Incidence of cervical intraepithelial neoplasia in women infected with human immunodeficiency virus (HIV) with no evidence of disease at baseline: Results of a prospective cohort study with up to 6.4 years of follow-up from India

We report the incidence of cervical intraepithelial neoplasia (CIN) among HIV-infected women who did not have any colposcopic or histopathological evidence of CIN at baseline. Of the 1,023 women without any CIN at baseline, 855 (83.6%) have been followed up to a maximum of 6.4 years contributing 2,875 person years of observation (PYO). Among these 855 women, 54 cases of any CIN were observed resulting in incidence rate of any CIN of 1.9 per 100 PYO. The median time for follow-up for women with any CIN was 3.0 (IQR 1.6–3.7) years. The cumulative incidence rate per 100 PYO of CIN 2 or worse lesion in women with HPV-18 infection at baseline was 13.3% (95% CI 5.1–26.8); in women with HPV-16 infection was 10.8% (95% CI 4.4–20.9); in women with HPV-31 infection was 4.2% (95% CI 0.9–11.7); and in women with other high-risk HPV infections was 5.4% (95% CI 2.6–9.7). HPV-18 infection at baseline contributed highest frequency of incident CIN 2 or worse lesions followed by HPV-16 infection; however, other high-risk HPV types were also responsible for substantial number of incident CIN. The elevated risk of CIN2+ disease in the study cohort was non-significant in women with CD4 count <200, possibly because of the small number of cases. Our results emphasize the need for regular cervical cancer screening of HIV-infected women and urgent implementation of cervical cancer screening services in HIV programs in India and other low and middle-income countries.     

Detection of High-risk Human Papillomavirus Types 16 and 18 but not 33 and 52 in External Genital Warts from Iranian Females

Background: External genital warts (EGW) are relatively common sexually transmitted diseases. In themajority of cases, low-risk human papilomaviruses (HPV), such as HPV-6 and HPV-11, are responsible but,high-risk types may also be detected and this has a bearing on vaccines for cervical cancer prevention. In thisstudy the incidence of the high-risk HPV types 16, 18, 33 and 52 in EGWs of females from the southwest of Iranwas assessed. Methods: Seventy-nine women with EGWs participated in this study. Quantitative real-time PCRwith gene specific primers and probes for the E6 gene of HPV-16, 18, 33 and 52, were used for the detection ofHPV DNA in the tissue and blood samples. Results: Of the 79 tissue specimens, 13 (16.5%) were HPV positive,only genetic materials of HPV-16 and HPV-18 being detected, twelve patients (15.2%) were positive only forHPV-18 and the coexistence of HPV-16 and HPV-18 was shown in one patient. Only one plasma sample showedevidence of HPV-16 with very low viral load. Conclusion: Our data showed that high-risk HPV types can befound in the tissue specimens of EGW samples obtained from female patients in the Southwest of Iran, withHPV-18 as the most abundant type; however, additional studies with a larger population are required to provethe finding and help to determine the most appropriate type of virus for vaccine design for Iranian women.     

Prospective Study of Antibody to Human Papilloma Virus type 16 and Risk of Cervical, Endometrial, and Ovarian Cancers (United States)

Objective: Human papilloma virus (HPV) is frequently detectable in cancers of the cervix, vagina, and vulva, but its role in endometrial and ovarian cancers is less certain. This analysis aimed to examine the association of presence of HPV type 16 (HPV-16) antibodies with subsequent risk of cervical, endometrial, and ovarian cancers. Methods: In a prospective study enrolling over 15,000 pregnant women, pre-cancer sera from women who developed cervical (n = 83), endometrial (n = 34), and ovarian (n = 35) cancers were compared with sera from 172 control women frequency-matched by age group and race. Results: HPV-16 seropositivity (OR = 2.0, 95% CI 1.0–3.4) was associated with cervical cancer, with the association more prominent for cancers occurring within 10 years of serum sampling (OR = 2.3, 95% CI 1.0–5.3) than cancers occurring later (OR = 1.6, 95% CI 0.75–3.6). Overall, the associations between HPV-16 seropositivity and endometrial (OR = 1.6, 95% CI 0.64–3.8) and ovarian cancers (OR = 1.1, 95% CI 0.43–2.8) were not significant, although the odds ratios for those cancers occurring within 20 years after serum sampling were similar to that for cervical cancer (OR = 2.2 for both). Conclusions: Our results confirm that HPV-16 infection precedes the development of cervical cancer. Predictability of HPV-16 seropositivity for risk of other female cancers warrants further investigation.     

HIV infection increases the risk of squamous intra-epithelial lesions in women with HPV infection: An analysis of HPV genotypes

We assessed the association between different HPV genotypes, HIV infection, and cervical squamous intra-epithelial lesions (SIL) in 236 women with known HIV serostatus enrolled in a longitudinal multicentric study in Italy. Of these women, 135 were HIV-infected, and were not markedly different from HIV-negative women with regard to demographic characteristics, sexual practices, smoking, or intravenous drug use. We obtained 232 cervical smears suitable for cytological examination and HPV-genotype analysis (134 from HIV-positive women and 98 from HIV-negative women). For 86 HIV-positive and 89 HIV-negative women, the smears appeared normal at cytomorphological analysis. Cytological dysplasia of varying degrees was detected in 48 smears from HIV-positive women and in 9 from HIV-negative women. HPV prevalence, assessed using polymerase-chain-reaction analysis, did not significantly differ between HIV-positive and HIV-negative women. The prevalence of HPV-associated SIL was much greater among HIV-infected women. The most frequently detected genotypes in both groups were HPV 16 and HPV 18. The prevalence of HPV 16 among HIV-positive women was similar to that for HIV-negative women; this was also true for HPV 18. However, in the HIV-positive group, most of these genotypes were associated with SIL. HIV-positive women showed a wider spectrum of genotypes, including non-oncogenic and rare types. An association between SIL and HIV infection was confirmed for all HPV genotype classes. Int. J. Cancer 72:982–986, 1997. © 1997 Wiley-Liss, Inc.     

Type-specific Prevalence of Human Papillomavirus by Cervical Cytology among Women in Brasov,Romania

The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination andHPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPVtypes. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.     

Prevalence and Distribution of High- and Low- Risk HPV Genotypes in Women Living in the Metropolitan Area of Naples: A Recent Update

Introduction: Human papillomavirus (HPV) can infect both male and female genitals, skin, and mucous membranes, causing benign or malignant lesions. HPV is a common sexually transmitted infection and it is the main cause of cervical cancer. The present retrospective study updated the previously published data on HPV genotypes distribution among women living in Naples. Materials and methods: In this study, 502 cervical scrape specimens were collected from women with abnormal cytological indication and analyzed for HPV DNA identification by Linear Array HPV genotyping test. Results: The HPV infection rate was 24.1%. HPV-16 (14.6%) was the most representative HR-HPV genotypes, followed by HPV-31 (13.8%), -18 (9.2%), and HPV-51 (8.5%). In addition, HPV-42 (16.4%) was the most prevalent genotype among LR-HPV  genotypes (low-risk human papillomavirus). It was also found that women at the age group of 23-29 years (42.5%) were at the highest risk of HPV infection. It was found that the HPV-16 frequency decreased, but HPV-31 and -18 frequency increased a little. The LR HPV-53 frequency decreased, leaving the first place for abundance to the LR HPV-42. HPV-6 frequency did not change. LR HPV -11 was no more present. Merging <23 and 23-29 age classes into one class followed the same result. Conclusion: HPV prevalence declined in comparison to the previous data. A frequency variation was recorded for several genotypes in this study.  Data can be useful to implement the preventative strategies and to promote HPV vaccination.     

Prevalence of human papillomavirus infection and phylogenetic analysis of HPV-16 E6 variants among infected women from Northern Brazil

Background

The main cause of cervical cancer in the world is high risks human papillomavirus infection (mainly represented by HPV-16 and HPV-18), that are associated to the development of malign transformation of the epithelium. HPV prevalence exhibits a wide geographical variability and HPV-16 variants have been related to an increased risk of developing cervical intraepithelial lesion. The aim of this study was to describe DNA-HPV prevalence and HPV-16 variants among a women population from Northern Brazil.

Methods

One hundred and forty three women, during routine cervical cancer screening, at Juruti Project, fulfilled an epidemiological inquiry and were screened through a molecular HPV test. HPV-16 variants were determined by sequencing the HPV-16 E6 open reading frame.

Results

Forty two samples were considered HPV positive (29.4%). None of those had abnormal cytology results. HPV prevalence varied between different age groups (Z(U)?=?14.62; p?=?<0.0001) and high-risk HPVs were more frequent among younger ages. The most prevalent type was HPV-16 (14%) and it variants were classified, predominantly, as European (87.5%).

Conclusions

HPV prevalence in our population was higher than described by others and the most prevalent HPV types were high-risk HPVs. The European HPV-16 variant was the most prevalent among HPV-16 positive samples. Our study reinforces the fact that women with normal cytology and a positive molecular test for high-risk HPVs should be submitted to continuous follow up, in order to verify persistence of infection, promoting an early diagnosis of cervical cancer and/or its precursors.

     

Variability of high risk HPV genotypes among HIV infected women in Mwanza,Tanzania- the need for evaluation of current vaccine effectiveness in developing countries

Background

High risk (HR) human papilloma Virus (HPV) genotypes have been associated with cervical cancer. In Tanzania there is a limited data on the epidemiology of HPV and genotypes distribution among HIV infected women. Here we document varieties of HPV genotypes associated with cervical squamous intraepithelial lesions (SIL) among HIV- infected women at Bugando Medical Centre, Mwanza-Tanzania.

Methods

A cross sectional hospital based study involving HIV infected women was conducted between August and October, 2014. Exfoliated cells from ectocervix and endocervix were collected using cytobrush. HPV genotypes were detected using polymerase chain reaction (PCR) followed by sequencing using specific primers targeting broad range of HPV types. Cytology was done to establish squamous intraepithelial lesions. Log binomial regression analysis was done to establish risk ratios (RR) associated with HPV infection using STATA version 11.

Results

A total of 255 HIV infected women with mean age 39.2?±?9.1 years were enrolled in the study. HPV DNA was detected in 138/255 (54.1 %, 95 % CI: 47-60) of HIV infected women. Twenty six genotypes were detected in various combinations; of these 17(65.3 %) were of HR genotypes. HR genotypes were detected in 124(48.6 %) of HIV infected women. Common HR genotypes detected were HPV-52(26), HPV-58(21), HPV-35(20) and HPV-16(14). The risk of being HPV positive was significantly higher among women with CD4 counts <100 (RR: 1.20, 95 % CI: 1.05-1.35, P?=?0.006) and women with SIL (RR: 1.37, 95 % CI: 1.11-1.68, P?=?0.005)

Conclusion

Significant proportion of HIV infected women with low CD4 counts have various grades of cervical SIL associated with varieties of uncommon HR genotypes. There is a need to evaluate the effectiveness of the current vaccine in preventing cervical cancer in developing countries where HIV is endemic.

     

Immunoglobulin-A and -G responses against virus-like particles (VLP) of human papillomavirus type 16 in women with cervical cancer and cervical intra-epithelial lesions

Immunoglobulin-A and -G (IgA and IgG) responses against HPV-16-like particles (VLP) were tested by ELISA in 104 women with cervical abnormalities, 26 atypical cells of undetermined significance (ASCUS) and 14 cytologically normal women with HPV DNA. As controls, 130 age-matched cytologically normal women with no HPV DNA were selected from the population in which the cases were generated. The existence of HPV DNA in cervical samples was tested by a PCR-based method. The normal women positive with HPV16 DNA were followed up at 4- to 7-month intervals for 16 to 24 months. IgA and IgG antibodies against HPV-16 VLP were frequently detected in these women repeatedly positive with HPV-16 DNA, suggesting that persistent HPV infection is crucial for effective antibody responses against the viruses. IgA response appears earlier and persists longer than IgG response. Women with HPV DNA of types 16, 31/33/35, 58 and unknown types showed significantly higher seropositivity for both IgA and IgG antibodies than the controls (p < 0.05 for both). No significant seropositivity for IgA or IgG was detected in the HPV-18/45-DNA-positive group. HPV 31/33/35, 58 appear to be types close to HPV 16, whereas HPV 18/45 appears to be distinct from HPV 16 in antigenicity. IgA and IgG responses against HPV-16 VLP were more frequently observed in women with normal cervices with HPV DNA, ASCUS, HSIL and cervical cancer than in the controls. Strong IgA and IgG responses depended on HPV-16 infection in HSIL and cervical cancer, but there was no correlation between the serological responses and the status of HPV DNA in ASCUS and LSIL. Antibody positivity reflects persistent viral infection that may increase the risk for malignant progression of the cervix. This serological assay using HPV 16-VLP may therefore be useful as a new diagnostic tool supplementing cervical cytological tests. Int. J. Cancer 75:529–535, 1998.© 1998 Wiley-Liss, Inc.     

Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso

Human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions (SILs) were studied in 379 high-risk women. Human papillomavirus DNA was detected in 238 of 360 (66.1%) of the beta-globin-positive cervical samples, and 467 HPV isolates belonging to 35 types were identified. Multiple (2-7 types) HPV infections were observed in 52.9% of HPV-infected women. The most prevalent HPV types were HPV-52 (14.7%), HPV-35 (9.4%), HPV-58 (9.4%), HPV-51 (8.6%), HPV-16 (7.8%), HPV-31 (7.5%), HPV-53 (6.7%), and HPV-18 (6.4%). Human immunodeficiency virus type 1 (HIV-1) seroprevalence was 36.0%. Human papillomavirus prevalence was significantly higher in HIV-1-infected women (87 vs 54%, prevalence ratio (PR) = 1.61, 95% confidence interval (CI): 1.4-1.8). High-risk HPV types (71 vs 40%, PR = 1.79, 95% CI: 1.5-2.2), in particular HPV-16+18 (22 vs 9%, PR = 2.35, 95% CI: 1.4-4.0), and multiple HPV infections (56 vs 23%, PR = 2.45, 95% CI: 1.8-3.3) were more prevalent in HIV-1-infected women. High-grade SIL (HSIL) was identified in 3.8% of the women. Human immunodeficiency virus type 1 infection was strongly associated with presence of HSIL (adjusted odds ratio = 17.0; 95% CI 2.2-134.1, P = 0.007) after controlling for high-risk HPV infection and other risk factors for HSIL. Nine of 14 (63%) HSIL cases were associated with HPV-16 or HPV-18 infection, and might have been prevented by an effective HPV-16/18 vaccine.     

Occurrence of vaccine and non-vaccine human papillomavirus types in adolescent Finnish females 4 years post-vaccination

Control of human papillomavirus (HPV)-related cancers by inclusion of HPV vaccination into national vaccination programmes is likely. One open question is replacement of the vaccine types with other high-risk (hr) HPV types in the vaccination era. We studied occurrence of HPV types in adolescent females participating in a population-based vaccination trial. A total of 4,808 16- to 17-year-old females from Finland were enrolled in the 1:1 randomized phase III (PATRICIA) trial of the efficacy of vaccination with the AS04-adjuvanted HPV-16/18 virus-like particle vaccine as compared to hepatitis A virus (HAV) vaccine. HPV infection was assessed from cervical samples taken every 6 months for 4 years post-vaccination by polymerase chain reaction (PCR) for genital oncogenic HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 58, 59, 66, 68, and 73 as well as low-risk types HPV-6 and HPV-11. The HPV-16/18 vaccine coverage ranged between 1 and 22% by age-cohort and study community. Odds ratios (ORs) for infections with different HPV types in baseline PCR negative HPV-16/18 vs. HAV vaccinated women, and Poisson regression derived HPV incidence rate ratios (IRRs) in baseline positive vs. negative women were calculated. The OR and IRR estimates for acquisition of any genital HPV types showed no excess risk neither in baseline HPV DNA-negative HPV-16/18-vaccinated women compared to baseline HPV DNA-negative HAV vaccinated women nor in HPV-16/18-vaccinated baseline HPV-16/18-positive women compared to baseline HPV-16/18-negative women. In the HAV-vaccinated, baseline HPV-18-positive women showed an increased risk of acquiring other clade A7 HPV types (39, 45, 59, 68) (IRR 1.8, 95% confidence interval = 1.01.-3.1). We found no increased occurrence of non-vaccine HPV types suggestive of type-replacement 1–4 years post-vaccination among HPV-16/18-vaccinated Finnish adolescents.     

HPV types, HIV and invasive cervical carcinoma risk in Kampala, Uganda: a case-control study

Background

While the association of human papillomavirus (HPV) with cervical cancer is well established, the influence of HIV on the risk of this disease in sub-Saharan Africa remains unclear. To assess the risk of invasive cervical carcinoma (ICC) associated with HIV and HPV types, a hospital-based case-control study was performed between September 2004 and December 2006 in Kampala, Uganda. Incident cases of histologically-confirmed ICC (N=316) and control women (N=314), who were visitors or care-takers of ICC cases in the hospital, were recruited. Blood samples were obtained for HIV serology and CD4 count, as well as cervical samples for HPV testing. HPV DNA detection and genotyping was performed using the SPF₁₀/DEIA/LiPA₂₅ technique which detects all mucosal HPV types by DEIA and identifies 25 HPV genotypes by LiPA version 1. Samples that tested positive but could not be genotyped were designated HPVX. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression, adjusting for possible confounding factors.

Results

For both squamous cell carcinoma (SCC) and adenocarcinoma of the cervix, statistically significantly increased ORs were found among women infected with HPV, in particular single HPV infections, infections with HPV16-related types and high-risk HPV types, in particular HPV16, 18 and 45. For other HPV types the ORs for both SCC and adenocarcinoma were not statistically significantly elevated. HIV infection and CD4 count were not associated with SCC or adenocarcinoma risk in our study population. Among women infected with high-risk HPV types, no association between HIV and SCC emerged. However, an inverse association with adenocarcinoma was observed, while decrease in CD4 count was not associated with ICC risk.

Conclusions

The ORs for SCC and adenocarcinoma were increased in women infected with HPV, in particular single HPV infections, infections with HPV16- and 18-related types, and high-risk HPV types, specifically HPV16, 18 and 45. HIV infection and CD4 count were not associated with SCC or adenocarcinoma risk, but among women infected with high-risk HPV types there was an inverse association between HIV infection and adenocarcinoma risk. These results suggest that HIV and CD4 count may have no role in the progression of cervical cancer.     

Elevation of HPV-18 and HPV-16 DNA in the Plasma of Patients with Advanced Cervical Cancer

Objective: Cervical cancer (CC) is one of the main problems in women’s health in which the pathologicrole of the human papilloma virus, HPV, is undeniable. Molecular methods have shown viral DNA in affectedtissues, related to the disease progression. Patients and Methods: We here studied 100 patients with abnormalPap test results. HPV DNA loads in the plasma samples were measured by quantitative real time PCR, usingspecific primers and probes for the E6 genes of HPV types 16, 18, 33 and 52. Another 50 women with no obviousmalignancy were enrolled as controls. Results: Pathological studies revealed 81 patients with CC and 19 withcervical intraepithelial neoplasia. Only 19 of the cancer patients (15 with squamous cell carcinomas and 4 withadenocarcinomas) had detectable genetic material of HPV-16 (N=4) and HPV-18 (N=15) in their plasma; geneticmaterial of other types was absent. HPV DNA copies increased with advanced disease in both types. Significantlysmaller amounts of HPV DNA of types 16 and/or 18 were detected in the plasma of 16% of the controls whileother types were negative. Conclusion: The evidence of HPV DNA of high risk types in the plasma of womenwith CCs strongly emphasizes the necessity of more longitudinal comprehensive studies to determine its role asa possible biomarker in cervical cancer.     

Human Papillomavirus Genotypes and Cervical Cancer in Northeast Thailand

Human papillomavirus (HPV) is a major cause of cervical cancer. More than 100 HPV genotypes have beenidentified; however the distribution varies geographically and according to ethnicity. The purpose of this studywas to investigate the prevalence and distribution of HPV subtypes among Northeast Thai women. Subjectsincluded 198 cases of SCCA and 198 age-matched, healthy controls. HPV-DNA was amplified by PCR using theconsensus primers GP5+/6+ system followed by reverse line blot hybridization genotyping. The prevalence ofhigh-risk HPV infection was 21 (10.1%) and 152 (76.8%) in the controls and in the cases, respectively. High-riskHPV significantly increased the risk for cervical cancer with an OR of 42.4 (95%CI: 22.4-81.4, p<0.001) and anadjusted OR of 40.7-fold (95%CI: 21.5-76.8, p <0.001). HPV-16 was the most prevalent HPV type in the SCCA(56.2%) followed by HPV-58 (17.8%) and HPV-18 (13.6%); whereas HPV-58 (46.4%) was a prominent genotypein the controls followed by HPV-16 (39.3%) and unidentified HPV types (25.0%). These findings indicate thatHPV infection remains a critical risk factor for SCCA; particularly, HPV-16, HPV-58 and HPV-18. In orderto eradicate cervical cancer, sustained health education, promoted use of prophylactics and a HPV-58 vaccineshould be introduced in this region.     

Nested Multiplex PCR Based Detection of Human Papillomavirusin Cervical Carcinoma Patients of North- East India

Background: Persistent infection of one or more of about 15 high-risk human papillomaviruses (HR-HPVs),most commonly HPV types 16/18, has a significant role in cervical cancer initiation and progression. There arelimited data available from north-east India about HPV prevalence though this region has high incidence ratesof cervical cancer. The aim of this study was to investigate the HPV genotypes prevalent in cervical cancerpatients of north-east India. Materials and Methods: We analyzed 107 cervical cancer patient samples. Nestedmultiplex PCR assays were employed for detection of 13 high risk and 5 low risk HPV types. Results: HPV wasconfirmed in 105 samples. The presence of 6 ‘carcinogenic’ HPV types, HPV-16 (88%), -18 (15%), -31(4%) ,-45(3%), -59 (4%), -58(1%), and one non carcinogenic, HPV-6/11 (6%), was recorded. Among various demographicand clinical factors only tumour stage showed a statistically significant association with HPV type infection(P=0.019). Conclusions: We suggest that the most prevalent genotype is HPV-16 followed by HPV-18 in cervicalcarcinoma patients of the north-eastern region of India. Advanced tumour stage may be associated with increasedpossibility of harbouring multiple HPV genotypes.     

陕西省延安地区女性HPV感染及基因分型年龄分布

目的 宫颈癌的发生发展与人乳头瘤病毒(human papillomavirus,HPV)密切相关,本研究分析陕西省延安地区女性宫颈HPV感染情况及基因亚型年龄分布,为本地区女性宫颈癌防治和HPV感染的分子流行病学研究提供重要依据.方法 选择2011-01-01-2015-07-31延安大学附属医院体检(478例)、"两癌"筛查、机会性筛查(2 250例)及就诊(814例)的3 542例女性患者作为研究对象,采用PCR体外扩增和DNA反向点杂交相结合的DNA芯片技术进行HPV基因分型检测.结果 HPV感染率为40.54%(1 436/3 542),其中高危型HPV感染率38.42%(1 361/3 542);低危型HPV感染率3.78%(134/3 542);感染年龄分布以≥61岁年龄组感染率最高,其次是51~60岁年龄组.各年龄组HPV感染率和高危感染率比较差异均有统计学意义,P<0.05;低危感染率比较差异无统计学意义,P>0.05.按年龄组统计,高危亚型检出频次由高到低排列前3位,≤30岁年龄组为HPV16、HPV58和HPV39,其余各组均为HPV16、HPV58和HPV52.低危感染以HPV6和HPV11为主.单一型别感染占总感染人数的74.72%(1 073/1 436),其中单一高危感染占69.56%(999/1 436),单一低危占5.15%(74/1 436).多重感染占总感染人数的25.27%(363/1 436),最高检出四重感染.单一感染率、单一高危感染率最高的为41~50岁年龄组,多重高危感染率和高低危混合多重感染率最高的是≥61岁年龄组,各年龄组高低危混合多重感染率比较差异有统计学意义(P<0.05),其余感染类型差异均无统计学意义,P>0.05.结论 陕西省延安地区HPV感染年龄分布以≥61岁年龄组较高,主要亚型为HPV16、HPV58和HPV52,感染类型以单一感染为主,提示HPV亚型的分析对疫苗的研发和宫颈癌的筛查及防治有指导意义.     

Prevalence of genital human papilloma virus infection and genotypes among young women in Sicily, South Italy

Infection with oncogenic human papilloma virus (HPV) types is a necessary cause of cervical cancer. This study assessed the prevalence of HPV infection and genotypes among 1,006 randomly selected women, ages 18 to 24 years, living in Sicily (south Italy). The overall HPV rate was 24.1% (95% confidence interval, 21.5-26.9). The most frequent types were HPV-16 (4.5%), HPV-53 (2.7%), and HPV-84 (2.6%). The prevalence of vaccine types HPV-6, HPV-11, and HPV-18 was 1.4%, 0.1%, and 1.3%, respectively. Cytologic abnormalities were uncommon (3.1%) and associated with HPV detection (P < 0.0001). The only risk factor for HPV infection was the number of sexual partners (women with 2-3 partners versus women with 1 partner: odds ratio, 3.86; 95% confidence interval, 2.45-6.09). Genital HPV infection is relatively high in young Italian women. The high prevalence of viral types other than vaccine types should be taken into account to ensure accurate postvaccine surveillance and early detection of a possible genotype replacement.     

广东妇女人乳头瘤病毒感染及宫颈细胞学的对照研究

目的探讨人乳头瘤病毒(HPV)与宫颈癌的相关性及HPV检测在宫颈癌筛查中的应用。方法用第二代杂交捕获法(HCⅡ)检测2636名妇女宫颈刷出物中13种高危型HPV,其中454例同时做宫颈脱落细胞液基薄层细胞学检测(TCT)。细胞学诊断采用Bethesda分级系统(TBS)。结果2636名妇女高危型HPV感染率为26.5%,其中20岁以下(含20岁)年龄组的高危型HPV感染率最高(59.4%),41～50岁年龄组最低(21.0%)。新会地区HPV感染率显著低于东莞、深圳和广州(P<0.01)。16例宫颈癌患者HPV感染率为93.8%,显著高于健康体检者(19.2%)和宫颈炎患者(30.8%,P<0.001)。454例同时做TCT检查的妇女中,鳞状细胞癌(SCC)、高度鳞状上皮内瘤变(HSIL)、低度鳞状上皮内瘤变(LSIL)、不典型鳞状细胞(ASC)的高危型HPV检出率分别为100%(2/2)、100%(12/12)、88.9%(16/18)和37.8%(28/74)。HPV阳性检出率随病变的严重程度而显著增加。结论高危型HPV是宫颈病变的重要病因学因素,可能诱发宫颈癌,HPV检测是筛查宫颈癌的一种有效辅助方法;HPV感染率的年龄和地区性差异可能和受检者不同生活方式有关。     

Invasive cervical cancers in the United States,Botswana and Kenya: HPV type distribution and health policy implications

Background

More deaths occur in African women from invasive cervical cancer (ICC) than from any other malignancy. ICC is caused by infection with oncogenic types of human papillomavirus (HPV). Co-infection with the human immunodeficiency virus (HIV) accelerates the natural history of ICC, and may influence the HPV type distribution. Because HPV vaccines are available, this malignancy is theoretically preventable, but the vaccines are largely type-specific in protection against infection. Data on specific HPV types causing ICC in African women is limited, and many studies utilized swab samples rather than actual cancer tissue. A previous study using archived, ICC tissue from women in Botswana identified an unusual HPV type distribution. A similar study was therefore performed in a second sub-Saharan country to provide additional information on the HPV type distribution in ICC.

Methods

Archived, formalin-fixed, paraffin-embedded ICCs were acquired from women in the United States, Kenya, or Botswana. DNA was extracted and HPV genotyping performed by Roche Linear Array. HIV sequences were identified in ICCs by PCR.

Results

HPV types 16 or 18 (HPV 16/18) were identified in 93.5 % of HPV-positive ICCs from the U.S., 93.8 % from Kenya, and 61.8 % from Botswana (p?<?0.0001). Non-HPV 16/18 types were detected in 10.9 % of HPV-positive cancers from the U.S., 17.2 % from Kenya, and 47.8 % from Botswana (p?<?0.0001). HIV was detected in 2.2, 31.5, and 32.4 % from ICCs from the U.S., Kenya, or Botswana, respectively (p?=?0.0002). The distribution of HPV types was not significantly different between HIVinfected or HIV-uninfected women. The percentages of ICCs theoretically covered by the bivalent/quadrivalent HPV vaccines were 93.5, 93.9, and 61.8 % from the U.S., Kenya and Botswana, respectively, and increased to 100, 98, and 77.8 % for the nanovalent vaccine.

Conclusions

HPV 16/18 caused most ICCs from the U.S. and western Kenya. Fewer ICCs contained HPV 16/18 in Botswana. HIV co-infection did not influence the HPV type distribution in ICCs from African women from the two countries. Available HPV vaccines should provide protection against most ICCs in the U.S. and Kenya. The recently developed nanovalent vaccine may be more suitable for countries where non-HPV 16/18 types are frequently detected in ICC.

     

Human papillomavirus types 52 and 58 are prevalent in cervical cancers from Chinese women

A substantial body of evidence has confirmed human papillomavirus (HPV) infection as an etiologic agent in human cervical cancer. To evaluate the association between HPV and cervical cancer in Chinese women, we examined tumor specimens from women who lived in Shanghai, People's Republic of China. Biopsies from 40 women, diagnosed with either squamous-cell carcinoma (n = 35) or adenocarcinoma (n = 5) were tested for HPV DNA by PCR. The HPV types present in tumors were determined either by hybridization of PCR products with HPV type-specific probes or by PCR-based sequencing. A total of 35 of the 40 cervical cancer specimens (87.5%) contained HPV DNA. The following distribution and types were detected: 7.5% HPV 16, 10% HPV 18, 20% HPVs 16 and 18, 15% HPV 52, 15% HPV 58, 12.5% HPVs 52 and 58 and 7.5% unclassified HPVs. In this population of Chinese women with cervical cancer, HPV 52 and 58 were as prevalent as the “high-risk” (for cervical cancer) viruses HPVs 16 and 18. Int. J. Cancer, 70:408–411, 1997. © 1997 Wiley-Liss, Inc.