Risk Of HPV Infection Research Articles

Human Papillomavirus infection in oral and anogenital sites: prevalence and rates of concordance

Introduction: HPV infection causes cancer at several anatomical sites. However, the infection’s natural history in non-cervical sites is understudied. Objective: To evaluate oral and anogenital HPV infections, correlating HPV prevalence rates and genotypes with site of infection and risk factors. Methods: In the present study, 351 samples from oral, genital, and anal sites of 117 patients were investigated by using PCR MY09/11 detection, followed by genotyping with RFLP. Results: HPV DNA prevalence was 89.7% (105/117) in genital lesions, 53.8% (63/117) in oral samples, and 58.9% (69/117) in anal samples. Regarding the risk factors associated with HPV in genital lesions, statistically significant rates for oral (p=0.039) and anal sex practices (p=0.0000012) were found. For oral samples, a relevant correlation concerning oral contraceptive use (p=0.039), tobacco smoking (p=0.036), and alcohol use (p=0.0075) were observed; whereas in anal samples, higher risk for HPV infection in patients who reported non-exclusive sexual partners (p=0.013) were found. The presence of viral DNA in all the three sites concurrently was observed in 36.8% of the cases (43/117). Among them, 18% (21/117) presented concordant HPV genotypes, diverging from the literature, and thus corroborating that there is still much to learn about HPV natural history, since different biological behaviors are expected within different populations. Differences in anatomy and physiology of the studied sites can determine different prevalence rates of infection by diverse genotypes. Conclusion: Due to the high prevalence of HPV DNA in extragenital sites, further studies are required to define aspects of HPV natural history among different human anatomical sites.

Papillomaviral infection and cervical diseases in pregnant women. Risk factors of social status, reproductive and contraceptive behavior

Aim. To determine the risk factors for human papillomavirus of high carcinogenic risk (HPV HCR) and cervical diseases (CD) in pregnant women associated with the social status, reproductive and contraceptive behavior.
 Materials and methods. Design: open-label comparative non-interventional cohort study in parallel groups. The total number of patients 330 people, of whom 148 women were negative for HPV and 182 women were positive. They were divided into 4 groups depending on the presence or absence of CD. Methods: analysis of anamnesis data, general clinical, test Kvant-21 to determine HPV, cytological examination, extended colposcopy.
 Results. The most significant risk factors for HPV HRS infection were identified: history of mycoplasma infection (OR 5.9) and BV (OR 5.3), alcohol consumption (OR 4.0). A history of STIs (trichomoniasis and chlamydial infection), as well as more than 3 sexual partners (OR 2.7) were also significant. The most significant risk factors for CD in HPV-infected women were: age over 35 years (OR 3.8), a history of bacterial vaginosis (OR 3.0), and lack of regular screening (OR 2.4). The coitarche earlier than 16 years old (OR 2.2) also mattered. There were also found factors indicating a low risk of HPV infection the use of condoms (OR 0.3), and a low risk of CD was indicated by age under 25 years (OR 0.2) and regular screening (OR 0.3).
 Conclusion. HPV infection with HRS and the prevalence of CMC in pregnant women against the background of HPV infection is associated mainly with social risk factors, to a lesser extent with factors of reproductive and contraceptive behavior.

Abstract PO-154: Establishing the prevalence of high-risk HPV infection and identifying associated risk factors in Santo Domingo, Ecuador

Abstract Human papillomavirus is a common sexually transmitted infection that affects men and women. For women, persistent infection with high-risk HPV genotypes is a significant risk factor for cervical cancer, and HPV infection is more prevalent in developing countries than in developed countries. Furthermore, women in developing countries experience a greater number of cervical cancer cases attributable to HPV infection than women in developed countries. In Ecuador, recent studies have shown an increased prevalence of high-risk HPV genotypes in certain regions, specifically Quito and in Southern Ecuador. No study has analyzed the prevalence of high-risk HPV in Santo Domingo, Ecuador. In this quantitative study, the prevalence of high-risk HPV in Santo Domingo was determined by analyzing cervical cytology samples taken from pregnant women visiting three local health clinics. Women younger than 18 years of age were excluded. The study also analyzed associated risk factors for infection. Overall, 24.1% of participants tested positive for high-risk HPV infection. Genotypes falling into the “other high risk” category (i.e. HPV- HPV-31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) were the most prevalent. This result differed slightly from findings in comparable studies completed in Ecuador where HPV-16 was found to be most prevalent among the study population. Age and Pap smear history were independently determined to be significant predictors of HPV status. These findings indicate the significance of routine female wellness and gynecological screenings at Saludesa Hospital, and Augusto Egas and Santa Martha clinics. Furthermore, results also emphasize the importance of vaccine use as primary prevention measures against HPV infection in adolescents in Santo Domingo. Currently, Saludesa Hospital, Augusto Egas and Santa Martha clinics do not offer vaccinations for protection against HPV infection. However, girls between ages of 11 and 12 seeking care at these facilities would likely benefit from preventive reproductive health care, including access to vaccinations, to protect against high- risk HPV infection. Education regarding the epidemiology of high-risk HPV infection could enhance the public’s acceptance of screening and intervention programs. Citation Format: Hanna Foster, Maria Alexandrova, Roya Ghiaseddin, David Gaus, Katherine Taylor, Danny Larco, Sharon Stack. Establishing the prevalence of high-risk HPV infection and identifying associated risk factors in Santo Domingo, Ecuador [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-154.

Depletion and activation of mucosal CD4 T cells in HIV infected women with HPV-associated lesions of the cervix uteri.

BackgroundThe burden of HPV-associated premalignant and malignant cervical lesions remains high in HIV+ women even under ART treatment. In order to identify possible underlying pathophysiologic mechanisms, we studied activation and HIV co-receptor expression in cervical T-cell populations in relation to HIV, HPV and cervical lesion status.MethodsCervical cytobrush (n = 468: 253 HIV- and 215 HIV+; 71% on ART) and blood (in a subset of 39 women) was collected from women in Mbeya, Tanzania. Clinical data on HIV and HPV infection, as well as ART status was collected. T cell populations were characterized using multiparametric flow cytometry-based on their expression of markers for cellular activation (HLA-DR), and memory (CD45RO), as well as HIV co-receptors (CCR5, α4β7).ResultsCervical and blood T cells differed significantly, with higher frequencies of T cells expressing CD45RO, as well as the HIV co-receptors CCR5 and α4β7 in the cervical mucosa. The skewed CD4/CD8 T cell ratio in blood of HIV+ women was mirrored in the cervical mucosa and HPV co-infection was linked to lower levels of mucosal CD4 T cells in HIV+ women (%median: 22 vs 32; p = 0.04). In addition, HIV and HPV infection, and especially HPV-associated cervical lesions were linked to significantly higher frequencies of HLA-DR+ CD4 and CD8 T cells (p-values < 0.05). Interestingly, HPV infection did not significantly alter frequencies of CCR5+ or α4β7+ CD4 T cells.ConclusionThe increased proportion of activated cervical T cells associated with HPV and HIV infection, as well as HPV-associated lesions, together with the HIV-induced depletion of cervical CD4 T cells, may increase the risk for HPV infection, associated premalignant lesions and cancer in HIV+ women. Further, high levels of activated CD4 T cells associated with HPV and HPV-associated lesions could contribute to a higher susceptibility to HIV in HPV infected women.

Prevalence of HPV infections in surgical smoke exposed gynecologists

ObjectivesHuman papillomavirus (HPV) has been reported recently in surgical smoke generated by gynecological operations. The objective of this study was to investigate whether gynecologists who have performed electrosurgery including loop electrosurgical excision procedure (LEEP), are at risk of acquiring HPV DNA through surgical smoke.MethodsA related questionnaire was designed and 700 gynecologist nasal swab samples were collected in 67 hospitals. In addition, the flow fluorescence hybridization technique was used to detect HPV DNA, and the Chi-square test was applied to analyze whether related risk factors including electrical surgery, were correlated with HPV infection in surgeons’ nasal epithelial cells.ResultsThe HPV infection rate in the nasal epithelial cells of the participants who performed electrosurgery (8.96%, 42/469) or LEEP (10.11%, 36/356) was significantly higher than that in the remaining participants who did not perform electrosurgery (1.73%, 4/231) or LEEP (2.91%, 10/344), respectively. The most prevalent HPV genotype in the electrosurgery group was HPV16 (76.19%, 32/42). The HPV-positive rate was increased in the group that had a longer duration of electrosurgery (P = 0.016). Additionally, the HPV detection rate was significantly lower in electrosurgery operators who used surgical mask (7.64%, 33/432) than in those who did not use protective masks (24.32%, 9/37). Furthermore, the N95 mask (0%, 0/196) significantly reduced the risk for HPV infection compared to that with the general mask (13.98%, 33/236, P < 0.001). Furthermore, 46 participants infected with HPV were followed-up for 3–24 months, and approximately 43.48% (20/46) and 100% (41/41) became negative for HPV DNA, respectively.ConclusionsGynecologists who performed electrosurgery including LEEP were at risk of acquiring HPV infection. Surgical masks, especially the N95 mask, significantly decreased the hazard of HPV transmission from surgical smoke.

A prospective study of incidence of cervical HPV infection &amp; its association with aetiological factors &amp; cervical cancer in adult women of Jamnagar

Introduction: Etiological link between cervical cancer & HPV is independent of other risk factors but their geographic variations need to be explored. Cervical cancer with profile of Sexually Transmitted Disease has consistent causal connection with persistent cervical HPV infection, so such carrier women are at High risk. Thus, study evaluate risk of HPV infection in women of Jamnagar region by exploring aetiological determinants related to their sexual life. Aim: To explore incidence of cervical HPV infection along with its association with cervical cancer as well with commonly proposed aetiological factors in adult women of Jamnagar Materials and Methods: The study was conducted in 2004 on random 110 women attending Gynecology out patient department of GG Hospital at MPSGMC Jamnagar by taking their cervical smear and administering them questionnaires about their sexual life. HPV infection was diagnosed based on cytopathic effects of HPV, by Microbiological staining techniques. Association of cervical HPV positive status of women in relation to common aetiological factors and carcinoma cervix were analyzed. Results: 10.9% of women exhibited cervical HPV infection out of them 20% belonged to higher age group (50-59 years) followed by 16.6% of young age group (20-29). 15.3% of women with HPV infection were having 6 -10 years of active married life. Accordingly 18.18% HPV infected women were multipara - bearing 3 - 4 children whereas nullipara had no HPV infection. 75% of women with carcinoma cervix were positive for cervical HPV which endorse strong causal connections. Conclusions: Study concludes that cervical HPV is prevalent in 10.9% adult women of Jamnagar region and is significantly attributable to cervical cancer. HPV positive woman have profile of sexually active life of initial years, early age at first coitus or had longer but active married life, so sexual transmission happens to be the predominant mode of HPV acquisition. Similarly, multiparity has aetiol

Human Papilloma Virus Transmission: Knowledge and Uptake of HPV Vaccine among In-school Adolescent Girls in South-South Nigeria

Background: HPV infection is the most common STI in sexually active adolescents. It has been implicated in majority of cases of cervical cancers. HPV is preventable. Potent Vaccines are available.&#x0D; Objective: This study assessed what adolescents know about HPV infection and HPV vaccination, their attitude and uptake of HPV vaccine. This was also to raise awareness and obtain data that will be useful in identifying where to intervene to improve coverage.&#x0D; Materials and Methods: A descriptive cross-sectional study carried out in Rivers State, Nigeria. Study tool was a semi-structured, self-administered questionnaire. Multi-stage sampling method was used to recruit adolescent girls from secondary schools.&#x0D; Results: 445 in-school adolescent girls aged 9 to 19 years participated. Mean age was 13.4 SD = ±2.2 years. 36.6% and 36.8% had heard of HPV infection and HPV vaccine respectively. Only 3.1% of the participants knew HPV could be prevented through vaccination. 71.7% indicated willingness to obtain the vaccine. Only 3.6% self reported to have received at least one dose of the vaccine at the time of the survey. Uptake of HPV vaccine (P=0.00), willingness to be vaccinated (P=0.005) highest among adolescents that had heard of HPV vaccine and those who perceived themselves to be at risk for HPV infection (P=0.005). Insufficient health information, cost of HPV vaccines identified as key barriers to vaccines utilization.&#x0D; Conclusion: Notwithstanding the low level of knowledge about HPV infection and HPV vaccines willingness to be vaccinated was high. Our study shows that uptake of vaccination is low in our locality.

Dietary Antioxidant Intake and Human Papillomavirus Infection: Evidence from a Cross-Sectional Study in Italy.

Several lines of evidence suggested that antioxidants might play a protective role against high-risk human papillomavirus (hrHPV) infection and cervical cancer. However, the effect of combined intake of antioxidants has not been investigated thus far. The current cross-sectional study aimed to understand the relationship between dietary antioxidant intake and the risk of high-risk HPV (hrHPV) infection among 251 Italian women with normal cervical cytology. Women were tested for hrHPV using the Digene HC2 HPV DNA Test. Dietary antioxidant intakes were assessed using a semi-quantitative food frequency questionnaire, and a Composite Dietary Antioxidant Index (CDAI) was constructed on the basis of zinc, selenium, manganese, vitamin A, vitamin C, vitamin E, carotenoid, and flavonoid intake. Logistic regression analysis was used to assess odds ratio (OR) and 95% confidence interval (95% CI) for the associations of antioxidant intakes or CDAI with hrHPV status, adjusting for age, smoking status, body mass index, parity, educational level, marital status, and use of multivitamins and oral contraceptives. We first observed that hrHPV-positive women (n = 84) reported lower intake of zinc, manganese, and vitamins A and C than non-infected women. Specifically, we found a negative association between dietary intake of zinc and hrHPV-positive status when all antioxidants were considered simultaneously (OR = 0.46; 95% CI = 0.27–0.80; p = 0.006). With respect to cumulative dietary antioxidant intake, we demonstrated that women with high CDAI (third tertile) had lower odds of being hrHPV-positive than those with low CDAI (first tertile) (OR = 0.39; 95% CI = 0.18–0.85; p = 0.018). To our knowledge, this is the first study demonstrating that a diet based on the combined intake of nutrients with antioxidant properties might reduce the risk of hrHPV infection. However, further research is needed to understand whether dietary antioxidant intake is associated with hrHPV infection or its persistence.

The past, present and future impact of HIV prevention and control on HPV and cervical disease in Tanzania: A modelling study.

Women with HIV have an elevated risk of HPV infection, and eventually, cervical cancer. Tanzania has a high burden of both HIV and cervical cancer, with an HIV prevalence of 5.5% in women in 2018, and a cervical cancer incidence rate among the highest globally, at 59.1 per 100,000 per year, and an estimated 9,772 cervical cancers diagnosed in 2018. We aimed to quantify the impact that interventions intended to control HIV have had and will have on cervical cancer in Tanzania over a period from 1995 to 2070. A deterministic transmission-dynamic compartment model of HIV and HPV infection and natural history was used to simulate the impact of voluntary medical male circumcision (VMMC), anti-retroviral therapy (ART), and targeted pre-exposure prophylaxis (PrEP) on cervical cancer incidence and mortality from 1995-2070. We estimate that VMMC has prevented 2,843 cervical cancer cases and 1,039 cervical cancer deaths from 1995-2020; by 2070 we predict that VMMC will have lowered cervical cancer incidence and mortality rates by 28% (55.11 cases per 100,000 women in 2070 without VMMC, compared to 39.93 with VMMC only) and 26% (37.31 deaths per 100,000 women in 2070 without VMMC compared to 27.72 with VMMC), respectively. We predict that ART will temporarily increase cervical cancer diagnoses and deaths, due to the removal of HIV death as a competing risk, but will ultimately further lower cervical cancer incidence and mortality rates by 7% (to 37.31 cases per 100,000 women in 2070) and 5% (to 26.44 deaths per 100,000 women in 2070), respectively, relative to a scenario with VMMC but no ART. A combination of ART and targeted PrEP use is anticipated to lower cervical cancer incidence and mortality rates to 35.82 and 25.35 cases and deaths, respectively, per 100,000 women in 2070. HIV treatment and control measures in Tanzania will result in long-term reductions in cervical cancer incidence and mortality. Although, in the near term, the life-extending capability of ART will result in a temporary increase in cervical cancer rates, continued efforts towards HIV prevention will reduce cervical cancer incidence and mortality over the longer term. These findings are critical background to understanding the longer-term impact of achieving cervical cancer elimination targets in Tanzania.

Association of antiretroviral therapy with anal high-risk human papillomavirus, anal intraepithelial neoplasia, and anal cancer in people living with HIV: a systematic review and meta-analysis

The effect of antiretroviral therapy (ART) on the natural history of anal high-risk HPV and anal lesion progression is not well established. We reviewed the association of ART and other HIV-related factors on anal HPV infection, anal intraepithelial neoplasia (AIN), and anal cancer among people living with HIV. For this systematic review and meta-analysis, we searched MEDLINE and EMBASE for studies published between Jan 1, 1996, and Oct 30, 2019, that reported the association of HIV-related exposures (ART or highly active ART [HAART], HIV-RNA plasma viral load [PVL], and nadir or current CD4 cell count) with outcomes of anal high-risk HPV prevalence, incidence, and persistence; prevalence, incidence, progression, or regression of anal histological and cytological abnormalities; and anal cancer incidence. Effect estimates were extracted whenever available; otherwise, they were calculated from raw data. We assessed the risk of bias of included studies using the Newcastle-Ottawa scale, and random-effects meta-analyses were done to examine heterogeneity using the I2 statistic. This study is registered on the PROSPERO database, CRD42018007271. We identified 6777 studies, of which 5377 were excluded before full-text review. 122 studies providing estimates for 130 distinct populations matched the inclusion criteria. The populations comprised 417 006 people living with HIV (women, men who have sex with men, and men who have sex with women). 41 (32%) population estimates were not stratified by sex or sexual orientation. People living with HIV receiving ART had 35% lower high-risk HPV prevalence than ART-naive people (crude odds ratio [OR] 0·65, 95% CI 0·54-0·79; I2 12·1%, p=0·31) in 18 studies, and prolonged ART use was associated with a 10% reduction per year in high-risk HPV prevalence in two studies (adjusted OR 0·90, 0·85-0·95; I2 0%, p=0·88). People living with HIV with undetectable PVL had lower HSIL-AIN2+ prevalence than those with detectable PVL (crude OR 0·84, 0·72-0·98; I2 0%, p=0·80) in 16 studies, particularly if sustained for more than 1 year (crude OR 0·62, 0·47-0·81; I2 0%, p=0·51). ART was not associated with anal cancer incidence when adjusted for years living with HIV in three studies (adjusted hazard ratio [HR] 1·11, 95% CI 0·68-1·80; I2 0%, p=0·57), but ART users with sustained undetectable HIV PVL had 44% lower risk of anal cancer than those without (adjusted HR 0·56, 0·44-0·70; I2 0%, p=0·94) and for each increase in nadir CD4 cell counts of 100 cells per μL, there was a 40% decrease in anal cancer incidence (crude HR 0·60, 0·46-0·78; I2 21·7%, p=0·26). Effective ART use and early initiation at high nadir CD4 counts might reduce anal high-risk HPV infection and anal cancer risk. Although most studies were cross-sectional in design and few adjusted for potential confounders, this analysis provides comprehensive estimates of the effect of ART and HIV-related factors on the natural history of anal HPV-related disease in people living with HIV. EU Marie Skłodowska-Curie Actions programme.

Association between Dietary Vitamin A and HPV Infection in American Women: Data from NHANES 2003-2016.

Objective Evidence regarding the relationship between vitamin A and HPV infection was limited. Therefore, this study is designed to investigate whether vitamin A was independently related to HPV infection in 13412 American women from NHANES for seven cycles. Methods The present study is a cross-sectional study. A total of 13412 eligible participants who had available HPV tests and vitamin A intake data were registered in the NHANE database from 2003 to 2016. The targeted independent variable and the dependent variable were vitamin A measured at baseline and HPV infection, respectively. We analyzed the association between dietary vitamin A intake and the prevalence of HPV infection. Besides, GAM and smooth curve fittings were used to address the nonlinear relationship between vitamin A and HPV infection to determine the effect of HPV infection. Results The result of fully adjusted binary logistic regression showed vitamin A was not associated with the risk of HPV infection after adjusting confounders (odds ratio = 0.97, 95% confidence interval: 0.97–1.02). A nonlinear relationship was detected between vitamin A and HPV infection, whose inflection point was 10.5 of log2 vitamin A (by the recursive algorithm). One unit increase of log2 vitamin A is associated with the 10% reduced risk of HPV infection when dietary vitamin A is < 1448.155mcg. Conversely, when the dietary vitamin A intake is ≧1448.155 mcg, for each additional log2 of vitamin A, the risk of HPV infection increased by 70%. Conclusions We found that dietary vitamin A was quite different from the trend of HPV infection in different confidence intervals. The results suggested that an appropriate amount (95% CI: 0.9–1.0, <10.5 of log2 transformer, i.e., 1448.155 mcg) of dietary vitamin A may be beneficial to prevent HPV infection. However, excessive intake of dietary vitamin A (95% CI: 1.1–2.8, ≧10.5 of log2 transformer, i.e., 1448.155 mcg) may increase the risk of HPV infection.

Prevalence and Incidence of Human Papillomavirus Infection in Men Having Sex With Men Enrolled in a Pre-exposure Prophylaxis Study: A Sub-study of the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales "Intervention Préventive de l'Exposition aux Risques avec et pour les hommes Gays" Trial.

Human papillomavirus (HPV) infection is more frequent in men having sex with men (MSM) who are living with human immunodeficiency virus (HIV) than in MSM without HIV. There are currently no data regarding HPV infections in preexposure prophylaxis (PrEP)-using MSM. MSM living without HIV who were enrolled in the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales "Intervention Préventive de l'Exposition aux Risques avec et pour les hommes Gays" PrEP study were prospectively enrolled. Anal, penile, and oral samples were collected at baseline and every 6 months for HPV detection and genotyping. Anal swabs for cytology were obtained at baseline and at 24 months. We enrolled 162 participants. The prevalences of any HPV genotypes at baseline were 92%, 32%, and 12% at the anal, penile, and oral sites, respectively. High-risk (HR) HPV genotypes were observed in 84%, 25%, and 10% of anal, penile, and oral baseline samples, respectively. Nonavalent HPV vaccine genotypes were observed in 77%, 22%, and 6% of anal, penile, and oral baseline samples, respectively. Multiple infections were observed in 76%, 17%, and 3% of cases at the anal, penile, and oral sites, respectively. The most frequent HR genotypes were HPV 53, 51, and 16 in anal samples; HPV 33, 39, and 73 in penile samples; and HPV 66 in oral samples. The incidence of any HPV genotype at the anal site was 86.2/1000 person-months and the incidence of HR-HPV genotypes was 72.3/1000 person-months. The baseline cytology was normal in 32% of cases and was classified as atypical squamous cells of undetermined significance, low-grade squamous intra-epithelial lesion, high-grade squamous intra-epithelial lesion (HSIL), and atypical squamous cells that cannot exclude HSIL in 23%, 40%, 5%, and 1% of cases, respectively. PrEP users have a similar risk of HPV infection as MSM living with HIV and the risk is much higher than that previously reported in MSM living without HIV.

Prevalence of cervical HPV and attitude towards cervical screening in IBD patients under immunomodulatory treatment: a multidisciplinary management experience.

Therapeutic strategies for Inflammatory Bowel Diseases (IBD: Crohn's disease and Ulcerative Colitis) have improved but the risk for HPV infection in patients under immunomodulatory/biologic treatment is unclear. Objective of the study is to identify the attitude of patients and caregivers to cervical screening. To determine the prevalence of HPV and cervical lesions in IBD patients receiving immunomodulatory/biological treatment. IBD patients treated with immunomodulators were enrolled from November 2016 to September 2017, thanks to a multidisciplinary cooperation. A survey was administered to enrolled patients as well as to a selected network of IBD expert physicians. Patients who consented underwent gynecological examination, smear, HPV DNA test, colposcopy, vaginal and cervical microbiological swabs. 294 patients from AMICI Onlus Association, 119 patients from the hospital clinic, 30 doctors from national IBD centers participated to the survey. 19 patients from the IBD clinic underwent cervical screening. More than 90% of doctors consider their patients at risk of cervical cancer. A low prevalence of high-risk genotypes and related HPV lesions and an increased prevalence of bacterial vaginosis emerged in the studied population. Biological drugs could lead to a positive immunomodulation towards HPV infection. In IBD patients an alteration of the vaginal and intestinal microbiota seems to be coexisting.

Factors influencing intention to obtain the HPV vaccine and acceptability of 2-, 4- and 9-valent HPV vaccines: A study of undergraduate female health sciences students in Fujian, China

BackgroundLittle research has been conducted on the intention to obtain HPV vaccine now that the vaccine is approved for use in China. Acceptance of the three HPV vaccines, which differ in valency and price, has never been investigated. MethodsAn online cross-sectional survey assessing female undergraduate students’ intention to obtain the HPV vaccine and their acceptability of 2-, 4- and 9-valent HPV vaccines (2vHPV, 4vHPV, and 9vHPV, respectively). ResultsOf a total of 997 complete responses, 55.2% reported intent to obtain the HPV vaccine. Some of the significant factors exerting influence on intent to obtain HPV vaccination were high knowledge score (OR = 1.469, 95% CI:1.087–1.987), perceived high risk of HPV infection (OR = 1.466, 95%CI:1.017–2.114), perception of no serious side effects (OR = 1.562, 95%CI:1.150–2.121), and mass media exposure to HPV vaccination information (OR = 2.196, 95%CI: 1.625–2.966). Socioeconomic status indicators did not significantly influence intent to obtain the HPV vaccine. A higher proportion of respondents were willing to pay for 2vHPV (78.6%) and 4vHPV (68.0%) compared with 9vHPV (49.3%). Socioeconomic status indicators were the strongest correlates of acceptability for all the three vaccines. Exposure to mass media reporting about HPV vaccination is the factor which exerts the most influence on acceptance of 9vHPV after socioeconomic status indicators. ConclusionsIt is important to improve knowledge and health beliefs, and to establish a mass media marketing strategy to promote HPV vaccination in order to enhance HPV vaccine uptake. Undergraduate female students should be provided with detailed information about the different valency vaccine choices to help them make informed decisions about immunization.

Prevalence and Factors Associated with Human Parvovirus B19 Infection in Sickle Cell Patients Hospitalized in Tanzania.

BackgroundThe distribution of human parvovirus B19 (HPV B19) infection is ubiquitous and occurs worldwide. The virus has high tropism to red blood cells progenitor’s cells leading to temporary infection of bone marrow and transient arrest of erythropoiesis. People with frequent episodes of hemolytic anemia including sickle cell disease (SCD) and thalassemia are at increased risk of infection. This study aimed at assessing prevalence and factors associated with HPV B19 infections among hospitalized SCD patients.MethodologyThis was a cross-sectional hospital-based study among SCD patients hospitalized at Muhimbili National Hospital. HPV B19 was detected using RT-PCR. Hematological and Chemistry tests were done using Sysmex XT2000i and Chemistry analyzer respectively.ResultsA total of 329 SCD patients, median age 15 years (interquartile range 7–22 years) were tested for HPV B19. The prevalence of HPV B19 was 29%. In multivariate logistic regression model, HPV B19 infection was associated with pain (OR=4.28, 95%CI: 1.20–15.19; p=0.025), low neutrophil counts (OR=0.57, 95%CI: 0.35–0.92, p=0.022) and MCH (OR=0.92, 95%CI: 0.85–0.99; p=0.033). Individuals infected with HPV B19 had slightly higher prevalence of severe anaemia (30.4% vs. 20.3%, p=0.054) and HIV infection (6.0% vs. 2.1%, p=0.083) in the univariate analysis. Considering the effect of HPV B19 virus on spleen, aplastic anemia and platelet counts in SCD patients, our study did not find any association with these parameters (p=0.244; p= 0.205 and p=0.567 respectively).ConclusionThe prevalence of HPV B19 among hospitalized SCD patients at MNH was high. SCD patients with HPV B19 were more likely to present with pain, low neutrophils levels, and MCH. HIV infection might be associated with a high risk of HPV infection in SCD patients; however, this requires further investigation.

Human papillomavirus genotypes in women with invasive cervical cancer with and without human immunodeficiency virus infection in Botswana.

Cervical cancer remains a significant cause of morbidity and mortality in women worldwide and is the leading cause of cancer-related death in Botswana. It is well established that women with HIV have a higher risk of persistent HPV infection leading to cervical cancer. We assessed HPV prevalence and genotype distribution in 126 tissue specimens from confirmed invasive cervical cancer cases using Abbott real-time PCR assay. Overall, 88 (69.8%) women were HIV-infected. Fifty-seven (64.8%) of the HIV-infected women had a baseline CD4+ count ≥350 cells/μl, and 82 (93.2%) were on antiretroviral therapy at the time of cervical cancer diagnosis. The median age of HIV-infected patients was significantly younger than that of HIV-uninfected patients (p < 0.001). HPV DNA was detected in all of 126 (100%) of tissues analyzed in our study. The HPV genotypes identified included the HPV-16 (75.4%), HPV-18 (28.6%) and other high-risk (hr) HPV genotypes (16.7%). HIV infection was positively associated with the presence of the HPV-16 genotype (p = 0.036), but not with HPV-18 or with other high-risk (hr)-HPV genotypes. Thirty-three percent of the patients had multiple hr-HPV genotypes, with higher rates in HIV-infected women. These results highlight the importance and potential impact of large-scale HPV vaccination programs covering HPV-16 and HPV-18 genotypes in countries like Botswana with high burden of HIV infection.

Insights on HPV vaccination in the United States from mothers’ comments on Facebook posts in a randomized trial

ABSTRACT In the United States, parents’ health beliefs affect HPV vaccination decisions for children. Our team acquired insights into mothers’ health beliefs from their reactions and comments to posts on HPV vaccination in a social media adolescent health campaign in a randomized trial (n = 881 mothers; 63.1% reported daughters had 1+ doses of the HPV vaccine) evaluating communication intended to reduce daughters’ indoor tanning. A total of 10 HPV vaccination messages in didactic (n = 7) and narrative (n = 3) formats were posted on vaccination need, uptake, and effectiveness and stories of young women who died from cervical cancer and a mother’s decision to vaccinate her daughters. These posts received 28 reactions (like, love, and sad buttons; mean = 2.8 per post) and 80 comments (mean = 8.0 per post). More comments were favorable (n = 43) than unfavorable (n = 34). Data was not collected on views for posts. The most common favorable comment reported that daughters were vaccinated (n = 31). Unfavorable comments cited safety concerns, lack of physician support, distrust of pro-vaccine sources, and increased sexual activity of daughters. Mothers posting unfavorable (18.2%) as opposed to favorable (78.6%) comments or not commenting (64.0%) were less likely to have had their daughters vaccinated (chi-square = 22.27, p < 0.001). Favorable comments often did not state reasons for vaccinating. Concerns about lack of vaccine safety remain a barrier. Mothers may express distrust in pro-vaccine sources to reduce discomfort with not vaccinating daughters to reduce their risk for HPV infection. Many mothers who remained silent had vaccinated daughters, which suggests they did not resisit HPV vaccination.

Efficacy and safety of glucosaminylmuramyl dipeptide in treatment of human papillomavirus-associated diseases: a systematic review

Introduction.Human papillomavirus infection (HPV-infection) remains one of the most important health problems as it significantly reduces the quality of life and stigmatizes the patients. Also, the prevalence of cervical cancer – the most severe outcome of the HPV-infection is 5 % of the global burden of cancer. Although vaccination against human papillomavirus has been proved efficient, its availability in Russia continues to be limited. Therefore, it is important to review other methods of HPV-infection control. A number of studies have confirmed the efficacy of glucosaminylmuramyl dipeptide (GMDP) in the treatment of diseases associated with HPV-infection, but no systematic evaluation of these studies has been published in the available literature.Aim:to analyze the data on the efficacy and safety of GMDP in the treatment of diseases and conditions associated with HPVinfection.Materials and methods.We used the PRISMA approach. The search for the relevant publications was conducted in international scientific databases: the Scientific Electronic Library, the Google Scholar, the ScienceDirect, the Cochrane Community Library, the Pubmed/MEDLINE, and clinical research registries. For this systematic analysis, only full-text publications were used. We evaluated the reliability of evidence and the methodological quality of the studies.Results.We used the following search queries: "glucosaminyl-muramyl dipeptide", "glucosamine L'muramyl dipeptide", "H-acetylglucosaminyl-H-acetylmuramyl dipeptide", "GMDP", "Licopid" (both in Russian and English transcriptions). Based on the results of the screening, 14 full-text publications were selected. At the final stage, review articles with secondary data were excluded; also excluded were original articles published in doubtful resources and those with an unclear status of peer reviewing. This systematic analysis includes 7 publications of acceptable methodological quality. Here, we summarize the consistent conclusions derived from these reports: the addition of therapy with GMDP to local (surgical) methods increases the efficacy of treatment and the duration of remission; destruction of condylomas is more effective when combined with the course of GMDP as compared to using the local destruction alone; GMDP enhances the production of cytokines that have a direct antiviral and antiproliferative effect in HPV-infection (interleukin-1, tumor necrosis factor alpha, gamma-interferon); GMDP causes normalization of cellular and humoral immunity (T-lymphocytes, T-cytotoxic lymphocytes, B-lymphocytes, CD3+, CD4+, CD8+, CD16+, and CD72+ lymphocytes, as well as the production of serum immunoglobulins IgA, IgG, and IgM). A high safety profile of GMDP is evidenced from the absence of reports on adverse events.Discussion.The recommendation for the inclusion of GMDP into a comprehensive treatment for HPV-infection in addition to local interventions is a strong recommendation. The differences between the Russian and international approaches can be explained by the difference in the available resources and funding. We propose to test whether using GMDP for reducing the risk of recurrent HPV-infection is beneficial in terms of pharmacoeconomics. Conclusion. The high efficacy and safety of GMDP in the combined therapy of HPV-infection has been confirmed. Further carefully designed studies on GMDP are needed.

3112 Factors Associated with Hesitancy of Human Papillomavirus Vaccination Among Latina Immigrant Mothers Despite Physician Recommendation

OBJECTIVES/SPECIFIC AIMS: The purpose of this study was to examine factors associated with Latina immigrant mothers’ hesitancy in having their 9-12 year old daughters vaccinated against HPV despite a physician recommendation. METHODS/STUDY POPULATION: The data analyzed for this study was from a previous effort that examined the efficacy of an intervention to promote HPV vaccination among daughters (9-12 years of age) of Latina immigrants (N=317) through a randomized trial. Baseline data among Latina immigrant mothers with unvaccinated daughters was collected prior to this intervention. Participants were surveyed on sociodemographic characteristics, knowledge and perceptions of cervical cancer and HPV, and intention to vaccinate their daughters with the HPV vaccine if recommended by the daughter’s physician. RESULTS/ANTICIPATED RESULTS: Out of 317 participants, 205 reported willingness to vaccinate following a physician recommendation (64.7%) while 112 reported hesitancy (defined as an answer of “maybe”) to vaccinate their daughters (35.3%). None of the participants indicated “no”. No sociodemographic factors were significantly associated with vaccine hesitancy except for the daughter’s health insurance status (p = 0.03). A significant difference existed in the mother’s perceived risk of cervical cancer in herself based on hesitancy and willingness to vaccination (p &lt; 0.001). Mother’s awareness of HPV (p &lt; 0.0001), knowledge of HPV (p &lt; 0.01), her perceived risk of HPV infection in herself (p &lt; 0.01) and in her daughter (p &lt; 0.0001), and her worry about her daughter being infected with HPV (p = 0.02) were also significant. Finally, there were differences among mothers in confidence of being able to have their daughters complete all three doses of the vaccine (p &lt; 0.0001), and having the time (p &lt; 0.0001) and the money (p &lt; 0.0001) to complete the vaccination series. Factors that were significant in the univariate analysis were then incorporated into a binary logistic multivariable regression. HPV knowledge score was excluded from this analysis due to its limited sample size (n = 169). The five variables that were strongly associated with the outcome of vaccine hesitancy included: HPV awareness, mother’s perceived risk of HPV infection in their daughter, confidence in the ability to receive all three shots in vaccine series, confidence in being able to afford the vaccine series, and daughter’s health insurance. All were positively correlated with intention to vaccinate except for daughter’s health insurance status. DISCUSSION/SIGNIFICANCE OF IMPACT: Despite research showing Latinos are pro-vaccination and the association between HCP provider recommendation and vaccine acceptability among parents, over 35% of Latina immigrant mothers in our study were still hesitant about having their daughters vaccinated against HPV following a physician recommendation. Factors that strongly contributed to this hesitancy included HPV awareness, mother’s perceived risk of their daughter being infected with HPV, self-efficacy (ability to receive all required shots and finding time to complete the HPV vaccination series), and daughter’s health insurance status. These results indicate that HCP recommendation may be not enough of a driving factor to motivate Latina immigrant mothers to vaccinate their daughters against HPV. Further research efforts should focus on heightening perceived risk of HPV infection, improving knowledge of HPV, and boosting their self-efficacy to get their children vaccinated against HPV.

Influence of human Papilloma Virus (hPV) infection on early pregnancy.

HPV infection in early pregnancy may be a cause of miscarriage. Pregnancy significantly increases the risk of HPV infection. While ascending intrauterine infection with colonization of the trophoblast is commonly observed, descend- ing hematogenous infection should also be considered. The aim of the study is to assess the prevalence of HPV infection and its influence on pregnancy. The study was conducted in the years 2010-2015 on a group of 143 pregnant women. The study group consisted of 84 women with abnormal course of the first trimester of pregnancy. The control group consisted of 59 women with normal pregnancy who delivered healthy neonates. Samples of cervix tissue along with samples of tropho- blast or placenta were taken for the study. The presence and genotype of the HPV virus were detected using a BIOTOOL B&M Labs set. Statistical analysis was conducted using R software. The rate of HPV infection in the entire studied population was 13% (19/143): the virus was confirmed in 18% (15/84) of patients in the study group and in 7% (4/59) of the control group. HR HPV was detected in 13 patients in the study group and three patients in the control group. HR HPV infection was more frequent in patients with an abnormal course of the first trimester of pregnancy (p = 0.03). HR HPV trophoblast infection was found only in patients in the study group (p = 0.02). In two members of the study group, the HPV virus was found in the trophoblast only. The obtained results may confirm the presence of adverse effects of HPV infection on early pregnancy. HR HPV trophoblast infection was observed only in women with 1st trimester complications. The presence of HPV only in trophoblast samples in some patients may suggest a descending - hematogenous route of primary infection.