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Yokoji K, Giguère K, Malagón T, Rönn MM, Mayaud P, Kelly H, Delany-Moretlwe S, Drolet M, Brisson M, Boily MC, Maheu-Giroux M. Association of naturally acquired type-specific HPV antibodies and subsequent HPV re-detection: systematic review and meta-analysis. Infect Agent Cancer 2023; 18:70. [PMID: 37941016 PMCID: PMC10631102 DOI: 10.1186/s13027-023-00546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/13/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Understanding the role of naturally acquired (i.e., infection-induced) human papillomavirus (HPV) antibodies against reinfection is important given the high incidence of this sexually transmitted infection. However, the protective effect of naturally acquired antibodies in terms of the level of protection, duration, and differential effect by sex remains incompletely understood. We conducted a systematic review and a meta-analysis to (1) strengthen the evidence on the association between HPV antibodies acquired through past infection and subsequent type-specific HPV detection, (2) investigate the potential influence of type-specific HPV antibody levels, and (3) assess differential effects by HIV status. METHODS We searched Embase and Medline databases to identify studies which prospectively assessed the risk of type-specific HPV detection by baseline homologous HPV serostatus among unvaccinated individuals. Random-effect models were used to pool the measures of association of naturally acquired HPV antibodies against subsequent incident detection and persistent HPV positivity. Sources of heterogeneity for each type were assessed through subgroup analyses stratified by sex, anatomical site of infection, male sexual orientation, age group, and length of follow-up period. Evidence of a dose-response relationship of the association between levels of baseline HPV antibodies and type-specific HPV detection was assessed. Finally, we pooled estimates from publications reporting associations between HPV serostatus and type-specific HPV detection by baseline HIV status. RESULTS We identified 26 publications (16 independent studies, with 62,363 participants) reporting associations between baseline HPV serostatus and incident HPV detection, mainly for HPV-16 and HPV-18, the most detected HPV type. We found evidence of protective effects of baseline HPV seropositivity and subsequent detection of HPV DNA (0.70, 95% CI 0.61-0.80, NE = 11) and persistent HPV positivity (0.65, 95% CI 0.42-1.01, NE = 5) mainly for HPV-16 among females, but not among males, nor for HPV-18. Estimates from 8 studies suggested a negative dose-response relationship between HPV antibody level and subsequent detection among females. Finally, we did not observe any differential effect by baseline HIV status due to the limited number of studies available. CONCLUSION We did not find evidence that naturally acquired HPV antibodies protect against subsequent HPV positivity in males and provide only modest protection among females for HPV-16. One potential limitation to the interpretation of these findings is potential misclassification biases due to different causes.
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Affiliation(s)
- Kana Yokoji
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, 2001 Avenue McGill College, Suite 1200, Montreal, QC, H3A 1G1, Canada
| | - Katia Giguère
- Institut national de santé publique du Québec, Quebec City, Canada
| | - Talía Malagón
- Division of Cancer Epidemiology, Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada
| | - Minttu M Rönn
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Philippe Mayaud
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Helen Kelly
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Mélanie Drolet
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, Canada
| | - Marc Brisson
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, Canada
| | - Marie-Claude Boily
- MRC Center for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, 2001 Avenue McGill College, Suite 1200, Montreal, QC, H3A 1G1, Canada.
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Pasmans H, Hoes J, Tymchenko L, de Melker HE, van der Klis FRM. Changes in HPV Seroprevalence from an Unvaccinated toward a Girls-Only Vaccinated Population in the Netherlands. Cancer Epidemiol Biomarkers Prev 2020; 29:2243-2254. [PMID: 32856612 DOI: 10.1158/1055-9965.epi-20-0596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/25/2020] [Accepted: 08/05/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In the Netherlands, bivalent human papillomavirus (HPV) vaccination was included in the National Immunization Program for 12-year-old girls in 2010 (vaccination coverage, 45%-60%). We examined possible changes in HPV seroprevalence in the HPV-unvaccinated Dutch population aged 0-89 years, comparing prevaccination data with data of approximately 6 years after implementation of national vaccination. METHODS Serum samples of men and women were used from two cross-sectional population-based serosurveillance studies performed before (2006-07, n = 6,384) and after (2016-17, n = 5,645) implementation of HPV vaccination in the Netherlands. Seven high-risk HPV-specific antibodies (HPV16, 18, 31, 33, 45, 52, and 58) were tested in a virus-like particle-based multiplex immunoassay. RESULTS Type-specific HPV seroprevalence increased in women between 2006-07 and 2016-17. Also, a higher seroprevalence for at least one type in women >15 years was found in 2016-17 (31.7%) compared with 2006-07 (25.2%). In men, overall HPV seroprevalence remained similar; however, a lower seroprevalence was found for HPV16 in 2016-17 (7.5%) compared with 2006-07 (10.6%). CONCLUSIONS Our results indicate an increase in high-risk HPV types in women and a rather stable exposure in men. No clear effects of the strategy of girls-only vaccination were observed in men, probably because of the short time after introduction combined with suboptimal coverage. IMPACT No herd immunity has been observed yet in a population with suboptimal HPV vaccination coverage.
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Affiliation(s)
- Hella Pasmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Joske Hoes
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Liza Tymchenko
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Vos RA, Pasmans H, Tymchenko L, Janga-Jansen AVA, Baboe-Kalpoe S, Hulshof K, de Melker HE, van der Klis FRM. High seroprevalence of multiple high-risk human papillomavirus types among the general population of Bonaire, St. Eustatius and Saba, Caribbean Netherlands. Vaccine 2020; 38:2816-2826. [PMID: 32088019 DOI: 10.1016/j.vaccine.2020.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Incidence and mortality of human papillomavirus (HPV)-related cancers differs geographically, with high rates in Caribbean countries. Seroepidemiological data provide information on lifetime cumulative HPV exposure and contributing risk factors, but has not been available yet for Caribbean Netherlands (CN), comprising the islands Bonaire, St. Eustatius and Saba. Therefore, a cross-sectional population-based serosurveillance study was performed in this (recently girls-only HPV-vaccinated) population in 2017. METHODS Blood samples from participants (n = 1,823, 0-90 years) were tested for seven high-risk (hr)-HPV-specific IgG-antibodies using a VLP-based multiplex-immunoassay. Risk factors for HPV-seropositivity were analysed among persons unvaccinated aged ≥ 15 years who ever had sex (n = 1,080). RESULTS Among unvaccinated individuals aged ≥ 15 years, overall seropositivity was high (34%), with over half of them being seropositive for ≥ 2 hr-HPV types, and HPV16 and 52 being most prevalent (13%). Seroprevalence was substantial higher in unvaccinated women (51%) than men (18%), predominantly peaking in women aged 20-59 years, and was highest on St. Eustatius (38%). Besides age and sex, sexual risk factors were associated with HPV-seropositivity. CONCLUSIONS In accordance with the Caribbean region, seroprevalence of multiple hr-HPV types was high in CN. These data corroborate the decision regarding introduction of a sex-neutral HPV-vaccination program and the relevance for considering a population-based cervical cancer screening program.
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Affiliation(s)
- Regnerus A Vos
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| | - Hella Pasmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Liza Tymchenko
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Alcira V A Janga-Jansen
- Department of Public Health, Public Entity Bonaire, Kaya Neerlandia 41, Kralendijk, Bonaire, Caribbean Netherlands, The Netherlands
| | - Sharda Baboe-Kalpoe
- Department of Public Health, Public Entity St. Eustatius, Cottageroad z/n, Oranjestad, St. Eustatius, Caribbean Netherlands, The Netherlands
| | - Koen Hulshof
- Department of Public Health, Public Entity Saba, The Bottom, Saba, Caribbean Netherlands, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Windon MJ, Waterboer T, Hillel AT, Chien W, Best S, Stewart C, Akst L, Troy T, Bender N, Miles B, Ryan WR, Mandal R, Pitman K, Eisele DW, Fakhry C, D'Souza G. Sex differences in HPV immunity among adults without cancer. Hum Vaccin Immunother 2019; 15:1935-1941. [PMID: 30650013 DOI: 10.1080/21645515.2019.1568157] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The incidence of human papillomavirus (HPV)-associated head and neck cancers is rising, particularly among men. Whether observed epidemiological differences in sex are explained by differences in sexual exposure and/or by immune response is unclear. In this cross-sectional, multi-institutional study, seroprevalence of antibodies to HPV L1 capsid antigen was compared by patient characteristics among 374 adult patients without cancer. A significantly higher seroprevalence was observed among women compared with men for HPV16 (OR = 2.96, 95% CI = 1.21-7.21) and HPV18 (OR = 2.84, 95% CI = 1.06-7.60) L1 antibodies. This difference persisted for HPV16 after controlling for lifetime and recent sexual behavior. After controlling for sex, HPV16 and HPV18 L1 seroprevalence was also significantly associated with higher number of lifetime (HPV16 OR = 1.05, 95% CI = 1.01-1.08; HPV18 OR = 1.04, 95% CI = 1.01-1.08) and recent (HPV16 OR = 1.54, 95% CI = 1.15-2.07; HPV18 OR = 1.40, 95% CI = 1.07-1.82) oral but not vaginal sexual partners. These findings potentially suggest a more robust immune response to HPV16/18 among women compared with men that may not be explained by differences in number of sexual partners, and thereby presumably HPV exposure. The independent association of HPV16/18 L1 seroprevalence with higher number of oral sexual partners suggests a possible role for site of mucosal exposure in the HPV immune response.
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Affiliation(s)
- Melina J Windon
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Tim Waterboer
- b Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Alexander T Hillel
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Wade Chien
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Simon Best
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Charles Stewart
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Lee Akst
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Tanya Troy
- c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
| | - Noemi Bender
- b Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Brett Miles
- d Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - William R Ryan
- e Head and Neck Surgery, Department of Otolaryngology, University of California San Francisco , San Francisco , CA , USA
| | - Rajarsi Mandal
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Karen Pitman
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - David W Eisele
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Carole Fakhry
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA.,c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.,f Bloomberg~Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Gypsyamber D'Souza
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA.,c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
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Rahman S, Pierce Campbell CM, Rollison DE, Wang W, Waterboer T, Michel A, Pawlita M, Villa LL, Lazcano Ponce E, Borenstein AR, Giuliano AR. Seroprevalence and Associated Factors of 9-Valent Human Papillomavirus (HPV) Types among Men in the Multinational HIM Study. PLoS One 2016; 11:e0167173. [PMID: 27902759 PMCID: PMC5130234 DOI: 10.1371/journal.pone.0167173] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/09/2016] [Indexed: 02/02/2023] Open
Abstract
Background Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Recently a 9-valent HPV (9vHPV) prophylactic vaccine was licensed. Seroprevalence prior to vaccine dissemination is needed for monitoring vaccine effectiveness over time. Few studies have assessed the seroprevalence of 9vHPV types in men. Objectives To investigate the seroprevalence of 9vHPV vaccine types and associated risk factors among men residing in Brazil, Mexico, and the United States. Methods Six hundred men were randomly selected from the HPV Infection in Men (HIM) Study. Archived serum specimens collected at enrollment were tested for antibodies against nine HPV types (6, 11, 16, 18, 31, 33, 45, 52 and 58) using a glutathione S-transferase (GST) L1-based multiplex serologic assay. Socio-demographic, lifestyle and sexual behavior data at enrollment were collected through a questionnaire. Binomial proportions were used to estimate seroprevalence and logistic regression was used to examine factors associated with seropositivity of type-specific and grouped (i.e. 9vHPV, high-risk 9vHPV, low risk 9vHPV, and five-additional) HPV types. Results Overall, 28.3% of men were seropositive for at least one of the 9vHPV vaccine types, 14.0% for at least one of the seven high-risk types (16, 18, 31, 33, 45, 52 and 58) and 11.2% for at least one of the five high-risk types (31, 33, 45, 52 and 58) not included in the quadrivalent HPV vaccine, and 17.4% for at least one of the low-risk types (6/11). In multivariate analyses, odds ratios adjusted (AOR) for country of residence, age, marital status, smoking, number of anal sex lifetime partners, compared to men with no anal sex lifetime partners, men with ≥2 partners were more likely to be seropositive for grouped HPV [(9vHPV: AOR 2.52; 95% confidence interval (CI) 1.40–4.54), (high-risk 9vHPV: AOR 2.18; 95%CI: 1.05–4.50) and (low-risk 9vHPV: AOR 2.12; 95%CI: 1.12–4.03)], and individual HPV types 6, 16, 33 and 58 with AORs ranging from 2.19 to 7.36. Compared to men aged 18–30 years, men older than 30 years were significantly more likely to be seropositive for any high-risk 9vHPV, in addition to individual types 18 and 45; and compared to never smokers, current smokers were more likely to be seropositive to 9vHPV, low-risk 9vHPV and HPV 6. In contrast, married men were less likely to be seropositive to any high-risk 9vHPV and individual HPV types 18 and 31 when compared to single men. Conclusions These data indicate that exposure to the nine HPV types included in the 9vHPV vaccine is common in men and that seropositivity to 9vHPV vaccine types is associated with older age and the lifetime number of anal sex partners. Nine valent HPV vaccination of males and females has the potential to prevent HPV related diseases and transmission in both sexes.
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Affiliation(s)
- Shams Rahman
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States of America.,Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States of America
| | | | - Dana E Rollison
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States of America
| | - Wei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States of America
| | - Tim Waterboer
- Molecular Diagnostics of Oncogenic Infections Division; Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Angelika Michel
- Molecular Diagnostics of Oncogenic Infections Division; Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Molecular Diagnostics of Oncogenic Infections Division; Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Luisa L Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Publica, Cuernavaca, Mexico
| | - Amy R Borenstein
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States of America
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States of America
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Oral human papillomavirus infection in men might contribute to HPV serology. Eur J Clin Microbiol Infect Dis 2014; 34:237-45. [DOI: 10.1007/s10096-014-2223-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/29/2014] [Indexed: 11/27/2022]
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Kang LN, Castle PE, Zhao FH, Jeronimo J, Chen F, Bansil P, Li J, Chen W, Zhang X, Qiao YL. A prospective study of age trends of high-risk human papillomavirus infection in rural China. BMC Infect Dis 2014; 14:96. [PMID: 24559293 PMCID: PMC3936871 DOI: 10.1186/1471-2334-14-96] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 02/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In China, high-risk human papillomavirus (HR-HPV) prevalence is unexpectedly high in older women, but the possible reasons have not been well studied yet. This study investigated the age trends of HR-HPV infection in a prospective study. METHODS A total of 7397 women aged 25-65 years without cervical precancer or cancer were evaluated during 2010-2011 with a stratified sample of 2791 women re-evaluated after one year. Test results for careHPV and careHPV16/18/45 were used to describe the HR-HPV prevalence, incidence and clearance. Risk factors associated with HR-HPV infections were explored using a logistic regression model. RESULTS The overall HR-HPV prevalence was 13.1% at baseline, with a peak of 19.3% in women aged 55-59 years. The prevalence of HR-HPV (p for trends < 0.001), HPV16/18/45 (p for trends = 0.002), and HR-HPV other than HPV16/18/45 (p for trends = 0.002) generally increased with increasing age. Number of infections that cleared was generally greater than number of incident infections within age groups. One-year clearance rate decreased with increasing age (p for trends < 0.001), however, incidence rate was unrelated to age (p for trends = 0.159). Risk factors that associated with HR-HPV infection differed between younger and older women. CONCLUSIONS The greater HR-HPV prevalence in older versus younger women in rural China may be explained by a cohort effect, higher than expected incidence, and/or poorer clearance at older age.
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Affiliation(s)
- Le-Ni Kang
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Lane, Beijing, 100021, China
| | - Philip E Castle
- Global Cancer Initiative, 100 Radcliff Drive, Chestertown, MD, 21620, USA
| | - Fang-Hui Zhao
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Lane, Beijing, 100021, China
| | - Jose Jeronimo
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Feng Chen
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Lane, Beijing, 100021, China
| | - Pooja Bansil
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Jing Li
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Lane, Beijing, 100021, China
| | - Wen Chen
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Lane, Beijing, 100021, China
| | - Xun Zhang
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Lane, Beijing, 100021, China
| | - You-Lin Qiao
- Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Lane, Beijing, 100021, China
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Ojiyi EC, Dike IE, Okeudo C, Ejikem C, Nzewuihe AC, Agbata A. Local risk factors in genital human papilloma virus infection in cervical smears. Ann Med Health Sci Res 2013; 3:529-35. [PMID: 24380003 PMCID: PMC3868118 DOI: 10.4103/2141-9248.122082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Infection with human papilloma virus (HPV) is the main cause of cervical cancer, but the local risk factors have not been sufficiently assessed. AIM The study is aimed at determining the prevalence and to evaluate the local risk factors of HPV infection in cervical smears at the Imo State University Teaching Hospital, Orlu, Nigeria. SUBJECTS AND METHODS The participants involved 445 randomly selected sexually active women attending the antenatal, postnatal, gynecology and family planning clinics in the Department of Obstetrics and Gynecology of the university between April 2004 and May 2012. A questionnaire assessing various socio-demographic characteristics of the participants was administered. The pap smears of the participants were examined microscopically for evidence of HPV infection. The SPSS version 17.0 (Chicago, Illinois, USA) was used to compute and analyze the results. The results were presented in tables as simple percentages. Tests of significance using the Chi-square and fisher exact tests were applied where appropriate. RESULTS The prevalence rate of HPV was 10.3%. The peak age-specific prevalence of 11.7% occurred in the 15-19 years age group. There were significant associations between the occurrence of HPV and multiple sexual partners, coital frequency, multiparity, contraceptive use, marital status, low socio-economic status, abnormal vaginal discharge, irregular menstruation, post-coital and post-menopausal bleeding, (P < 0.05). CONCLUSION All sexually active women including teenagers should be screened for cervical HPV infection in an organized systematic program equipped with a good call and recall system. There is, therefore, a need to move emphasis from the current practice of opportunistic screening to a systematic screening of the whole population at risk despite cost implications.
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Affiliation(s)
- EC Ojiyi
- Department of Obstetrics and Gynecology, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria
| | - IE Dike
- Department of Obstetrics and Gynecology, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria
| | - C Okeudo
- Department of Obstetrics and Gynecology, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria
| | - C Ejikem
- Department of Obstetrics and Gynecology, Abia State, University Teaching Hospital, Aba, Abia State, Nigeria
| | - AC Nzewuihe
- Department of Surgery, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria
| | - A Agbata
- Department of Histopathology, Anambra State University Teaching Hospital, Amaku, Awka, Nigeria
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Tiggelaar SM, Lin MJ, Viscidi RP, Ji J, Smith JS. Age-specific human papillomavirus antibody and deoxyribonucleic acid prevalence: a global review. J Adolesc Health 2012; 50:110-31. [PMID: 22265107 PMCID: PMC3572199 DOI: 10.1016/j.jadohealth.2011.10.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 10/14/2011] [Accepted: 10/15/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE Global data on human papillomavirus (HPV) serological and deoxyribonucleic acid (DNA) prevalence are essential to optimize HPV prophylactic vaccination strategies. METHODS We conducted a global review of age-specific HPV antibody and studies with both antibody and DNA prevalence for HPV-16, -18, -6, and -11. RESULTS One hundred seventeen studies were included; participants' ages ranged from several hours to >90 years. HPV-16 seroprevalence was generally higher in Africa, Central and South America, and North America, more prevalent among women than among men, and peaked around ages 25-40 years. HPV-18 seroprevalence was generally lower than HPV-16 with a later age peak. Data were limited for HPV-6 and -11, both of which peaked at ages similar to HPV-18. Among 9-26-year-old females, HPV-16 seroprevalence ranged from 0%-31% in North America, 21%-30% in Africa, 0%-23% in Asia/Australia, 0%-33% in Europe, and 13%-43% in Central and South America. HPV-16/-18 DNA prevalence peaked 10-15 years before corresponding HPV-16/-18 antibody prevalence. CONCLUSIONS Females within the HPV vaccine-eligible age-group (9-26 years) had a range of dual HPV-16 DNA and serology negativity from 81%-87%, whereas 90%-98% were HPV-16 DNA negative. Serology and DNA data are lacking worldwide for females younger than age 15 years, the prime target group for vaccination.
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Affiliation(s)
- Sarah M Tiggelaar
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Vanderbilt University, School of Medicine, Nashville, TN USA
| | - Margaret J Lin
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Washington University School of Medicine, Saint Louis, MO, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Raphael P Viscidi
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jia Ji
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Division of Pharmaceutics, College of Pharmacy, Ohio State University, Columbus, OH, USA
| | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Lu B, Viscidi RP, Lee JH, Wu Y, Villa LL, Lazcano-Ponce E, da Silva RJC, Baggio ML, Quiterio M, Salmerón J, Smith DC, Abrahamsen M, Papenfuss M, Stockwell HG, Giuliano AR. Human papillomavirus (HPV) 6, 11, 16, and 18 seroprevalence is associated with sexual practice and age: results from the multinational HPV Infection in Men Study (HIM Study). Cancer Epidemiol Biomarkers Prev 2011; 20:990-1002. [PMID: 21378268 DOI: 10.1158/1055-9965.epi-10-1160] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Few human papillomavirus (HPV) serology studies have evaluated type-specific seroprevalence of vaccine HPV types in men. This study investigates seroprevalence of HPV 6, 11, 16, and 18, and associated risk factors in men residing in three countries (United States, Mexico, and Brazil). METHODS Data from 1,477 men aged 18 to 70 enrolled in the HPV Infection in Men Study (HIM Study) were analyzed. Serum antibody testing was performed with virus-like particle-based ELISA. Potential risk factors were assessed for individual HPV types by the use of logistic regression. RESULTS Overall, HPV-6, 11, 16, and 18 seroprevalence was 14.8%, 17.3%, 11.2%, and 5.8%, respectively. Thirty-four percent of men were seropositive to one or more HPV types. When examined by sexual practice, 31.2% of men who had sex with women, 65.6% of men who had sex with men (MSM), and 59.4% of men who had sex with both men and women (MSMW) were seropositive to one or more HPV types. Seroprevalence increased with age among young-to-middle-aged men with significant upward age trends observed for HPV 11, 16, and 18. Men with multiple lifetime male anal sex partners were 2 to 4 times more likely to be HPV 6 or 11 seropositive and 3 to 11 times more likely to be HPV 16 or 18 seropositive. CONCLUSION Our data indicate that exposures to vaccine HPV types were common in men and highly prevalent among MSM and MSMW. IMPACT Our study provides strong evidence that the practice of same-sex anal intercourse is an independent risk factor for seroprevalence of individual vaccine HPV types. Examination of antibody responses to HPV infections at various anatomic sites in future studies is needed to elaborate on the mechanism.
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Affiliation(s)
- Beibei Lu
- H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612-9416, USA
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Vaccarella S, Franceschi S, Clifford GM, Touzé A, Hsu CC, de Sanjosé S, Pham THA, Nguyen TH, Matos E, Shin HR, Sukvirach S, Thomas JO, Boursaghin L, Gaitan J, Snijders PJF, Meijer CJLM, Muñoz N, Herrero R, Coursaget P. Seroprevalence of antibodies against human papillomavirus (HPV) types 16 and 18 in four continents: the International Agency for Research on Cancer HPV Prevalence Surveys. Cancer Epidemiol Biomarkers Prev 2011; 19:2379-88. [PMID: 20826835 DOI: 10.1158/1055-9965.epi-10-0336] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Few human papillomavirus (HPV) seroprevalence studies have been carried out in women from low-resource countries. METHODS Seroprevalence of antibodies against HPV16 and HPV18 was assessed in 7,074 women ≥15 years of age (median 44 years) from eight world areas. Serum antibodies against HPV16 and HPV18 were tested for using enzyme-linked immunosorbent assay. HPV DNA was assessed using a general primer GP5+/6+-mediated PCR. RESULTS HPV16 and HPV18 seroprevalence both ranged from <1% (Hanoi, Vietnam) to >or=25% (Nigeria). Of women who were HPV16 or HPV18 DNA-positive, seropositivity for the same type was 39.8% and 23.2%, respectively. Seropositivity for either type was directly associated with markers of sexual behavior. HPV16 and/or 18 (HPV16/18)-seropositive women had an increased risk of having cytologic abnormalities only if they were also HPV DNA-positive. A high international correlation was found between HPV16/18 seroprevalence and overall HPV DNA prevalence (r = 0.81; P = 0.022). However, HPV16/18 seroprevalence was substantially higher than the corresponding DNA prevalence in all study areas (although to different extents) and, contrary to DNA, tended to increase from young to middle age, and then decline or remain fairly constant. In all study areas, the vast majority of the information on the burden of exposure to HPV16/18 derived from serology. CONCLUSIONS The correlation between HPV DNA and HPV serology was not very good at an individual woman level, but high at a population level. IMPACT HPV serology is a poor marker of current infection or related lesions, but it can contribute, together with DNA, in evaluating the variations in the burden of HPV infection worldwide.
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Affiliation(s)
- Salvatore Vaccarella
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France.
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Abstract
BACKGROUND A vaccine to prevent human papillomavirus (HPV) 6, HPV 11, HPV 16, or HPV 18 and associated diseases is licensed for females, and it may be licensed for men in the future. There are limited data on HPV 6/11, 16, and/or 18 seroprevalence in men. METHODS A total of 490 men aged 18 to 40 years were enrolled in a study of HPV in men in Tucson, AZ, and Tampa, FL. Enrolled men completed a self-administered questionnaire, and HPV serology was performed using HPV 6/11, 16, and 18 VLP assays. RESULTS Overall, seroprevalence to HPV 16 was 12.1%, HPV 6/11 was 9.7%, and to HPV 18 was 5.4%. Seroprevalence to HPV 6/11, 16, and/or 18 was 21% and was highest among 35 to 40 year olds (48%); prevalence in this age group was significantly higher compared to the 18 to 24 year olds (adjusted odds ratio (aOR) 6.8, 95% confidence interval (CI) 3.7, 12.8). Independent predictors of seropositivity to HPV 6/11, 16, and/or 18 were older age, greater number of female sex partners in the past 3 months, and current smoking. CONCLUSIONS HPV vaccine-type seroprevalence was highest in 35 to 40 year old men. These data on the epidemiology of HPV seroprevalence in men are useful for discussions regarding recommendations for HPV vaccine if licensed for use in men.
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Lu B, Hagensee ME, Lee JH, Wu Y, Stockwell HG, Nielson CM, Abrahamsen M, Papenfuss M, Harris RB, Giuliano AR. Epidemiologic Factors Associated with Seropositivity to Human Papillomavirus Type 16 and 18 Virus–Like Particles and Risk of Subsequent Infection in Men. Cancer Epidemiol Biomarkers Prev 2010; 19:511-6. [DOI: 10.1158/1055-9965.epi-09-0790] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Achour M, Kahla S, Zeghal D, Kochbati L, Mongi M, Zouari F, Oueslati R. Analysis of antibody response to HPV 16 and HPV 18 antigens in Tunisian patients. Viral Immunol 2009; 22:7-16. [PMID: 19210223 DOI: 10.1089/vim.2008.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this present study was to use Luminex technology to detect antibodies against the late antigen L1 as well as those directed against the early antigens E6 and E7. BACKGROUND DATA Human papillomavirus (HPV) serology is complex because infection and disease lead to distinct type-specific antibody responses. MATERIALS AND METHODS Viral antigens were expressed with pGEX vectors in Escherichia coli and then used in Luminex as coating antigens for antibody detection in 205 human sera samples: 71 cervical cancer cases, 64 cases of cervical inflammation, and 70 controls. RESULTS The data showed that 90.14% of sera among the cervical cancer patients had seropositivity toward at least one of the HPV 16 or HPV 18 antigens. Moreover, the percentages of positivity toward E6 and E7 HPV 16 antigens were 44% and 61%, respectively, versus only 21% for the L1 antigen. Among cervical cancer patients, the data showed different distributions in women of different ages. In addition, the intensity of the antibody response was also different for the six antigens analyzed. CONCLUSIONS Antibody detection depends on the type of antigen, and is well correlated with international scientific findings. The differences in antibody response between patients with inflammation and patients with cervical cancer were significant.
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Affiliation(s)
- Mongia Achour
- Department of Biology, IMEC Unit, Faculty of Sciences, Zarzouna, Bizerte, Tunisia
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Noguez PT, Muccillo-Baisch AL, Cezar-Vaz MR, Soares MCF. Aborto espontâneo em mulheres residentes nas proximidades do parque industrial do município do Rio Grande - RS. TEXTO & CONTEXTO ENFERMAGEM 2008. [DOI: 10.1590/s0104-07072008000300004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Estudo transversal que objetivou identificar a prevalência de abortos espontâneos e fatores associados em mulheres em idade reprodutiva residentes nas proximidades de um parque industrial. A amostra foi de 285 mulheres expostas à poluição e 280 não expostas. Os dados foram coletados por meio de um instrumento com questões fechadas, em 2004 e analisados pelo teste qui-quadrado e regressão logística, mostraram prevalência de abortos espontâneos de 17,7%. Na análise bivariada associaram-se com o desfecho: idade da menarca (OR=0,26; p=0,0008); número de filhos (OR=4,00; p=0,001). Na análise multivariada a idade da menarca entre 11 e 13 anos (OR=0,32; p=0,005), presença de três ou mais filhos (OR=2,92; p=0,03) e história de baixo peso ao nascer (OR=2,39; p=0,049) associaram-se com aborto espontâneo. Não houve associação com o local de moradia nas proximidades do parque industrial. Sugere-se a realização de estudos com biomarcadores para identificar possível influência do ambiente sobre a saúde reprodutiva, nessa população, ou afastar definitivamente essa suspeita.
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Michael KM, Waterboer T, Sehr P, Rother A, Reidel U, Boeing H, Bravo IG, Schlehofer J, Gärtner BC, Pawlita M. Seroprevalence of 34 human papillomavirus types in the German general population. PLoS Pathog 2008; 4:e1000091. [PMID: 18566657 PMCID: PMC2408730 DOI: 10.1371/journal.ppat.1000091] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Accepted: 05/16/2008] [Indexed: 11/23/2022] Open
Abstract
The natural history of infections with many human papillomavirus (HPV) types is poorly understood. Here, we describe for the first time the age- and sex-dependent antibody prevalence for 29 cutaneous and five mucosal HPV types from 15 species within five phylogenetic genera (alpha, beta, gamma, mu, nu) in a general population. Sera from 1,797 German adults and children (758 males and 1,039 females) between 1 and 82 years (median 37 years) were analysed for antibodies to the major capsid protein L1 by Luminex-based multiplex serology. The first substantial HPV antibody reactions observed already in children and young adults are those to cutaneous types of the genera nu (HPV 41) and mu (HPV 1, 63). The antibody prevalence to mucosal high-risk types, most prominently HPV 16, was elevated after puberty in women but not in men and peaked between 25 and 34 years. Antibodies to beta and gamma papillomaviruses (PV) were rare in children and increased homogeneously with age, with prevalence peaks at 40 and 60 years in women and 50 and 70 years in men. Antibodies to cutaneous alpha PV showed a heterogeneous age distribution. In summary, these data suggest three major seroprevalence patterns for HPV of phylogenetically distinct genera: antibodies to mu and nu skin PV appear early in life, those to mucosal alpha PV in women after puberty, and antibodies to beta as well as to gamma skin PV accumulate later in life.
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Affiliation(s)
- Kristina M Michael
- Infection and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Clifford GM, Shin HR, Oh JK, Waterboer T, Ju YH, Vaccarella S, Quint W, Pawlita M, Franceschi S. Serologic response to oncogenic human papillomavirus types in male and female university students in Busan, South Korea. Cancer Epidemiol Biomarkers Prev 2007; 16:1874-9. [PMID: 17855708 DOI: 10.1158/1055-9965.epi-07-0349] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In the absence of genital samples, human papillomavirus (HPV) serology may be useful to assess HPV infection in young men and women. HPV seroprevalence and determinants of seropositivity were assessed in 817 female and 518 male university students in Busan, South Korea, of whom 74% and 44%, respectively, reported never having had penetrative sexual intercourse. Type-specific HPV DNA status, assessed by a short PCR fragment primer set, was available from genital samples. Seropositivity to L1 proteins of HPV types 16, 18, 31, 33, 45, 52, and 58 were assessed using multiplex HPV serology. Among women, HPV seroprevalence was significantly higher among sexually active (26.1%) than nonsexually active students [11.1%, odds ratio (OR) = 2.9; 95% confidence interval (95% CI), 1.8-4.7], although the association was weaker than that for HPV DNA prevalence (OR, 14; 95% CI, 4.7-42). Furthermore, HPV seroprevalence was higher among HPV DNA-positive (24%) than HPV DNA-negative women (13%), and there was a positive correlation of type-specific seroprevalence with the presence of HPV DNA of the same type. In contrast, HPV seropositivity among men was not associated with sexual behavior or the presence of HPV DNA. Seroprevalence correlates with genital HPV exposure in young women, but its meaning in young men is unclear.
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Phillips AA, Jacobson JS, Magai C, Consedine N, Horowicz-Mehler NC, Neugut AI. Cancer incidence and mortality in the Caribbean. Cancer Invest 2007; 25:476-83. [PMID: 17882661 DOI: 10.1080/07357900701359841] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Nearly 10% of immigrants to the United States come from the Caribbean region. In this paper, we analyzed incidence and mortality rates of the major cancers in the Bahamas, Barbados, Cuba, the Dominican Republic, Haiti, Jamaica, Puerto Rico, and Trinidad and Tobago, and compared them with US patterns. METHODS We obtained age-standardized, sex-specific cancer incidence and mortality rates for cancers of the bladder, breast, cervix, esophagus, large bowel, liver, lung, pancreas, prostate, and stomach for 8 Caribbean countries and the United States from the GLOBOCAN program of the International Agency for Research in Cancer (IARC) and for the U.S. population from the Surveillance, Epidemiology, and End Results (SEER) Program of the NCI. RESULTS GLOBOCAN incidence and mortality rates for the overall United States were lower than but correlated with overall SEER rates. Based on GLOBOCAN data, the incidence and mortality rates of cancers of the breast, prostate, large bowel, and lung, and, among males, bladder cancer were lower in the Caribbean countries than the United States. Caribbean countries had higher rates of cancers of the cervix, esophagus, liver, and stomach. Haiti had the highest incidence and mortality rates of cervix and liver cancers. Jamaica and Haiti had the highest rates of stomach cancer. CONCLUSIONS Cancer incidence and mortality in the Caribbean generally follow known patterns of association with economic development, infectious agents, and racial/ethnic origin. Studying these patterns and how immigration changes them may yield clues to cancer etiology. A better understanding of cancer incidence and mortality rates may help health policymakers to implement state-of-the-art treatment and preventive services for people of Caribbean descent both in their native countries and in immigrant communities in the United States.
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Affiliation(s)
- Adrienne A Phillips
- Department of Medicine, Mailman School of Public Health, Columbia University, New York, New York 10032, USA
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19
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Kreimer AR, Alberg AJ, Viscidi R, Gillison ML. Gender differences in sexual biomarkers and behaviors associated with human papillomavirus-16, -18, and -33 seroprevalence. Sex Transm Dis 2004; 31:247-56. [PMID: 15028941 DOI: 10.1097/01.olq.0000118425.49522.2c] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The elevated risk for incident head and neck cancer among human papillomavirus (HPV)-16-seropositive individuals has substantiated a role for HPV in the etiology of head and neck cancers. The relationship between HPV seroreactivity and prevalent oral HPV infection in men and women without cancer has yet to be investigated. GOAL The goal of this study was to evaluate a possible association between oral HPV infection and HPV seroreactivity after adjustment for gender, sexual behaviors, and sexually transmitted disease. STUDY DESIGN A cross-sectional study of factors associated with HPV-16, -18, and -33 seroreactivity was performed in a population of 586 men and women with and without HIV infection. Antibodies in sera were measured by use of a virus-like protein (VLP)-based enzyme-linked immunosorbent assay. Exfoliated cells from the tonsillar and oral mucosa were analyzed for the presence of 38 mucosal HPV types by polymerase chain reaction. RESULTS Women had significantly greater seroreactivity for all HPV types investigated when compared with men (odds ratio, 4.3; 95% confidence interval, 3.0-6.0). Seroprevalence was greatest in men and women aged 35 to 45 years. Tonsillar HPV infection, oral sex with men, and HIV infection were independently associated with HPV seroreactivity in men after adjustment for age and number of sexual partners. In women, HSV-2 seropositivity and a history of sexually transmitted diseases were similarly important. Oral and tonsillar HPV infection were not associated with HPV seroreactivity in women. CONCLUSION HPV seropositivity is associated with sexually transmitted diseases among women and possibly mucosal HPV exposures in men. Tonsillar HPV infection could impact seroprevalence, particularly in men.
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Affiliation(s)
- Aimee R Kreimer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Wang SS, Schiffman M, Shields TS, Herrero R, Hildesheim A, Bratti MC, Sherman ME, Rodriguez AC, Castle PE, Morales J, Alfaro M, Wright T, Chen S, Clayman B, Burk RD, Viscidi RP. Seroprevalence of human papillomavirus-16, -18, -31, and -45 in a population-based cohort of 10000 women in Costa Rica. Br J Cancer 2003; 89:1248-54. [PMID: 14520455 PMCID: PMC2394308 DOI: 10.1038/sj.bjc.6601272] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Human papillomavirus (HPV) seroprevalence and determinants of seropositivity were assessed in a 10049-woman population-based cohort in Guanacaste, Costa Rica. Serologic responses based on VLP-based ELISA were obtained from the plasma collected at study enrollment in 1993/1994 for HPV-16 (n=9949), HPV-18 (n=9928), HPV-31 (n=9932), and HPV-45 (n=3019). Seropositivity was defined as five standard deviations above the mean optical density obtained for studied virgins (n=573). HPV-16, -18, -31, and -45 seroprevalence was 15, 15, 16, and 11%, respectively. Of women DNA-positive for HPV-16, -18, -31, or -45, seropositivity was 45, 34, 51, and 28%, respectively. Peak HPV seroprevalence occurred a decade after DNA prevalence; lifetime number of sexual partners was the key determinant of seropositivity independent of DNA status and age. DNA- and sero-positive women showed the highest risk for concurrent CIN3/cancer, followed by DNA-positive, sero-negative women.
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Affiliation(s)
- S S Wang
- National Cancer Institute, Bethesda, MD 20892-7234, USA.
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Castle PE, Escoffery C, Schachter J, Rattray C, Schiffman M, Moncada J, Sugai K, Brown C, Cranston B, Hanchard B, Palefsky JM, Burk RD, Hutchinson ML, Strickler HD. Chlamydia trachomatis, herpes simplex virus 2, and human T-cell lymphotrophic virus type 1 are not associated with grade of cervical neoplasia in Jamaican colposcopy patients. Sex Transm Dis 2003; 30:575-80. [PMID: 12838087 DOI: 10.1097/00007435-200307000-00009] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND A few recent studies have suggested that other sexually transmitted infections may increase the likelihood of a human papillomavirus (HPV) infection progressing to high-grade cervical neoplasia and cancer. GOAL The goal was to assess whether exposures to Chlamydia trachomatis, human T-cell lymphotrophic virus type 1 (HTLV-I), and/or human simplex virus type 2 (HSV-2) are greater in colposcopy patients with cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) than in patients with low-grade cervical neoplasia (CIN1). STUDY DESIGN Sequential patients (n=447) attending a colposcopy clinic in Kingston, Jamaica, a country with high cervical cancer rates and high HTLV-I prevalence, were tested for (1) HPV DNA by L1 consensus primer (MY09/11) polymerase chain reaction assays, (2) C trachomatis DNA by ligase chain reaction, (3) C trachomatis antibodies by both microimmunofluorescence and a peptide (VS4) enzyme linked immunosorbent assay (ELISA), (4) HTLV-I antibodies by ELISA confirmed by western blotting, and (5) HSV-2 antibodies by a recombinant HSV-2-specific ELISA. Odds ratios and 95% confidence intervals were estimated with use of multinomial logistic regression models. RESULTS HPV DNA detection was associated with grade of cervical neoplasia but other evaluated sexually transmitted infections were not. CONCLUSIONS HTLV-I, C trachomatis, and/or HSV-2 were not associated with severity of cervical neoplasia in Jamaican women.
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Affiliation(s)
- Philip E Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892, USA.
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Karem KL, Poon AC, Bierl C, Nisenbaum R, Unger E. Optimization of a human papillomavirus-specific enzyme-linked immunosorbent assay. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2002; 9:577-82. [PMID: 11986263 PMCID: PMC120007 DOI: 10.1128/cdli.9.3.577-582.2002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A strategy was developed for the control, standardization, and critical evaluation of an enzyme-linked immunosorbent assay (ELISA) for the detection of human papillomavirus-specific immunoglobulin G in human sera. Control human sera, polyclonal animal sera, and monoclonal antibodies were used to establish optimal assay parameters, including antigen coating, serum dilutions, and criteria for daily reproducibility, monitoring, and rejection of assays. Three evaluation techniques were used in parallel to define an optimal cutoff absorbance value that yields greater than 93% sensitivity and 98.5% specificity in the assay's ability to discriminate positive and negative control sera. This strategy provides an optimal method by which to determine cutoff absorbance values for ELISA.
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Affiliation(s)
- Kevin L Karem
- Viral Exanthems and Herpesvirus Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Castle PE, Hildesheim A, Bowman FP, Strickler HD, Walker JL, Pustilnik T, Edwards RP, Crowley-Nowick PA. Cervical concentrations of interleukin-10 and interleukin-12 do not correlate with plasma levels. J Clin Immunol 2002; 22:23-7. [PMID: 11958590 DOI: 10.1023/a:1014252402630] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Human papillomavirus (HPV) infects the transformation zone of the cervix and is the primary cause of cervical cancer. The infection is localized to the cervix and mucosal immunity is likely to be an important determinant for viral clearance. Previous studies of immunity to HPV have measured immune markers in the blood, but the relationship of systemic immunity to cervical immunity is poorly understood. In this study of 70 women enrolled in the ASCUS-LSIL Triage Study (ALTS), a clinical trial for management of low-grade cytologic abnormalities of the cervix, we collected paired plasma and cervical secretions to investigate the relationship between cervical concentrations of interleukin-10 (IL-10) and interleukin-12 (IL-12) and plasma levels. Neither IL-10 (p = 0.11), or IL-12 (p = -0.04) nor the ratio of IL-12 to IL-10 (p = 0.06) were correlated between blood and cervical secretions. Except for weak correlations of IL-10 among nonsmokers (p = 0.35. P = 0.019) and those in day 18-27 of their menstrual cycle (p = 0.51, P = 0.015), this lack of correlation persisted in all subgroups defined by genital inflammation or infection, current oral contraceptive use, heme contamination and volume of collected secretions, HPV16 seropositivity, and repeat HPV infection and/or cytologic abnormalities. The lack of correlation and high concentrations in cervical secretions indicate that the cervical IL-10 and IL-12 concentrations exceed what could be expected from blood as a principle source of IL-10 and IL-12 and suggest that cytokine concentrations in cervical secretions are predominantly the result of local cytokine production.
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Affiliation(s)
- Philip E Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20892-7234, USA.
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Touzé A, de Sanjosé S, Coursaget P, Almirall MR, Palacio V, Meijer CJ, Kornegay J, Bosch FX. Prevalence of anti-human papillomavirus type 16, 18, 31, and 58 virus-like particles in women in the general population and in prostitutes. J Clin Microbiol 2001; 39:4344-8. [PMID: 11724843 PMCID: PMC88547 DOI: 10.1128/jcm.39.12.4344-4348.2001] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2001] [Accepted: 10/08/2001] [Indexed: 11/20/2022] Open
Abstract
Genital human papillomavirus (HPV) infection is sexually transmitted. The aim of the study was to characterize serological responses to HPV types 16, 18, 31, and 58 by exploring type-specific virus-like particles (VLPs) in two groups of women with very distinct sexual behaviors. Anti-VLP antibodies for types 16, 18, 31, and 58 and HPV DNA in cervical cells were investigated with 177 prostitutes and 283 age-matched controls from the female general population in Spain. Anti-VLP positivity increased with number of lifetime sexual partners in women from the general population, and no seroresponse was found in virgins. However, in prostitutes HPV infection was characterized by higher multireactivity to three or four VLPs (25%) than the general population (3%) and by a more frequent antibody response to HPV-58 than in the general population. About 75% of the women seropositive for type 58 had been born in a Latin American country. Seroprevalence of HPV and cervical HPV DNA in prostitutes were 14 and 10 times higher than observed in women in the general population (prevalence odds ratio [POR] of HPV seropositivity, 14.04 [95%; CI = 8.4 to 23.6] and POR for HPV DNA, 10.4 [95% CI = 3.9 to 27.6). Our results indicate that prostitutes are at an increased risk of oncogenic HPV infections, and they confirm the validity of anti-VLPs as markers of present or past HPV infection, that the number of sexual partners is the major determinant in acquisition of oncogenic HPV, and that anti-VLPs could be used as a marker of repeated infection in prostitutes.
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Affiliation(s)
- A Touzé
- Laboratoire de Virologie Moléculaire, INSERM EMI-U 00-10 Protéases et Vectorisation, Faculté de Pharmacie, 37200 Tours, France
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Weinstein SJ, Ziegler RG, Frongillo EA, Colman N, Sauberlich HE, Brinton LA, Hamman RF, Levine RS, Mallin K, Stolley PD, Bisogni CA. Low serum and red blood cell folate are moderately, but nonsignificantly associated with increased risk of invasive cervical cancer in U.S. women. J Nutr 2001; 131:2040-8. [PMID: 11435527 DOI: 10.1093/jn/131.7.2040] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Previous observational epidemiologic studies of folate and cervical cancer, as well as folate supplementation trials for cervical dysplasia, have produced mixed results. We examined the relationship between serum and RBC folate and incident invasive cervical cancer in a large, multicenter, community-based case-control study. Detailed in-person interviews were conducted, and blood was drawn at least 6 mo after completion of cancer treatment from 51% of cases and 68% of controls who were interviewed. Blood folate was measured with both microbiologic and radiobinding assays. Included in the final analyses were 183 cases and 540 controls. Logistic regression was used to control for all accepted risk factors, including age, sexual behavior, smoking, oral contraceptive use, Papanicolaou smear history and human papillomavirus (HPV)-16 serology. For all four folate measures, the geometric mean in cases was lower than in controls (e.g., 11.6 vs. 13.0 nmol/L, P < 0.01 for the serum radiobinding assay). Folate measures using microbiologic and radiobinding assays were correlated (serum: r = 0.90; RBC: r = 0.77). For serum folate, multivariate-adjusted odds ratios (OR) in the lowest vs. highest quartile were 1.3 [95% confidence interval (CI) = 0.8--2.9] and 1.6 (0.9--2.9), using the microbiologic and radiobinding assays, respectively. For RBC folate, comparable OR were 1.2 (0.6--2.2) and 1.5 (0.8--2.7). Similar risks were obtained when restricting analyses to subjects with a history of HPV infection. Thus, low serum and RBC folate were each moderately, but nonsignificantly, associated with increased invasive cervical cancer risk. These findings support a role for one-carbon metabolism in the etiology of cervical cancer.
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Affiliation(s)
- S J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Marais DJ, Rose RC, Lane C, Kay P, Nevin J, Denny L, Soeters R, Dehaeck CM, Williamson AL. Seroresponses to human papillomavirus types 16, 18, 31, 33, and 45 virus-like particles in South African women with cervical cancer and cervical intraepithelial neoplasia. J Med Virol 2000; 60:403-10. [PMID: 10686023 DOI: 10.1002/(sici)1096-9071(200004)60:4<403::aid-jmv7>3.0.co;2-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of the study was to determine the prevalence of antibodies to human papillomavirus (HPV) types 16, 18, 31, 33, and 45 in woman in Cape Town with cervical intraepithelial neoplasia (CIN) (n = 95), cervical cancer (n = 40), female blood donors (n = 95) and children (n = 110). The enzyme-linked immunosorbent assay (ELISA) made use of baculovirus synthesised HPV virus like particles (VLPs) as antigen. Antibodies to at least one HPV type were detected in sera from 75% of cancer patients, 71.6% of CIN patients, 44.2% of blood donors and 27.3% of children. Sera from 95 women with CIN were compared with age-matched female blood donors. There was a significant association of seropositivity to VLP-16 (P = 0.006) and VLP-45 (P = 0.008) with CIN compared with the blood donors. There was also a significant difference in the seropositivity of women with CIN to any of the five virus-like particle (VLP) types compared to the blood donors (P = 0.0002: OR = 3.2). Thirty-nine of sixty-nine (56.5%) women with CIN were found to be HPV-16 DNA positive. The average age of women in this group that were VLP-16 seropositive was 34 years and those found to be VLP-16 seronegative was 52 years of age. Antibodies to all five VLP types were detected in these populations, thus an ideal vaccine should induce protection from infection by a wide range of HPV types.
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Affiliation(s)
- D J Marais
- Department of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
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Marais D, Rose RC, Lane C, Aspinall S, Bos P, Williamson AL. Seroresponses to virus-like particles of human papillomavirus types 16, 18, 31, 33, and 45 in San people of Southern Africa. J Med Virol 2000; 60:331-6. [PMID: 10630966 DOI: 10.1002/(sici)1096-9071(200003)60:3<331::aid-jmv12>3.0.co;2-a] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Virus-like particles (VLPs) of the high-risk human papillomavirus (HPV) types 16, 18, 31, 33, and 45 were used as antigen in enzyme-linked immunosorbent assay (ELISA) to determine the prevalence of serum IgG in a group of San people originally from Namibia, now residing in South Africa. The San children had low seroprevalence to all VLP types, but 26/115 (22.6%) of the children were seropositive to at least 1 VLP type. Among the adults, seroprevalence was significantly higher. The seroprevalence of antibodies in 101 San women to VLP-16 was 16.8%, VLP-18 18.8%, VLP-31 12.9%, VLP-33 17.8%, and VLP-45 22.8%. Five of the 11 men were seropositive: 2 for VLP-31, 1 for VLP-18, 1 for VLP-33, and 1 for VLP-45. Seroreactivity appeared to be type specific, except possibly to VLP-18 and -45. Of the adults, 50.5% were seropositive to at least 1 VLP type and 24.8% were seropositive to >1 VLP type. From this study, it is concluded that the San people are exposed to HPV-16, -18, -31, -33, and -45, with antibodies to VLP-45 being the most prevalent.
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Affiliation(s)
- D Marais
- Department of Medical Microbiology, UCT Medical School, Cape Town, South Africa
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Manns A, Strickler HD, Wikktor SZ, Pate EJ, Gray R, Waters D. Low incidence of human papillomavirus type 16 antibody seroconversion in young children. Pediatr Infect Dis J 1999; 18:833-5. [PMID: 10493350 DOI: 10.1097/00006454-199909000-00020] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A Manns
- Viral Epidemiology Branch, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
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