Identification of a novel human papillomavirus (HPV97) related to HPV18 and HPV45

Human papillomavirus (HPV) type 97 was identified and the genome was cloned from cervicovaginal cells of a Costa Rican woman with a normal Pap smear. The HPV97 L1 open reading frame (ORF) was most closely related to HPV45 (84% identity) and HPV18 (79% identity), placing it into the high-risk alpha7 species. Ectopic expression of the HPV97 E6 and E7 proteins significantly decreased steady state p53 and pRb levels using an in vitro cotransfection assay, respectively. These data suggest that HPV97 shares a most recent common ancestor with HPV18 and HPV45 and should be evaluated in cancer specimens from different geographic populations.     

Knowledge towards HPV infection and HPV vaccines among Syrian mothers

Cervical cancer is caused by HPV infection and can be prevented by early vaccination. Objective: To assess Syrian women’s level of knowledge and determinants of good knowledge of cervical cancer, HPV infection and its vaccines. Methods: A cross sectional survey was undertaken among mothers with daughters in sixth grade classes enrolled in primary schools in Aleppo city, Syria. Samples were selected through cluster sampling and data collected using a self-administered questionnaire. Results: Less than a third of the mothers had heard of HPV infection and vaccines against cervical cancer and levels of knowledge were generally low. Good knowledge was associated with high education level, higher family monthly income, having few - less than four children, positive history of cervical cancer screening, and working or having relatives working in the medical field. The main source of information was television and few reported health care providers as a source of knowledge on HPV infection and vaccine. Conclusion: Since knowledge of HPV infection and its connection with cervical cancer and its vaccine are low, more efforts must be made to educate Syrians prior to introduction of any HPV vaccination programme. Public health efforts must focus on educating mothers, the public as well as health care providers.     

子宫颈癌患者人乳头瘤病毒16、18检测

 目的　探讨人乳头瘤病毒（HPV）16、18型在子宫颈癌的发生、发展中的意义。方法　应用实时荧光定量聚合酶链反应技术对子宫颈原位癌13例，子宫颈癌Ⅰ期32例，子宫颈上皮内瘤样病变（CIN）Ⅰ~Ⅱ级12例，对照组54例（慢性子宫颈炎组37例、非研究疾病组17例）进行HPV16、HPV18型荧光基因定量检测，计算出HPV DNA的拷贝数。结果　研究组、对照组HPV16、HPV18的感染率差异有统计学意义（P＜0.05），在子宫颈癌发生的不同阶段，HPV16、HPV18的感染定量差异亦有统计学意义。子宫颈癌HPV含量与肿瘤直径大小、浸润间质深度、淋巴结阳性个数无相关性（r = 0.168， r = 0.280， r = 0.333，P＞0.05）；局部肿瘤的直径大小与浸润间质深度呈正相关（r = 0.473，P＜0.05）。结论　致癌性HPV的持续、高浓度存在是子宫颈癌发生、发展的主要因素之一。     

HPV and cancer

Human papillomavirus (HPV) has been largely demonstrated involved in the pathogenesis of several intraepithelial lesions and cancers. The role of HPV in the carcinogenesis of intraepithelial and invasive anogenital lesions is currently well established, characterized by integrated DNA HPV inside the lesions. HPV genotypes are classified according to their risk of oncogenesis and HPV16 remains the most common and higher oncogenic types. HIV-infected patients have a higher rate of HPV infection with a higher persistence and higher viral loads than general population, which can explain the increasing risk of cancers in such patients. However, independently of HIV infection, HPV infections seems to be strongly associated with several neoplasms, including head and neck, oral, cervical, anal, vulvar, vaginal cancers and probably some lung cancers. Paradoxically, little information about the immunity role and virological factors involved in the occurrence and outcome of HPV epithelial lesions are currently available, leading to more effective and biological approaches, in this HPV infection setting.     

北京市社区妇女人乳头瘤病毒感染率及其对HPV和疫苗认知情况的调查分析

[目的]评估北京市社区妇女人乳头瘤病毒（HPV）的感染率;调查社区人群对HPV的认知情况以及对HPV疫苗接种的态度。[方法]采用横断面调查方法,对北京市展览路社区15￣54岁女性进行HPV认知和流行病学问卷调查,并留取了宫颈脱落细胞或会阴部标本进行HPV DNA检测。[结果]1013名女性接受了问卷调查,832例HPV DNA检测结果纳入了统计学分析。HPV总检出率为15.38%,高、低危型HPV感染率分别为13.34%和3.25%,同时感染高、低危型HPV的检出率为1.20%。1013名调查对象中有30.7%听说过HPV,其中51.78%知道HPV感染与宫颈癌有关;HPV的知晓率与年龄和教育程度有关（P〈0.05）;经过简单宣教后,75.91%愿意接种HPV疫苗。[结论]北京市社区妇女HPV现患率较高,对HPV的知晓率也较高。开展公众健康教育,提高人群的认识水平是疫苗计划获得成功的关键因素。     

Possible Epithelial Ovarian Cancer Association with HPV18 or HPV33 Infection

The present study was conducted to investigate the prevalence of HPV infection in epithelial ovarian cancer (EOC) in Hunan province. DNA samples were collected from paraffin embedded ovarian tissue from 322 patients with EOC, 99 with ovarian benign tumors and 199 normal persons. The polymerase chain reaction and direct sequencing were used to identify the HPV types in the samples. The relationship between the infection of human papillomavirus (HPV) and the epithelial ovarian carcinoma (EOC) was investigated combined with clinical data. The prevalence of HPV18 and HPV33 in EOC group and benign group was higher than in the normal group. HPV18 and HPV33 may play a role in the development of both EOC and ovarian benign tumor and may participate in the development of EOC with traditional risk factors, family history and abortion, possibly exerting synergistic effects.     

HPV与肛门肿瘤

人乳头状瘤病毒（HPV）感染作为一种重要致癌因素越来越受到广泛的重视，在不同类型肿瘤中的相关研究也竞相展开。以往的流行病学证据显示肛门肿瘤的发生与HPV高危亚型的感染相关，HPV检测方法的标化及前瞻性临床实验的开展将有助于进一步阐明肛门部位HPV感染的自然史以及与肛门癌发生发展的关系。     

HPV infection in Europe

In order to estimate the impact of primary cervical cancer screening with human papillomavirus (HPV) testing, and implementation of the current HPV vaccines, we have summarised the most recent and largest HPV studies in Europe. Eighteen studies including between 897 and 46,900 women from 14, mostly Northern and Western European, countries were included. Everywhere, high-risk (HR) HPV prevalence peaked before age 25 or 30 years with steady declines thereafter. For women in the 30–64-year age-range, for whom primary HPV testing is considered, age-adjusted HR HPV prevalence ranged from 2% in Spain to approximately 12% in Belgium and France, where sustained elevated levels were found in women aged ?35 years. HPV16 and 18, the two HR types prevented by current HPV vaccines, accounted for 30% (range 19–43%) and 12% (range 0–22%) of all HR HPV positives, respectively, and varied according to the presence of cervical lesions. Based on an updated meta-analysis of HPV type distribution in the whole of Europe, HPV16 and/or 18 are estimated to be present in 52%, 61% and 76% of cytologically detected high-grade squamous intraepithelial lesions, histologically confirmed cervical intraepithelial neoplasia grade 2/3, and invasive cervical carcinoma, respectively.     

Knowledge of Pap smear, HPV and the HPV vaccine and the acceptability of the HPV vaccine by Thai women

Aims: The primary prevention for cervical cancer, a human papilloma virus (HPV) vaccine, has been available in Thailand for almost 3 years. The present study evaluates knowledge about the Papanicolaou (Pap) smear, HPV and the HPV vaccine and focuses on identifying predictors for the acceptability of the HPV vaccine. Methods: A sample of 764 women attending the gynecology clinic at Ramathibodi Hospital, Bangkok, was asked to answer a questionnaire on their personal background, their knowledge of the Pap smear and HPV and the HPV vaccine and the acceptability of the HPV vaccine for themselves and their daughters. Results: Knowledge of the Pap smear (96%) is higher than that of HPV (41%) and the HPV vaccine (36%). Only 40% of participants had previously heard about HPV. The acceptability of the HPV vaccine for participants and their daughters was high, 77% and 84%, respectively. Knowing about HPV increases acceptance for the HPV vaccine (adjusted OR = 1.7, 95% CI = 1.2–2.5, in the participants and OR = 2.3, 95% CI = 1.5–3.6 in their daughters). Participants younger than 45 years old (OR = 2.3 and 95% CI = 1.6–3.4 for themselves; OR = 2.2 and 95% CI = 1.4–3.3 for their daughters) were more likely to accept the vaccination than those aged 45 years old and above. Conclusion: Knowledge about HPV and the HPV vaccine is generally poor in Thai women. However, the acceptability of the HPV vaccine is good. Knowing about HPV and age under 45 years predict the acceptability of the HPV vaccine.     

HPV与肛门肿瘤

人乳头状瘤病毒(HPV)感染作为一种重要致癌因素越来越受到广泛的重视,在不同类型肿瘤中的相关研究也竞相展开.以往的流行病学证据显示肛门肿瘤的发生与HPV高危亚型的感染相关,HPV检测方法的标化及前瞻性临床实验的开展将有助于进一步阐明肛门部位HPV感染的自然史以及与肛门癌发生发展的关系.     

Molecular cloning of two new HPV types (HPV 37 and HPV 38) from a keratoacanthoma and a malignant melanoma

Several benign and malignant skin tumors were analyzed for the presence of human papillomavirus (HPV) DNA. By hybridization with different HPV DNA probes under non-stringent conditions (Tm -40 degrees C), two tumors were found to contain HPV-specific DNA sequences in high copy numbers: (1) a keratoacanthoma from a patient who also suffered from a basalioma; (2) a superficial spreading malignant melanoma of an immunosuppressed patient. For further analysis of these DNA sequences genomic libraries from both tumor DNAs were constructed and, out of these, 4 different HPV DNA types have been cloned. By cross-hybridization experiments and restriction map analysis HPV 9 DNA was identified in the keratoacanthoma whereas HPV 17a DNA could be cloned from the malignant melanoma. From each tumor one additional HPV-type not identical to other known HPV-types was cloned. These isolates are closely related to HPV 9, 15, 17, 22 and 23. A physical map of both HPV DNAs was constructed. Size (7.8 kbp), co-linear alignment to HPV 16, cross-hybridization with other HPV-types under conditions of low stringency and monomeric episomal state of the HPV molecules indicate that these two DNA probes represent new HPV types that have been tentatively designated as HPV 37 (keratoacanthoma) and HPV 38 (malignant melanoma). None of these two HPV types could be found in any other of 231 tumor DNAs originating from different tissues.     

HPV6／HPVll型病毒在儿童复发性呼吸道乳头状瘤中的表达

目的研究儿童复发性呼吸道乳头状瘤（juvenile onset recurrent respiratory papillomatosis，JORRP）的患儿首次发病及完全治愈时肿瘤组织中HPV6型和HPVl1型病毒含量的表达变化以及其病毒感染率。方法收集从首次发病到完全治愈的JORRP患儿29例，分别取每例患儿首次发病及治愈时的标本，采用qRT．PCR法分别测定其首次发病及完全治愈时乳头状瘤组织标本中HPV病毒的含量。结果①首次发病组与治愈组HPV6型与HPVl1型病毒qRT—PCR相对定量结果的差异均无统计学意义（P〉0．05）。②首次发病组与治愈组HPV6型病毒感染的总体阳性率相同（P〉0．05）；HPVll型病毒感染的总体阳性率不同（P〈0．05）。结论①完全治愈组与首次发病组的JORRP患儿相比，HPV6型与HPVll型病毒量的表达并无明显变化。②首次发病组的患儿均有HPVll型病毒感染，治愈组的患儿HPVll型病毒感染率有所下降。     

HPV and Cervical Cancer Epidemiology - Current Status of HPV Vaccination in India

Cervical cancer (CaCx) is the second most fatal cancer contributing to 14% of cancers in Indian females, which account for 25.4% and 26.5% of the global burden of CaCx prevalence and mortality, respectively. Persistent infection with high-risk human papilloma virus (HPV- strains 16 and 18) is the most important risk factor for precursors of invasive CaCx. Comprehensive prevention strategies for CaCx should include screening and HPV vaccination. Three screening modalities for CaCx are cytology, visual inspection with acetic acid, and HPV testing. There is no Indian national policy on CaCx prevention, and screening of asymptomatic females against CaCx is practically non-existent. HPV vaccines can make a major breakthrough in the control of CaCx in India which has high disease load and no organized screening program. Despite the Indian Government's effort to introduce HPV vaccination in the National Immunization Program and bring down vaccine cost, challenges to implementing vaccination in India are strong such as inadequate epidemiological evidence for disease prioritization, duration of vaccine use, parental attitudes, and vaccine acceptance. This paper reviews the current epidemiology of CaCx and HPV in India, and the current status of HPV vaccination in the country. This article stresses the need for more research in the Indian context, to evaluate interventions for CaCx and assess their applicability, success, scalability and sustainability within the constraints of the Indian health care system.     

Concordance in Cervical HPV Detection between Hybrid Capture 2 and HPV GenoArray Tests

HPV type-specific detection may promote cervical screening program and vaccination developmentworldwide. We conduct a study comparing HPV Hybrid capture II (HC II) Test and Hybribio GenoArray test,a newly developed HPV type-specific assay, in patients with cervical epithelial neoplasm. Results showed agood concordance in cervical HPV detection between two tests (kappa value 0.80, p<0.05, McNemar test). Ourstudy may promote utilization of type-specific HPV detection that is helpful for cervical cancer screening andvaccination.     

HPV prevalence and accuracy of HPV testing to detect high-grade cervical intraepithelial neoplasia

Concern was raised on using testing for high-risk (HR) human papillomavirus (HPV) in cervical cancer screening in populations where HPV prevalence is high. The impact of HR HPV prevalence on the efficiency of HPV test-based screening has never been directly evaluated. A meta-regression of the relationship between HR HPV prevalence and the specificity and positive predictive value (PPV) of HPV DNA testing for the presence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was performed. Only studies that used Hybrid Capture 2 (HC2) were included. Country income (low-medium vs. high) was used as a proxy of previous screening. Twenty-six populations from 20 studies were included. For a 10% increase in HR HPV prevalence, HC2 specificity decreased by 8.41% [95% confidence interval (CI): 8.02-8.81], whereas PPV increased by 4.74% (95% CI: 2.45-7.03). HR HPV prevalence explained 98% of the variability in HC2 specificity and 38% of the variability in PPV. Country income did not affect specificity, but low-medium income was associated with higher PPV (3.81%; 95% CI: 1.53-6.10) after adjustment for HR HPV prevalence. When HR HPV prevalence is high, the specificity of HPV testing for CIN2+ decreases, but PPV does not decrease and it is high in inadequately screened populations. The number of HPV-positive women needing further assessment or treatment per CIN2+ case detected will therefore decrease and screening efficiency will improve. This is explained by the fact that HR HPV causes CIN2+: an increase in HR HPV prevalence is inevitably accompanied by an increase in CIN2+.