HPV 16 and HPV 18 and are responsible for the development of more than 70% of all cervical cancers. HPV 16 has the greatest oncogenic potential. Due to oncogenic potential, human papilloma viruses are divided into high-risk, low-risk and undefined malignant potential. Low-risk types cause genital warts, while high-risk types are associated with preinvasive cervical lesions and cervical cancer. HPV infects basal cells of the squamous epithelium of the genital tract. Infection occurs at the site of microtrauma, areas of metaplasia, and through certain, little-known cellular receptors. Of the total infected, 1% develop a persistent infection, and in a small number of cases, one of the premalignant or malignant changes develops. For the occurrence of malignant changes, it is necessary that the infected organism has a decline in the body’s defenses, the existence or occurrence of other diseases and other viral infections, all with the cooperation of general risk factors (smoking, UV radiation, chemical agents) and with some risk behavior (promiscuity). Cervical intraepithelial (CIN) lesion is a premalignant change of the cervix that occurs due to chronic infection with high-risk types of HPV. Conclusion: It is very important in the future to connect the area of cervical cancer, HPV and DNA methylation, in order to better determine the changes that precede cervical cancer. Prevention and screening measures could also greatly reduce the incidence of HPV infection and the mortality rate caused by cervical cancer.

Polygenic risk scores for cervical HPV infection, neoplasia and cancer show potential for personalised screening: comparison of two methods

The era of precision medicine requires the achievement of accurate risk assessment. Polygenic risk scores (PRSs) have strong potential for increasing the benefits of nationwide cancer screening programs. The current pool of evidence on the role of a PRS as a risk stratification model in actual practice and implementation is limited. To better understand the impact of possible method-induced variance, we constructed and validated two PRSs for cervical cancer (CC) using the Estonian Biobank female population (691 CC cases and 13,820 controls) and evaluated their utility in predicting incident cervical neoplasia (CIN), cancer, and human papillomavirus (HPV) infection using two methods (LDPred and BayesRR-RC). This study demonstrated that two genetic risk scores were significantly associated with CIN, CC, and HPV infection incidence. Independent of the method, we demonstrated that women with elevated PRS values reached the observed cumulative risk levels of CIN or CC much earlier. Our results indicated that the PRS-based discrimination rules could differ substantially when the PRSs contain similar predictive information. In summary, our analysis indicated that PRSs represent a personalized genetic component that could be an additional tool for cervical cancer risk stratification, and earlier detection of abnormalities provides invaluable information for those at high risk.

Epidemiology, Molecular Pathogenesis, Immuno-Pathogenesis, Immune Escape Mechanisms and Vaccine Evaluation for HPV-Associated Carcinogenesis.

Human papillomavirus (HPV) is implicated in over 90% of cervical cancer cases, with factors like regional variability, HPV genotype, the population studied, HPV vaccination status, and anatomical sample collection location influencing the prevalence and pathology of HPV-induced cancer. HPV-16 and -18 are mainly responsible for the progression of several cancers, including cervix, anus, vagina, penis, vulva, and oropharynx. The oncogenic ability of HPV is not only sufficient for the progression of malignancy, but also for other tumor-generating steps required for the production of invasive cancer, such as coinfection with other viruses, lifestyle factors such as high parity, smoking, tobacco chewing, use of contraceptives for a long time, and immune responses such as stimulation of chronic stromal inflammation and immune deviation in the tumor microenvironment. Viral evasion from immunosurveillance also supports viral persistence, and virus-like particle-based prophylactic vaccines have been licensed, which are effective against high-risk HPV types. In addition, vaccination awareness programs and preventive strategies could help reduce the rate and incidence of HPV infection. In this review, we emphasize HPV infection and its role in cancer progression, molecular and immunopathogenesis, host immune response, immune evasion by HPV, vaccination, and preventive schemes battling HPV infection and HPV-related cancers.

Incidence, clearance, and factors associated with anal human papilloma virus infection among men with HIV.

This study aims to estimate the incidence and persistence/clearance of anal human papilloma virus (HPV) infection and related factors among men with HIV in Taizhou, China. A prospective cohort study. Men with HIV were recruited and followed up from 2016 to 2021. Questionnaire surveys were used to collect social-demographic and behavioral characteristics, and anal swabs were collected for HPV Genotyping. A total of 675 men with HIV were recruited and followed up. After an average follow-up time of 1.75 years, HPV39 (3.8/100 person-years), HPV52 (3.6/100 person-years), HPV51 (3.1/100 person-years), HPV58 (2.5/100 person-years) and HPV16 (2.4 cases/100 person-years) in the high-risk types showed the highest incidence rate. In marriage with woman [adjusted hazard ratio (aHR) = 0.44, 95% confidence interval (CI) 0.20-0.99] showed an inverse association with HPV incidence, while bisexuality or undetermined sexual orientation (aHR = 2.62, 95% CI 1.08-6.36) showed a positive association. For those infected at baseline, the top three high-risk HPV with the lowest clearance density were HPV52 (32.2/100 person-years), HPV58 (38.1/100 person-years), and HPV16 (43.5/100 person-years). Daily consumption of 1-28 g alcohol (aHR = 0.62, 95% CI 0.41-0.95) showed an inverse association with HPV clearance, while illicit drug use (aHR = 3.24, 95% CI 1.59-6.59) showed a positive association. Anal HPV infection and clearance were both active in men with HIV in China. Marriage status and sexuality were associated with the incidence of HPV infection, while substance use including alcohol and illicit drug were associated with HPV clearance. More studies are needed to explore the risk factors of HPV persistence.

HPV vaccination in Kenya: a study protocol to assess stakeholders' perspectives on implementation drivers of HPV vaccination and the acceptability of the reduced dose strategy among providers.

Cervical cancer is the leading cause of cancer-related deaths among Kenyan women. Persistent infection with high-risk oncogenic Human papillomavirus (HPV) genotypes is a necessary cause of cervical cancer. HPV vaccines are safe, durable, and efficacious in preventing incident HPV infections. In Kenya, despite efforts to increase HPV vaccination, coverage remains low. We sought to assess: (1) barriers and facilitators of HPV vaccination from the perspective of adolescent girls and young women (AGYW), their guardians as well as stakeholders involved in HPV vaccine delivery, and (2) the acceptability of the single dose of the HPV vaccination among healthcare providers (HCPs). Our study is nested within the KENya Single-dose HPV-vaccine Efficacy study (KEN SHE) that sought to test the efficacy of single-dose bivalent (HPV 16/18) and single-dose nonavalent (HPV 16/18/31/33/45/52/58/6/11) vaccination. We are conducting this study in Kiambu, Nairobi, and Kisumu counties. In these counties, we are interviewing stakeholders (n = ∼25), selected based on their role in HPV vaccination at the county and national levels. Interviews are audio recorded and conducted in English or Swahili. The semi-structured interview guides were designed based on: (1) the Theoretical Domains Framework (TDF) for AGYW and guardians and (2) the Consolidated Framework for Implementation Research (CFIR) for other stakeholders. The Theoretical Framework of Acceptability (TFA) was leveraged to design the survey administered to HCPs (n = ∼309) involved in HPV vaccination. We will develop a codebook based on emerging codes from the transcripts and constructs from the TDF and CFIR. Emerging themes will be summarized highlighting similarities and differences between and within the different stakeholder groups and counties. Descriptive statistics and a χ2 test will be used to assess the distribution of responses between the different sites and regression analysis will be used to assess factors associated with high acceptability of the single-dose strategy while controlling for confounding variables. Our study will describe key barriers and facilitators that affect HPV vaccination from the perspective of multiple stakeholders as well as insights on the perspective of HCPs towards the single-dose strategy to inform the designing of strategies to increase HPV vaccination uptake in Kenya and comparable settings.

Risk factors for human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer: an umbrella review and follow-up Mendelian randomisation studies

BackgroundPersistent infection by oncogenic human papillomavirus (HPV) is necessary although not sufficient for development of cervical cancer. Behavioural, environmental, or comorbid exposures may promote or protect against malignant transformation. Randomised evidence is limited and the validity of observational studies describing these associations remains unclear.MethodsIn this umbrella review, we searched electronic databases to identify meta-analyses of observational studies that evaluated risk or protective factors and the incidence of HPV infection, cervical intra-epithelial neoplasia (CIN), cervical cancer incidence and mortality. Following re-analysis, evidence was classified and graded based on a pre-defined set of statistical criteria. Quality was assessed with AMSTAR-2. For all associations graded as weak evidence or above, with available genetic instruments, we also performed Mendelian randomisation to examine the potential causal effect of modifiable exposures with risk of cervical cancer. The protocol for this study was registered on PROSPERO (CRD42020189995).ResultsWe included 171 meta-analyses of different exposure contrasts from 50 studies. Systemic immunosuppression including HIV infection (RR = 2.20 (95% CI = 1.89–2.54)) and immunosuppressive medications for inflammatory bowel disease (RR = 1.33 (95% CI = 1.27–1.39)), as well as an altered vaginal microbiome (RR = 1.59 (95% CI = 1.40–1.81)), were supported by strong and highly suggestive evidence for an association with HPV persistence, CIN or cervical cancer. Smoking, number of sexual partners and young age at first pregnancy were supported by highly suggestive evidence and confirmed by Mendelian randomisation.ConclusionsOur main analysis supported the association of systemic (HIV infection, immunosuppressive medications) and local immunosuppression (altered vaginal microbiota) with increased risk for worse HPV and cervical disease outcomes. Mendelian randomisation confirmed the link for genetically predicted lifetime smoking index, and young age at first pregnancy with cervical cancer, highlighting also that observational evidence can hide different inherent biases. This evidence strengthens the need for more frequent HPV screening in people with immunosuppression, further investigation of the vaginal microbiome and access to sexual health services.

Natural History of Oral HPV Infection among Indigenous South Australians.

This study aims to describe the natural history of and identify the risk factors associated with oral human papillomavirus (HPV) infections in an Australian Indigenous cohort. A longitudinal cohort study design, with baseline (2018), 12-month, and 24-month data obtained from Indigenous Australians aged 18+ years in South Australia, was performed. Face-to-face interviews were conducted, and saliva samples for HPV testing were collected at each time point. Basic descriptive analyses were conducted to calculate prevalence, incidence, persistence, clearance, and incidence proportions of any HPV infection. Multivariable logistic regression analyses with adjusted prevalence ratios (PRs) were conducted to identify risk factors associated with oral HPV infection. Among 993 participants with valid saliva samples, 44 HPV types were identified. The prevalence of infection with any oral HPV infection was 51.3%, high-risk HPV was 11%, and types implicated in Heck's disease (HPV 13 or 32) was 37.4%. The incidence, persistence, and clearance of any and high-risk HPV infections were 30.7%, 11.8% and 33.3% vs. 9.3%, 2.8%, and 9%, respectively. Our findings indicate that the prevalence, incidence, and persistence of oral HPV infection in a large sample of Indigenous Australians were high, and clearance was low. Oral sex behaviours and recreational drug use were risk factors associated with incident high-risk HPV infection.

A STUDY OF CERVICAL LESIONS IN CORRELATION WITH HUMAN PAPILLOMAVIRUS ANALYSIS BY IMMUNOHISTOCHEMICAL ASSAY

Background: It has become clear that human papillomavirus (HPV) plays a critical role in the pathogenesis of nearly all cervical squamous cell carcinomas. Because HPV causes a variety of cervix lesions, including benign, premalignant, and malignant lesions, early detection of this infection benefits the patient. Objective: The goal of this study is to identify neoplastic and non-neoplastic cervix lesions, to study neoplastic and non-neoplastic cervix lesions caused by HPV in correlation with HPV analysis by immunohistochemistry (IHC), and to understand the significance of HPV in screening cervical lesions. Methods: The current study evaluated and compared HPV cocktail expression in 100 samples collected from 100 cases with cervical lesions. A semi-quantitative method was used to determine the positivity of the HPV cocktail. Comparison of expression of HPV cocktail IHC and histopathology was carried out. Results: Of the 100 cases, 30 were carcinoma cervix (CC), 4 were carcinoma in situ (CIS), 22 were squamous intraepithelial lesions (SIL), 20 were chronic cervicitis, 16 were chronic cervicitis with Koilocytic change, 7 were Koilocytic change, and 1 was Inflammatory polyp. SIL and CIS have a mean age of 46.8 and 44.5 years, respectively. There was a 42% incidence of carcinoma cases seen in the fourth decade, with a mean age of 45.9 years. The most common complaint presented by CC patients is AUB, with postmenopausal bleeding being the most common complaint. Seven patients with Squamous cell carcinoma present with postmenopausal bleeding. There were neoplastic lesions in 56% of the cases and non-neoplastic lesions in 44% of the cases. Premalignant cervix lesions include low grade squamous intra epithelial lesion, high grade squamous intra epithelial lesion, and CIS, which account for 46.42% of all cases. Non-neoplastic lesions such as chronic cervicitis account for 45.55% of all cases, followed by chronic cervicitis with Koilocytic change (36.36%), Koilocytic change (15.91%), and Polyp (2.27%). There were 28 Squamous cell carcinomas and 2 Adenocarcinomas among the 30 cases of CC. Squamous cell carcinoma accounted for 93.33% of all cases, while adenocarcinoma accounted for 6.67%. Moderately differentiated squamous cell carcinomas account for 86.66% of the cases, followed by well differentiated squamous cell carcinomas and poorly differentiated squamous cell carcinomas, which account for 6.66% of the cases. 26 (86.6%) of 30 squamous cell carcinomas tested positive for IHC. All two Adenocarcinoma cases (100%) and all CIS cases (100%) were positive. Out of the 22 SIL cases, 18 (81.81%) were positive. Out of 16 cases of chronic cervicitis with Koilocytic change, 14 (87.5%) were positive. Out of 20 chronic cervicitis cases, 12 (60%) were positive. 5 (71.43%) of the 7 cases of Koilocytic change were positive. Cervical lesions (benign, premalignant, and malignant) have a significant correlation with HPV cocktail IHC (p=0.01). Conclusion: The expression of the HPV cocktail was associated with clinical and histopathologic parameters in benign, premalignant, and malignant cervical lesions. Periodic follow-up allows patients to be better managed by providing vital data on the incidence of HPV infection in various cervical lesions. Low-grade SILs and high-grade SILs with HPV +ve infection can be monitored by HPV once a year instead of every 6 months. Patients over the age of 30 years with HPV-positive non-neoplastic cervical lesions can be monitored once every three years rather than annually. HPV is a biomarker for a better prognosis in cervical cancer, regardless of age, International Federation of Obstetricians and Gynecologists stage, or histologic type. HPV-positive tumors have a better prognosis.

The incidence of HPV infection of high carcinogenic risk in women of the Kemerovo region

Aim. Toassess the prevalence of various types of human papillomavirus (HPV) of high carcinogenic risk (HCR) and the rate of abnormal findings of cytological examination in HPV-positive and HPV-negative women of the Kemerovo region.&#x0D; Materials and methods. A continuous cross-sectional study was conducted. The study included 675 women aged 21 to 65 (mean age 40.510.6 years) residing in the Kemerovo region. Patients were sampled from the cervical canal for semi-quantitative HPV-typing and cytological examination with Papanicolaou staining (PAP-test) using a liquid-based cytology method. For HPV-positive patients, an HPV typing with the quantification of 14 HCR HPV types was performed by polymerase chain reaction with real-time detection. Statistical data processing was performed using the StatSoft Statistica 6.1 software bundle.&#x0D; Results. The mean rate of HCR HPV detection in women of the Kemerovo region in the age group of 2165 years is 17.8% and decreases with age. HPV type 16 prevailed and was detected in 31.6% of women. In 19.2% of women, the HPV subtype 31 was diagnosed; in 18.3%, the subtype 35; in 16.7%, the subtype 33. The HPV subtypes 39, 56, and 66 were the rarest. One subtype of HCR HPV was detected in 26.7% of women, two subtypes in 6.7%, and three or more subtypes in 66.6% of women. According to the cytological examination, CIN 1, 2, and 3 rates were 3.3, 0.8, and 0.7%, respectively. HSIL (CIN 23) was detected in 1.5% of cases, LSIL (CIN 1) in 3.3%. The rate of CIN 1 in HPV(+) women was higher: 13.3% vs 1.0% in HPV(-) (2=43.197; p0.001). CIN 2 and CIN 3 were reported in HPV(+) patients only. HSIL+ was diagnosed in 7.9% of HPV(+) females (2=39.778; p0.001).&#x0D; Conclusion. Thus, the study results showed that the mean infection rate of HCR HPV in women of the Kemerovo region at the age of 2165 years is 17.8% and decreases with age. HPV subtype 16 is predominant; subtypes 31, 35, and 33 were less common. In HPV-positive women, abnormal findings of cytological examination were significantly more common.

Type-specific HPV incidence and clinical spectrum of lesions induced by high-risk oncogenic HPV types among study participants in Eastern Uganda

Different studies show that high-risk HPV genotypes are the main etiological agents for cervical cancer development and cancer-related deaths in women worldwide. In Uganda, cervical malignancies due to human papillomavirus (HPV) are predominant among sexually active women. However, data on the incidence and clinical spectrum of lesions associated with high-risk HPV infection is inadequate. The current study was aimed to determine incidence and clinical spectrum of lesions induced by high-risk oncogenic HPV types among study participants in Eastern Uganda. We piloted a prospective follow-up study among 1,077 women aged 15-55 years to assess the incidence and clinical spectrum of lesions associated with human papillomavirus infections (HPV). HPV Real-Time PCR using HPV High-Risk Screen Real-TM Quant 2x kit (Sacace, Biotechnologies, Italy) was used for genotyping high-risk HPV types. Four hundred and sixteen (416) of 1,077 (38.6%) women were monitored for an average time of 18 months (inter-quartile range 9.6-26.6). Forty-three (43) women had incident HPV infections during 214 person-years of follow-up reflecting an incidence rate of 20.1 per 100 person-years. Incident HPV infections were marginally associated with HIV positivity (RR = 3.0, 95% CI: 0.8 - 8.2) and usage of oral contraceptives (RR=2.6, 95% CI: 1.4 - 2.8) but not with the age of study subjects, or number sexual partners. Clearance for high-risk HPV infections was frequently ranging between 37.5% and 100.0% for high-risk types. Only 41.3% of women cleared all their infections. Clearance was associated with HIV negativity (Adjusted clearance = 0.3, 95% CI: 0.2 - 0.8) but not with age at study entry or oral contraceptive usage. Incident HPV infections and clearance of HPV type-specific infections were common among study participants. We also found a high prevalence of high-risk HPV types in cervical lesions, which reveals an association between cervical lesions and high-risk HPV types.

Association between Human Papillomavirus and Oral Cancer in Iranian Clinical Samples: A Meta-Analysis Review.

Oral squamous cell carcinoma (OSCC) is one of the most common malignancies and is a serious problem worldwide. The role of HPV in oral cavity squamous cell carcinoma has been studied in several researches. This present review and meta-analysis aimed to investigate the relation between human papillomavirus (HPV) and oral cancer. Relevant studies were found using online international databases including Science direct, Web of science (ISI), PubMed, Scopus, Embase, and Google scholar, to determine relevant studies published between 2000 and Jan 2020. Suitable studies were selected and assessed by two independent researchers. The quality of all papers were determined by a checklist. Heterogeneity assay among the primary studies was evaluated by Cochran's Q test and I2 index. The statistical analyses were done using Stata SE, V.11 software. Trim and Fill method was applied to confirm the validity of the results. This meta-analysis consists of 8 primary studies on the incidence of HPV infection in Iranian patients with oral diseases. The odds ratio between HPV infection and risk of oral cancer was 4.00 (95%CI: 2.31, 6.93). This meta-analysis showed associations between prevalence of HPV infection and oral cancer among Iranian patients. The chance of developing oral cancer among HPV positive patients was higher than that in HPV negative patients.

A comprehensive analysis of penile cancer in the region with the highest worldwide incidence reveals new insights into the disease

BackgroundAlthough penile cancer (PC) is uncommon in developed countries, it is widespread in developing countries. The state of Maranhão (Northeast, Brazil) has the highest global incidence recorded for PC, and, despite its socioeconomic vulnerability, it has been attributed to human papillomavirus (HPV) infection. This study aimed to determine the histopathological features, the prevalence of HPV infection, and the immunohistochemical profile of PC in Maranhão.MethodsA retrospective cohort of 200 PC cases were evaluated. HPV detection was performed using nested-PCR followed by direct sequencing for genotyping. Immunohistochemistry (IHC) was performed using monoclonal antibodies anti-p16INK4a, p53, and ki-67.ResultsOur data revealed a delay of 17 months in diagnosis, a high rate of penile amputation (96.5%), and HPV infection (80.5%) in patients from Maranhão (Molecular detection). We demonstrated the high rate of HPV in PC also by histopathological and IHC analysis. Most patients presented koilocytosis (75.5%), which was associated with those reporting more than 10 different sexual partners during their lifetime (p = 0.001). IHC revealed frequent p16INK4a overexpression (26.0%) associated with basaloid (p < 0.001) and high-grade tumors (p = 0.008). Interestingly, p16 appears not to be a better prognostic factor in our disease-free survival analysis, as previously reported. We also demonstrated high ki-67 and p53 expression in a subset of cases, which was related to worse prognostic factors such as high-grade tumors, angiolymphatic and perineural invasion, and lymph node metastasis. We found a significant impact of high ki-67 (p = 0.002, log-rank) and p53 (p = 0.032, log-rank) expression on decreasing patients’ survival, as well as grade, pT, stage, pattern, and depth of invasion (p < 0.05, log-rank).ConclusionsOur data reaffirmed the high incidence of HPV infection in PC cases from Maranhão and offer new insights into potential factors that may contribute to the high PC incidence in the region. We highlighted the possible association of HPV with worse clinical prognosis factors, differently from what was observed in other regions. Furthermore, our IHC analysis reinforces p16, ki-67, and p53 expression as important diagnosis and/or prognosis biomarkers, potentially used in the clinical setting in emerging countries such as Brazil.

Role of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: systematic review and meta-analysis

ObjectiveTo explore the efficacy of human papillomavirus (HPV) vaccination on the risk of HPV infection and recurrent diseases related to HPV infection in individuals undergoing local surgical treatment.DesignSystematic review and...

Vaginal microbiota associated with oncogenic HPV in a cohort of HPV-vaccinated women living with HIV.

BackgroundWomen living with HIV (WLWH) experience higher rates of human papillomavirus (HPV) infection and cervical cancer than women without HIV. Changes in the vaginal microbiome have been implicated in HPV-related disease processes such as persistence of high-risk HPV infection but this has not been well defined in a population living with HIV.MethodsFour hundred and 20 girls and WLWH, age ≥9, across 14 clinical sites in Canada were enrolled to receive three doses of quadrivalent HPV vaccine for assessment of vaccine immunogenicity. Blood, cervical cytology, and cervico-vaginal swabs were collected. Cervico-vaginal samples were tested for HPV DNA and underwent microbiota sequencing.ResultsPrincipal component analysis (PCA) and hierarchical clustering generated community state types (CSTs). Relationships between taxa and CSTs with HPV infection were examined using mixed-effects logistic regressions, Poisson regressions, or generalized linear mixed-effects models, as appropriate. Three hundred and fifty-six cervico-vaginal microbiota samples from 172 women were sequenced. Human papillomavirus DNA was detected in 211 (59%) samples; 110 (31%) contained oncogenic HPV. Sixty-five samples (18%) were taken concurrently with incident oncogenic HPV infection and 56 (16%) were collected from women with concurrent persistent oncogenic HPV infection.ConclusionsNo significant associations between taxa, CST, or microbial diversity and HPV-related outcomes were found. However, we observed weak associations between a dysbiotic microbiome and specific species, including Gardnerella, Porphyromonas, and Prevotella species, with incident HPV infection.