Human Papillomavirus Prevalence and Genotype Distribution among HIV-Infected Women in Korea

The epidemiology on human papillomavirus (HPV) among human immunodeficiency virus (HIV)-infected women in Korea is not well established. A retrospective study was conducted to determine the prevalence and genotype distribution of HPV infection among HIV-infected women in Korea. HPV DNA genotype and cervical cytology were examined in 60 HIV-positive women and 1,938 HIV-negative women. HPV genotypes were analyzed by using a HPV DNA chip. HIV-infected women had higher prevalence of high-risk HPV (hr-HPV) infection (30% vs 4.9%, adjusted odds ratio [AOR], 6.96; 95% confidence interval [CI], 3.63-13.34, P<0.001) and abnormal cervical cytology (18.3% vs 1.8%, AOR, 10.94; 95% CI, 5.18-23.1, P<0.001) compared with controls. The most common hr-HPV genotype detected in HIV-infected women was HPV 16 (10%), followed by 18 (6.7%) and 52 (5%). Prevalence of quadrivalent vaccine-preventable types (HPV 6, 11, 16, and 18) was 21.7% and 2.3% in HIV-positive women and HIV-negative women, respectively. Age was a significant risk factor for hr-HPV infection in HIV-infected women (P=0.039). The presence of hr-HPV was significantly associated with abnormal cervical cytology (P<0.001). These findings suggest that HPV testing for cervical cancer screening in HIV-infected women would be necessary, particularly among young age group.     

北京市北苑地区女性HPV感染现状及基因型分布研究

目的 调查我院辖区范围内即北京市北苑地区成年女性人乳头状瘤病毒(HPV)感染现状及亚型分布情况.方法 采用核酸分子快速导流杂交基因芯片分型技术对本院辖区范围内(北苑地区)来我院妇科门诊就诊的14582例女性患者采集宫颈脱落细胞标本进行HPV及21种亚型检测.结果 ①HPV感染阳性检出2419例,感染阳性率16.59％(2419/14582),在HPV感染阳性人群中,以单一高危型HPV感染为主,单一感染HPV阳性1951例,占HPV阳性感染人群80.65％(1951/2419);多重感染以二重感染为主,多重感染HPV阳性468例,二重感染HPV阳性361例,占HPV阳性感染人群14.92％(361/2419),以高危型感染以为主.②各HPV基因亚型检出总和为3035项次,高危型HPV感染占91.73％(2784/3035),排在前五位由高到低依次是HPV16(17.36％,527/3035)、HPV52(11.89％,361/3035)、HPV58(11.80％,358/3035)、HPV53(8.27％,251/3035)、CP8304(7.05％,214/3035),以HPV16型为主;低危型HPV感染占8.27％(251/3035),由高到低依次是HPVl1 (3.95％,120/3035)、HPV6(3.57％,108/3035)、HPV44(0.43％,13/3035)、HPV42 (0.16％,5/3035)、HPV43 (0.16％,5/3035),以HPV11为主.③按年龄段划分,≤20岁年龄组阳性率最高,阳性率31.30％ (36/115);其次是≥61岁年龄组,阳性率21.05％ (64/304).结论 本院辖区范围内(北苑地区)成年女性HPV感染阳性率16.59 ％(2419/14582),以单一高危型HPV感染为主,高危型HPV16、HPV52、HPV58、HPV53、CP8304是本院辖区范围内成年女性HPV感染的主要亚型.     

Depressive Symptoms and Cervical Neoplasia in HIV+ Low-Income Minority Women with Human Papillomavirus Infection

Background  Prior work has related elevated life stress to greater risk of cervical neoplasia in women with human immunodeficiency virus (HIV) and human papillomavirus (HPV). Purpose  This study investigated associations between depressive symptoms and cervical neoplasia in HIV+ HPV+ women. Participants were 58 HIV+ HPV+ women. Method  Participants underwent colposcopy, including HPV screening, Papanicolaou smear, and cervical biopsy to determine study eligibility. Eligible participants completed the Beck Depression Inventory (BDI) and the Center for Epidemiologic Studies-Depression (CES-D) scale. Results  Presence and severity of clinically significant depressive symptomatology were associated with cervical neoplasia. Hierarchical logistic regression analysis revealed that women with greater depressive symptoms had marginally greater odds of presenting with cervical neoplasia (BDI: OR = 1.16, p = 0.092; CES-D: OR = 1.15, p = 0.067. Women with greater somatic depressive symptoms, specifically, had significantly greater odds of presenting with cervical neoplasia (BDI: OR = 1.86, p = 0.027; CES-D: OR = 1.56, p = 0.017). Conclusion  These findings suggest that screening HIV+ women for somatic depression may help identify those at risk for cervical neoplasia. Future depression research with medical populations should discern somatic depressive symptoms from disease symptoms, as they may have important value in independently predicting health outcomes.     

Types of Human Papillomavirus Observed in Hospital-Based Population

Background and Objectives: Human papillomavirus (HPV) is the causative agent of cervical cancer, a major cause of cancer mortality in Indian women. The current study was undertaken to add information to the existing data on HPV type distribution in Indians, in an attempt to document HPV types for future vaccination programme, if any. Materials and Methods: HPV infection was screened in 223 cervical cancer cases and 2408 healthy women without cancer and cervical intraepithelial neoplasia (control). HPV was typed using polymerase chain reaction, Southern hybridisation using specific probes and HPV GenoArray (Hybribio) test. Results: HPV DNA was found in 92.8% of cases and 7.3% of controls. Of the 383 HPV-infected women, 30.0% had single infection; 50.9% had multiple infections (two or more types) and 19.1% were infected with HPV types other than HPV-16, -18, -6 and -11. Besides HPV-16, HPV-51 and HPV-33 were also seen as single infection in cases. In cases, HPV-18 or its homologous HPV-45 was always present as co-infection with HPV-16 or with other high-risk type. Binary logistic regression (backward) analysis highlighted significant association of age, parity and socioeconomic status with HPV infection. The present study highlighted the presence of multiple HPV infection (186 of 207, 89.9%) along with HPV-16 in women with cervical cancer. In control, 27.3% were co-infected with other sexually transmitted infections, while Chlamydia trachomatis infection was seen in 13% of cases. Conclusions: The study highlighted the type of HPV infection seen among the hospital-based population. For better screening, HPV tests available in the market should include all the types seen in the population.     

Ultrastructural Visualization of Human Papillomavirus DNA in Verrucous and Precancerous Squamous Lesions

Human papillomavirus (HPV) DNA was ultrastructurally localized by the non-isotopic in situ hybridization technique in formalin-fixed, paraffin-embedded specimens of verruca vulgaris of the skin, condyloma acuminatum of the penis and severe dysplasia of the uterine cervix. Biotinylated DNA probe cocktails were employed for the visualization of HPV-DNA, types 6 and 11 (HPV 6/11) and types 16 and 18 (HPV 16/18). The papillomavirus genus-specific antigen was also visualized by pre-embedding immunoelectron microscopy using rabbit antiserum. In verruca vulgaris, HPV antigen-positive 50-60 nm-particles of mature viral size were observed in the nuclei of the granular cells and parakeratotic cells with perinuclear haloes, whereas HPV 6/11 and HPV 16/18 DNA were negative. In condyloma acuminatum, the nuclei were positive for the HPV antigen and HPV 6/11 DNA, but were negative for HPV 16/18 DNA. More cells were labeled for the viral DNA than for the viral antigen. The ultrastructural observation indicated the presence of the naked (plasmid) viral DNA as fine particles sized 15-20 nm. In the dysplastic cervical mucosa, dotlike positivity of HPV 16/18 DNA was recognized. The HPV antigen and HPV 6/11 DNA were undetectable. HPV 16/18 DNA was localized in part of the nuclear chromatin. This pattern of localization may suggest integration of the viral DNA into the host cell DNA. Acta Pathol Jpn 41: 757-762, 1991.     

Low Rate of Cervical Cancer Screening among Women with Hematologic Malignancies after Stem Cell Transplant

Annual cervical cancer screening with Papanicolaou (Pap) and human papillomavirus (HPV) testing after stem cell transplant (SCT) is recommended, but the uptake is unknown. We aimed to determine the prevalence and predictors of cervical cancer screening in patients with hematologic malignancies. We searched MarketScan Commercial Claims database for women who underwent allogeneic or autologous SCT. The primary outcome was cervical cancer screening, defined as procedures or abnormal results for HPV and/or Pap testing according administrative codes within 2 years after SCT. A multivariable logistic regression model was fitted with cancer type, SCT year, age, geographic area, insurance plan, comorbidity, and presence of graft-versus-host disease (GVHD).The study included 1484 patients; 1048 patients (70.6%) had autologous and 436 (29.4%) allogeneic SCT. Mean age was 52.5 years. Overall, 660 patients (44.5%) had screening within 2 years after SCT, 214 (49.1%) with allogeneic SCT and 446 (42.6%) with autologous SCT (P?=?.02). In the allogeneic SCT group, patients with GVHD had a lower rate of screening than patients without GVHD (42.5% versus 55.4%, P?<?.01), and GVHD was associated with lower odds of screening (odds ratio, .50; 95% confidence interval, .32 to .79). In the autologous SCT group, patients with comorbid medical conditions had a lower rate of screening than patients without comorbidity (36.0% versus 45.7%, P?<?.01). In both allogeneic and autologous SCT groups older patients had lower odds of screening. Cervical cancer screening rates after SCT are low, particularly in patients with GVHD, who are at significant risk of second malignancies. Future work is needed to develop strategies to increase uptake.     

用通用引物聚合酶链反应对宫颈刮片中人乳头瘤病毒感染的快速筛检

用通用引物聚合酶链反应（ＧＰ－ＰＣＲ）可同时对人乳头瘤病毒（ＨＰＶ）６、１１、１６、１８、３１、３３等型进行检测。该方法成功地用于临床宫颈刮片样品广谱ＨＰＶ感染的筛检。结果，宫颈癌组ＨＰＶ检出率（８５．５％）明显高于非癌组（１３．９％）（Ｐ＜０．０１）；对宫颈癌放疗前后ＨＰＶ阳性率比较，二者亦有明显差异（８５．５％，４３．７％，Ｐ＜０．０１）。证明ＧＰ－ＰＣＲ是一种在大规模人群中快速筛检多型ＨＰＶ感染的有效方法。     

徐州地区女性宫颈感染人乳头瘤病毒基因亚型分析

目的：了解徐州地区不同年龄段女性生殖道人乳头瘤病毒（HPV）感染状况及其分布规律,为徐州地区HPV分子流行病学研究提供依据。方法：以2009年2月～2009年5月来我院就诊的1299例可疑患者为对象,采集其阴道宫颈分泌物标本。用凯普医用核酸分子杂交系统（简称H ybriMax）进行21种HPV（8304、6、11、16、18、31、33、35、39、42、43、45、44、51、52、53、56、58、59、66、68）基因型的分型检测,分析常见感染亚型和分布规律。结果：HPV阳性总检出率为26.02%（338/1299）,高危型主要为HPV16,其余依次为HPV58、52、68、33、53、18感染。低危型主要为HPV11、6、8304感染;〈35岁、35～44岁、〉44岁各年龄组中HPV阳性率分别为26.92%、26.79%、22.27%;宫颈癌患者以HPV16感染为主。结论：HPV6、11、16、58、52、68、33是徐州地区HPV感染的主要型别;不同年龄段HPV阳性率无显著性差异（P〉0.05）;对HPV阳性者进行定期跟踪是防治宫颈癌的重点。     

子宫颈癌中人乳头瘤病毒16型E7基因检测及变异分析

用聚合酶链反庆法检测宫颈癌中人乳头瘤病毒１６型转化基因Ｅ７，检出阳性率为１０／２２，其中４例进行ＰＣＲ－ＳＳＣＰ分析发现该基因与标准对照株存在明显变异。核苷酸序列分析证实有两处发生碱基突变。研究提示，ＰＣＲ方法能快速检测宫颈癌中人乳头瘤 转化基因，可作为宫颈癌的辅助诊断方法，ＳＳＣＰ分析能发现病毒株间小变异的基因片段。     

Predominance of High-Risk Human Papillomavirus Genotype 16 and 39 in Women with Premalignant and Malignant Cervical Pathology from Raipur,Chhattisgarh: Clinical Evaluation of Tagging Oligonucleotide Cleavage and Extension Mediated Genotyping Assay

Background: Identification of 14 high-risk human papillomavirus (HR-HPV) is immensely important in elucidating molecular epidemiology, patient monitoring and evidence-based treatment. There is paucity of such data from Chhattisgarh state of Central India. The present study has evaluated tagging oligonucleotide cleavage and extension-mediated Anyplex HR-HPV genotyping assay in identification of 14 HR-HPV genotypes attributable to premalignant and malignant cervical lesion in comparison to GP5+/6+ assay, cytology and colposcopy. Materials and Methods: A total of 185 clinically suspected cases of premalignant and malignant cervical lesion were investigated by HR-HPV genotyping, GP5+/6+, cytology and colposcopy. Results: Genotyping assay showed clinical sensitivity and specificity of 86.5% (confidence interval [CI]: 80.7–91.0) and 100% (CI: 86.3–100) respectively and found noninferior to GP5+/6+ assay (P > 0.05). HR-HPV prevalence was 76.3%, 88.4%, 94.8%, 100% and 100% among cervical intraepithelial neoplasia (CIN) Grade I–III, squamous cell carcinoma and adenocarcinoma cases, respectively. The four most common genotypes detected in CIN I–III were HPV 16 (63.9%), HPV 39 (15.0%), HPV 18 (6.0%) and HPV 33 (5.3%). In cervical cancer (CC) cases, HPV 16 (44.4%), HPV 39 (11.1%), dual infection of HPV 16, 18 (11.1%) and triple infection of HPV 16, 18, 33 (11.1%) were the four most identified genotypic aetiologies. A novel coinfection of HR-HPV 35, 39 were found in two and one cases of CIN I and II. Finding of HPV 39 as the second most prevalent genotype was unusual and underscores the importance of genotyping screening. Conclusion: Anyplex HR-HPV assay is arguably the useful assay for better patient management and can be useful for HR-HPV screening by its unique individual genotype identification of all HR-HPV. Finding of HPV 16, 39, 18, 33 and coinfection of 16,18 and 16, 18, 33 in CIN and CC would help vaccine manufacturer to design specific future HPV polyvalent vaccine preparation to curb down the CC-associated mortality.     

湖北省人乳头瘤病毒基因分型检测分析

目的 调查湖北省女性人群人乳头状瘤病毒(human papillomavirus,HPV)感染状况,为宫颈癌防治提供参考依据.方法 收集2013年1月至2014年11月在湖北省中山医院就诊的3956例宫颈脱落细胞标本,采用PCR体外扩增和DNA反向点杂交相结合的DNA芯片技术,对宫颈脱落细胞标本进行HPV基因分型检测.结果 3956例患者中共检出HPV阳性818例,阳性率为20.68％,其中高危型HPV感染阳性率为15.77％(624/3956).在被检测的23个HPV-DNA亚型中,最常见的依次为16型(3.72％,147/3956),52型(3.67％,145/3956),43型(3.64％,144/3956),58型(2.78％,110/3956),18型(1.49％,59/3956),33型(1.06％,42/3956),未检出MM4型.HPV阳性者中多重感染率为17.36％(142/818),以二重感染最常见(85.21％,121/142).结论 湖北省地区高危型HPV感染以HPV16、52、58、18和33比较常见,低危型HPV感染以HPV43比较常见.     

Prevalence and genotype distribution of human papillomavirus infection among women: A population-based study in Dali Bai Autonomous Prefecture,Yunnan Province,China

Accumulating evidence indicates that persistent infection with high-risk oncogenic human papillomavirus (HPV) genotypes is the most important risk factor for cervical cancer, and that the distribution of HPV genotypes varies regionally. This study explored the prevalence and genotype distribution of HPV infection among Han, Yi, and Bai women in various regions of Dali Bai Autonomous Prefecture, Yunnan Province, China. This cross-sectional study included 2779 women (20–76 years old) who were referred for 21-HPV genotype array diagnostic from five regions of Dali Bai Autonomous Prefecture between February 2013 and May 2016. Statistical methods used included a the χ² test, Fisher's exact test, t test, and logistic regression. Overall HPV prevalence in the study population was 7.6%. HPV-52, HPV-58, HPV-18, HPV-81, and HPV-16 were the most prevalent genotypes in the study area, and notably, the prevalence of HPV-58 was significantly higher among women in Heqing County than that in other regions. Univariate analysis showed that husband's age, region, fertility status, and parity were potential factors associated with HPV infection. Multivariate logistic regression analysis revealed that Heqing County was an independent risk factor for HPV infection among women in the Dali area, moreover, Yi women showed the highest risk for HPV infections. Overall, our finding emphasizing the urgent need for an HPV screening and prevention program in Heqing County and Yi women. We also suggest that HPV-related health education should be provided not only to women, but also to men, to reduce the risk of infection in women.     

High Grade Cervical Intraepithelial Neoplasia and Viral Load of High-Risk Human Papillomavirus: Significant Correlations in Patients of 22 Years Old or Younger

High-risk human papillomavirus (HR-HPV) is recognized as the primary cause for the development of cervical cancers and their precursor lesions. We investigated whether high-grade cervical dysplasia correlates with high viral load of HR-HPV in an age-dependent manner. Cases were retrospectively selected to include patients with a prior cytological diagnosis of ASCUS or higher grade squamous intraepithelial lesions, and a positive Digene Hybrid Capture II (HC-II) HR-HPV testing within 2 months before or after cervical biopsy. The quantitative viral load data was classified as negative, low, moderate and high according to the manufacturer’s instruction. Cases were then stratified into 4 age groups: ≤22 years, 23-30 years, 31-40 years and >40 years. Chi-Square analysis and logistic regression were performed where appropriate. A total of 995 patients were identified. Age categories were significantly associated with HPV loads (p=0.046). Moderate to high viral loads of HPV were significantly related to the histological grade of dysplasia (p=0.029). Logistic regression analysis further confirmed the association of HPV with histological grades, even after adjusting for age factor. In particular, high-grade dysplasia (p=0.011) but not low grade dysplasia (p=0.140) was significantly associated with moderate to high HPV loads. Patients of 22 years old or younger were the only group found significantly correlated with high viral loads of HPV (p=0.015). In conclusion, high-grade squamous intraepithelial lesions and patients’ age of 22 years old or younger are significantly associated with a moderate to high viral load of HR-HPV.     

Prevalence and genotype distribution of human papillomavirus infection among female sex workers in Guangxi, China: implications for interventions

Human papillomavirus (HPV) infection is a major public health concern in women, but information on HPV among female sex workers in China is limited. The aim of the study was to estimate the prevalence and genotype distribution of HPV infection among female sex workers in two cities in Guangxi, China. A total of 811 female sex workers were recruited from venues between July and September of 2009. Data on socio-demographic and behavior characteristics were collected, and cervical swabs were collected to determine HPV infection and genotype distribution. The overall prevalence of infection with any HPV type was 38.9%. HPV type 52 was the most prevalent type with prevalence of 11%, followed by HPV types 16, 58, 53, and CP8304, with prevalences of 6.5%, 5.7%, 5.6%, and 4.8%, respectively. HPV 16 or 18 accounted for 23.2% of all HPV positive cases. Age group <20 years was significantly associated with infection of the high-risk and multiple types of HPV infection. A higher prevalence of multiple HPV infection was observed among female sex workers from the outdoor venues (14.0%; 95%CI, 10.6%-17.3%). These findings have important implications for developing HPV prevention programs including HPV vaccination in female sex workers.     

Evaluating the PGMY-Centre Hospitalier Universitaire Vaudois Assay as a Cost-effective Tool for Human Papillomavirus Genotyping in HIV-infected Women

Aims: Cervical cancer is one of the leading causes of cancer among women, worldwide. HIV-positive women tend to have persistent infection and infection with multiple human papillomavirus (HPV) types. There is a need for affordable HPV DNA tests as viable alternatives to the existing costly commercial assays. The aim of the study was to establish PGMY-CHUV reverse hybridization assay as a cost-effective tool for HPV genotyping. Study Design: This was a prospective study conducted in a tertiary care centre from March 2011 to July 2012. Subjects and Methods: Fifty cervical brush samples from HIV-infected women and 43 WHO reference samples were tested by both the CHUV assay and linear array (LA). Results: The CHUV assay in comparison to the LA showed a sensitivity of 91%, specificity of 52% and a moderate agreement for all samples that were compared. However, most high-risk HPV types were identified amongst the clinical samples, and the entire range of genotypes in the WHO reference panel was detected. Statistical Analysis: The accuracy indices such as sensitivity, specificity, positive predictive value and negative predictive value were calculated. The level of agreement (kappa value) between the two assays was also calculated. Conclusion: The CHUV assay had an acceptable sensitivity, but it lacked specificity for HPV detection. Despite the lower rates of detection of multiple infections from clinical samples, better results were obtained with the WHO reference samples and the ability of the assay to identify the entire range of genotypes suggests that it can be an efficient tool for genotyping.