1
|
Martinelli M, Giubbi C, Saderi L, Musumeci R, Perdoni F, Leone BE, Fruscio R, Landoni F, Piana A, Sotgiu G, Cocuzza CE. Evaluation of Human Papilloma Virus (HPV) Genotyping and Viral Load Determination as Diagnostic Biomarkers of Cervical Cancer Risk. Int J Mol Sci 2023; 24:ijms24021320. [PMID: 36674835 PMCID: PMC9865838 DOI: 10.3390/ijms24021320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/27/2022] [Accepted: 01/07/2023] [Indexed: 01/12/2023] Open
Abstract
HPV testing in cervical cancer screening programs offers the possibility of introducing molecular standardized biomarkers for the triage of HPV-positive women. This study aimed to evaluate the role of HPV genotyping and viral load as possible diagnostic biomarkers of high-grade cervical lesions (CIN2+) by performing a preliminary evaluation of a new HPV test. Cervical specimens were obtained from 200 women referred for a colposcopy. Samples were tested using both Anyplex™ II HR-HPV as well as OncoPredict HPV® Screening (SCR) and quantitative typing (QT). Using a cycle threshold cutoff (Ct) of 36.8 for the SCR assay and 1.27 log10 (viral copies/104 cells) for the QT assay, relative clinical sensitivity for CIN2+ and relative clinical specificity for CIN2- as compared to Anyplex™ II HR-HPV were, respectively, 0.92 and 1.00 for SCR and 1.35 and 1.24 for QT. The distribution of high-risk HPV (HR-HPV) genotypes (p = 0.009) as well as the viral copy numbers (CIN2-: 3.7 log10 (viral copies/104 human cells); CIN2+: 4.3 log10 (viral copies/104 human cells); p = 0.047) were found to differ in women with high- and low-grade cervical lesions, suggesting a possible role of HPV genotyping and normalized viral load as potential biomarkers to identify women at increased risk of cervical lesions.
Collapse
Affiliation(s)
- Marianna Martinelli
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Chiara Giubbi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Rosario Musumeci
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Federica Perdoni
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Biagio Eugenio Leone
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Robert Fruscio
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Clinic of Obstetrics and Gynecology, San Gerardo Hospital, 20900 Monza, Italy
| | - Fabio Landoni
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Clinic of Obstetrics and Gynecology, San Gerardo Hospital, 20900 Monza, Italy
| | - Andrea Piana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Clementina Elvezia Cocuzza
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-0264488358
| |
Collapse
|
2
|
Li M, Zhao C, Zhao Y, Li J, Zhang X, Zhang W, Gao Q, Wei L. Association and Effectiveness of PAX1 Methylation and HPV Viral Load for the Detection of Cervical High-Grade Squamous Intraepithelial Lesion. Pathogens 2022; 12:pathogens12010063. [PMID: 36678411 PMCID: PMC9865608 DOI: 10.3390/pathogens12010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/29/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Background: PAX1 methylation (PAX1m) and HPV viral load (VL) have been reported to detect cervical high-grade squamous intraepithelial lesions (HSIL), but the relationship between them is unclear. This study aimed to evaluate the correlation between HPV VL and PAX1m and its effectiveness in predicting cervical lesions. (2) Methods: A total of 476 women referred to colposcopy for abnormal cervical screening at the Peking University People’s Hospital between November 2020 and November 2021 were enrolled. PAX1m and HPV VL were determined by QMSP and BMRT-HPV reports type-specific VL/10,000 cells, respectively. (3) Results: PAX1m was significantly increased in HSIL, especially in cervical cancer, but there was no significant difference between cervical intraepithelial neoplasms 1(CIN1) and CIN2. However, HPV VL significantly differed between CIN1 and CIN2 but not between CIN3 and cervical cancer. In general, PAX1m positively correlated with all hrHPV VL, mainly in the HPV16/18 VL (p < 0.001), but had no relationship with the other 12 types of hrHPV VL. PAX1m had the highest specificity in diagnosing CIN2+, followed by HPV16/18 VL, which are higher than cytology ≥ASCUS. (4) Conclusions: Hypermethylation of PAX1 is associated with high HPV VL, especially HPV16/18, and both present advantageous specificity in detecting CIN2+.
Collapse
|
3
|
Jalil AT, Khan MUF, Muhammed HA, Kawen AA, Saeed BQ, Karevskiy A. Detection of HPV16 viral load in L2 gene as a related predictor of cervical cancer among women in Dhi-Qar province by qRT-PCR. Mol Biol Rep 2022; 49:11847-11853. [PMID: 36214947 DOI: 10.1007/s11033-022-07955-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/16/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The most common infection among young women that increases the risk of developing cervical cancer (CC) is human papillomavirus (HPV). In this study, we are going to assess whether HPV16 DNA concentration helps indicate cervical cancer progression ,As well as for age groups and their relationship to cervical cancer. METHODS Present study included 93 adult females suffering from cervical cancer during the period from 2017 to 2020. Molecular detection of HPV was done using amplification of the L2 gene (minor capsid protein). RESULTS Present results showed that 60 (65%) of the patients from 93 cervical cancer cases were infected by HPV16 while only 5 (8%) of healthy patients from the control group were positive for HPV16. So, the current study revealed high HPV16 load in cervical cancer ranged from 1.09 × 102 IU/ml to 5.07 × 103 IU/ml with a mean ± SD of viral load was 1043.25 ± 8.50 IU/ml while in healthy individuals very low viral load ranging from 88 IU/ml to 101 IU/ml and mean ± SD of viral load was 91.25 ± 2.90 IU/ml was reported. CONCLUSION HPV16 viral load is significantly associated with cervical carcinoma among women in Dhi-Qar Province.
Collapse
Affiliation(s)
- Abduladheem Turki Jalil
- Faculty of Biology and Ecology, Yanka Kupala State University of Grodno, Ozhesko str., 22, Grodno, Belarus. .,Department, Medical Laboratories Techniques, Al-Mustaqbal University College, Babylon, 51001, Hilla, Iraq.
| | | | | | | | - Balsam Qubais Saeed
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Aleksandr Karevskiy
- Dean Faculty of Biology and Ecology, Yanka Kupala State University of Grodno, Ozhesko str., 22, Grodno, Belarus
| |
Collapse
|
4
|
Yang Q, Du H, Qu X, Dai W, Gui L, Li C, Wang C, Guo C, Zhang Y, Wei L, Belinson JL, Wu R. Comparison of cycle threshold values of the Cobas HPV test and viral loads of the BMRT HPV test in cervical cancer screening. Front Public Health 2022; 10:1010066. [PMID: 36438219 PMCID: PMC9686283 DOI: 10.3389/fpubh.2022.1010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022] Open
Abstract
Objective To validate the HPV viral loads that are reflected by the cycle threshold values of Cobas4800 as the viral load indicators by verifying the consistency of the viral loads per unit (10,000 cells) from the BMRT assay. Methods The analysis is based on data from the Chinese Multi-Center Screening Trial (CHIMUST). The cases included in the analysis are all positive for physician-collected hrHPV on SeqHPV and/or Cobas4800 or negative for hrHPV but abnormal in cytology (≥LSIL), and some cases selected by nested case-control randomization from those negative for physician-collected hrHPV and cytology. With HPV testing results and relevant Ct values from Cobas4800 available, we tested the entire sample set with the BMRT HPV testing assay and analyzed their agreement with Cobas4800, followed by a comparison of the CtV from Cobas4800 and viral loads (lg) from BMRT by lesion grade. Results We included 4,485 women (mean age: 45.4 years) in the study, and 4,290 had complete data. The consistency of genotypes from Cobas4800 and BMRT for hrHPV, HPV-16, HPV-18, and 12-HPV pools was 94.9% (4070/4290, Kappa = 0.827), 99.1% (4251/4290, Kappa = 0.842), 99.6% (4,273/4,290, Kappa = 0.777), and 95.3% (4,089/4,290, Kappa = 0.821), respectively. Further analysis shows that any inconsistency between the two assays is likely among samples with comparatively lower viral loads. When analyzing per lesions of CIN2+ and CIN3+, the CtV from Cobas4800 and VL (lg) from BMRT are highly correlated inversely and follow the linear regression for HPV16 and 12-HPV pool (Pearson's or Spearman's correlation coefficient (r): In CIN3+, r HPV16 = -0.641, P < 0.001; r 12-HPVpool = -0.343, P = 0.109; In CIN2+, r HPV16 = -0.754, P < 0.001; r 12-HPVpool = -0.429, P < 0.001). Conclusion The CtV from Cobas4800 and the viral loads (lg) of per unit cells from the BMRT are well correlated for lesion grading when tested on physician-collected samples. Cobas-CtV is worthy of further study for clinical application.
Collapse
Affiliation(s)
- Qing Yang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hui Du
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xinfeng Qu
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China
| | - Wenkui Dai
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Liming Gui
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Changzhong Li
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Chun Wang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Chunlei Guo
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yi Zhang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Lihui Wei
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China,*Correspondence: Lihui Wei
| | - J. L. Belinson
- Preventive Oncology International, Inc., The Women's Health Institute, Cleveland Clinic, Cleveland, OH, United States,J. L. Belinson
| | - Ruifang Wu
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China,Institute of Obstetrics and Gynecology, Peking University–Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, China,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Peking University Shenzhen Hospital, Shenzhen, China,Ruifang Wu
| |
Collapse
|
5
|
Kaklauskas A, Abraham A, Ubarte I, Kliukas R, Luksaite V, Binkyte-Veliene A, Vetloviene I, Kaklauskiene L. A Review of AI Cloud and Edge Sensors, Methods, and Applications for the Recognition of Emotional, Affective and Physiological States. SENSORS (BASEL, SWITZERLAND) 2022; 22:7824. [PMID: 36298176 PMCID: PMC9611164 DOI: 10.3390/s22207824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/28/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Affective, emotional, and physiological states (AFFECT) detection and recognition by capturing human signals is a fast-growing area, which has been applied across numerous domains. The research aim is to review publications on how techniques that use brain and biometric sensors can be used for AFFECT recognition, consolidate the findings, provide a rationale for the current methods, compare the effectiveness of existing methods, and quantify how likely they are to address the issues/challenges in the field. In efforts to achieve the key goals of Society 5.0, Industry 5.0, and human-centered design better, the recognition of emotional, affective, and physiological states is progressively becoming an important matter and offers tremendous growth of knowledge and progress in these and other related fields. In this research, a review of AFFECT recognition brain and biometric sensors, methods, and applications was performed, based on Plutchik's wheel of emotions. Due to the immense variety of existing sensors and sensing systems, this study aimed to provide an analysis of the available sensors that can be used to define human AFFECT, and to classify them based on the type of sensing area and their efficiency in real implementations. Based on statistical and multiple criteria analysis across 169 nations, our outcomes introduce a connection between a nation's success, its number of Web of Science articles published, and its frequency of citation on AFFECT recognition. The principal conclusions present how this research contributes to the big picture in the field under analysis and explore forthcoming study trends.
Collapse
Affiliation(s)
- Arturas Kaklauskas
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Ajith Abraham
- Machine Intelligence Research Labs, Scientific Network for Innovation and Research Excellence, Auburn, WA 98071, USA
| | - Ieva Ubarte
- Institute of Sustainable Construction, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Romualdas Kliukas
- Department of Applied Mechanics, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Vaida Luksaite
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Arune Binkyte-Veliene
- Institute of Sustainable Construction, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Ingrida Vetloviene
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Loreta Kaklauskiene
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| |
Collapse
|
6
|
Meaning of the Decreased HPV Normalized Viral Load Marker in Clinical Evolution of Women with HPV Infection. Appl Microbiol 2022. [DOI: 10.3390/applmicrobiol2030050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
(1) Background: HPV infection can progress over the years to become cervical cancer. In this study, genotype and a normalized viral load were evaluated as surrogate markers of progression to cancer. (2) Methods: A total of 558 endocervical swabs were collected from 120 women (mean, 40.1 ± 11.8 years old). Seventy-eight of the women underwent clinical intervention (CI) to clear the infection during the course of the study, while forty-two did not (NCI). Normalized viral load (NVL) was calculated using a COBAS 4800 system. The INNOLIPA genotyping system was used to classify HPV which was neither type 16 or 18. (3) Results: The mean age of CI women was 41.1 ± 11.4 (22–68) years old and that of the NCI group was 37.7 ± 12.13 (23–65) (p: 0.104). HPV16 was present in 11 (25%) NCI and 30 (35.2%) CI patients, HPVα9non16 in 20 (45%) NCI and 34 (40%) CI, and HPVnonα9 in 13 (29.5%) NCI and 21 (24.7%) CI (p = 0.48). In NCI women there was an average NVL decrease of 0.95 log after two years and a further decrease of 2.35 log at the end of the third year. At the end of the study, 34 (80%) of the NCI patients were clear of HPV. However, NVL of CI women remained at around 5 log until intervention (p < 0.001). (4) Conclusions: Viral load decreased in NCI women at follow-up in the second year. In contrast, in CI women, their viral load did not fall over the follow-up period. This work thus demonstrates that a reduction in normalized viral load was associated with good evolution.
Collapse
|
7
|
Modeling and Mathematical Analysis of the Dynamics of HPV in Cervical Epithelial Cells: Transient, Acute, Latency, and Chronic Infections. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8650071. [PMID: 36050998 PMCID: PMC9427304 DOI: 10.1155/2022/8650071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022]
Abstract
The aim of this paper is to model the dynamics of the human papillomavirus (HPV) in cervical epithelial cells. We developed a mathematical model of the epithelial cellular dynamics of the stratified epithelium of three (basale, intermedium, and corneum) stratums that is based on three ordinary differential equations. We determine the biological condition for the existence of the epithelial cell homeostasis equilibrium, and we obtain the necessary and sufficient conditions for its global stability using the method of Lyapunov functions and a theorem on limiting systems. We have also developed a mathematical model based on seven ordinary differential equations that describes the dynamics of HPV infection. We calculated the basic reproductive number (R0) of the infection using the next-generation operator method. We determine the existence and the local stability of the equilibrium point of the cellular homeostasis of the epithelium. We then give a sufficient condition for the global asymptotic stability of the epithelial cell homeostasis equilibrium using the Lyapunov function method. We proved that this equilibrium point is nonhyperbolic when R0 = 1 and that in this case, the system presents a forward bifurcation, which shows the existence of an infected equilibrium point when R0 > 1. We also study the solutions numerically (i.e., viral kinetic in silico) when R0 > 1. Finally, local sensitivity index was calculated to assess the influence of different parameters on basic reproductive number. Our model reproduces the transient, acute, latent, and chronic infections that have been reported in studies of the natural history of HPV.
Collapse
|
8
|
Zheng JJ, Miao JR, Wu Q, Yu CX, Mu L, Song JH. Correlation between HPV-negative cervical lesions and cervical microenvironment. Taiwan J Obstet Gynecol 2021; 59:855-861. [PMID: 33218401 DOI: 10.1016/j.tjog.2020.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To investigate the correlation between high-risk human papillomavirus (HR HPV)-negative cervical lesions and cervical microenvironment in Inner Mongolia, China, and to find the pathogenic factors of HR HPV-negative cervical lesions. MATERIALS AND METHODS 74 cases of HR HPV-negative healthy women and 80 cases of patients with cervical lesions (28 cases of LSIL, 49 cases of HSIL and 3 cases of CSCC) were selected as the study group; 26 cases of HPV-positive women and 352 cases of patients with cervical lesions (108 cases of LSIL, 214 cases of HSIL and 30 cases of CSCC) were control group. Questionnaires were collected from the study group and the control group and specimens were collected. Gram staining, hematoxylin and eosin staining microscopy, and substrate colorimetry method were used to detect vaginal micro-ecological indicators; ELISA was used to detect the concentration of SIgA, IgG, IL-2 and IL-10 in vaginal lavage fluid. Genetic testing was used to detect HPV, mycoplasma, and chlamydia infection. The changes of vaginal micro-ecology evaluation index and local immune factor concentration in healthy women and cervical lesions of all grades in the study group and the control group were compared. RESULTS Patients with cervical lesions, compared with healthy women, had a decrease in dominant lactobacilli and dysbacteriosis (P < 0.05), and this trend became more apparent as the disease progressed. The diversity and concentration of the flora in the HPV-negative group increased, the abnormal composition ratio decreased, and the HPV-positive group showed the opposite trend. As the lesion progressed, H2O2 decreased first and then increased, and the overall trend of SNa, LE, GUS, and GADP increased. The infection rate of trichomoniasis, BV and chlamydia increased and infection rate of Candida decreased. Also, compared with healthy women, patients with cervical lesions showed changes in immune factor concentration (P < 0.05). As the lesion progressed, IL-2 decreased, IL-10 increased, and IL-2/IL-10 decreased. However, IL-2 expression in HPV-negative group was higher than HSIL. SIgA was significantly lower in patients with cervical lesions than in healthy women. IgG had an upward trend in the HPV positive group. CONCLUSION This study showed that vaginal micro-ecological imbalance and weakening of local cervical immune function are important reasons for the development of cervical lesions. It is expected to inhibit the development of cervical lesions by regulating the balance of vaginal micro-ecology and enhancing local immune function. By detecting Lactobacillus vaginalis, pre-enzyme, IL-2, IL-10, SIgA, it can guide the further diversion of HPV-positive women and predict the development direction of cervical lesions after HPV infection.
Collapse
Affiliation(s)
- Jing-Jing Zheng
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Jing-Rui Miao
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Qiang Wu
- Department of Neurosurgery, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Cong-Xiang Yu
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Lin Mu
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Jing-Hui Song
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China.
| |
Collapse
|
9
|
Depuydt C, Donders G, Verstraete L, Beert J, Salembier G, Bosmans E, Dhont N, Kerkhofs C, Ombelet W. Negative Impact of Elevated DNA Fragmentation and Human Papillomavirus (HPV) Presence in Sperm on the Outcome of Intra-Uterine Insemination (IUI). J Clin Med 2021; 10:jcm10040717. [PMID: 33670283 PMCID: PMC7917808 DOI: 10.3390/jcm10040717] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 01/04/2023] Open
Abstract
We wanted to determine the sperm DNA fragmentation index (DFI) cutoff for clinical pregnancies in women receiving intra-uterine insemination (IUI) with this sperm and to assess the contribution of Human Papillomavirus (HPV) infection on sperm DNA damage and its impact on clinical pregnancies. Prospective non-interventional multi-center study with 161 infertile couples going through 209 cycles of IUI in hospital fertility centers in Flanders, Belgium. Measurement of DFI and HPV DNA with type specific quantitative PCRs (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68) in sperm before its use in IUI. Clinical pregnancy (CP) rate was used as the outcome to analyze the impact on fertility outcome and to calculated the clinical cutoff value for DFI. A DFI criterion value of 26% was obtained by receiver operating characteristic (ROC) curve analysis. Couples with a male DFI > 26% had significantly less CPs than couples with DFI below 26% (OR 0.0326; 95% CI 0.0019 to 0.5400; p = 0.017). In sperm, HPV prevalence was 14.8%/IUI cycle. Sperm samples containing HPV had a significantly higher DFI compared to HPV negative sperm samples (29.8% vs. 20.9%; p = 0.011). When HPV-virions were present in sperm, no clinical pregnancies were observed. More than 1 in 5 of samples with normal semen parameters (17/78; 21.8%) had an elevated DFI or was HPV positive. Sperm DFI is a robust predictor of clinical pregnancies in women receiving IUI with this sperm. When DFI exceeds 26%, clinical pregnancies are less likely and in vitro fertilization techniques should be considered.
Collapse
Affiliation(s)
- Christophe Depuydt
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium; (C.D.); (L.V.); (J.B.); (E.B.)
- Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium
| | - Gilbert Donders
- Femicare, Clinical Research for Women, 3300 Tienen, Belgium
- University Hospital Antwerpen, 2650 Antwerp, Belgium
- Department of Obstetrics and Gynecology, Regional Hospital Heilig Hart, 3300 Tienen, Belgium
- Correspondence: or ; Tel.: +32-16-808102
| | - Ludo Verstraete
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium; (C.D.); (L.V.); (J.B.); (E.B.)
- Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium
| | - Johan Beert
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium; (C.D.); (L.V.); (J.B.); (E.B.)
- Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, 2020 Antwerp, Belgium;
| | - Geert Salembier
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, 2020 Antwerp, Belgium;
| | - Eugene Bosmans
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium; (C.D.); (L.V.); (J.B.); (E.B.)
- Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium
| | - Nathalie Dhont
- Genk Institute for Fertility Technology, ZOL Hospitals, 3600 Genk, Belgium; (N.D.); (C.K.); (W.O.)
| | - Carmen Kerkhofs
- Genk Institute for Fertility Technology, ZOL Hospitals, 3600 Genk, Belgium; (N.D.); (C.K.); (W.O.)
| | - Willem Ombelet
- Genk Institute for Fertility Technology, ZOL Hospitals, 3600 Genk, Belgium; (N.D.); (C.K.); (W.O.)
- Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium
| |
Collapse
|
10
|
Oyervides-Muñoz MA, Pérez-Maya AA, Sánchez-Domínguez CN, Berlanga-Garza A, Antonio-Macedo M, Valdéz-Chapa LD, Cerda-Flores RM, Trevino V, Barrera-Saldaña HA, Garza-Rodríguez ML. Multiple HPV Infections and Viral Load Association in Persistent Cervical Lesions in Mexican Women. Viruses 2020; 12:E380. [PMID: 32244347 PMCID: PMC7232502 DOI: 10.3390/v12040380] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/18/2020] [Accepted: 03/22/2020] [Indexed: 12/04/2022] Open
Abstract
Persistent high-risk human papillomavirus (HR-HPV) infections play a major role in the development of invasive cervical cancer (CC), and screening for such infections is in many countries the primary method of detecting and preventing CC. HPV typing can be used for triage and risk stratification of women with atypical squamous cells of undetermined significance (ASC-US)/low-grade cervical lesions (LSIL), though the current clinical practice in Mexico is to diagnose CC or its preceding conditions mainly via histology and HR-HPV detection. Additional information regarding these HPV infections, such as viral load and co-infecting agents, might also be useful for diagnosing, predicting, and evaluating the possible consequences of the infection and of its prevention by vaccination. The goal of this follow-up hospital case study was to determine if HPV types, multiple HPV infections, and viral loads were associated with infection persistence and the cervical lesion grade. A total of 294 cervical cytology samples drawn from patients with gynecological alterations were used in this study. HPV types were identified by real-time PCR DNA analysis. A subset of HPV-positive patients was reevaluated to identify persistent infections. We identified HPV types 16, 18, and 39 as the most prevalent. One hundred five of the patients (59%) were infected with more than one type of HPV. The types of HPV associated with multiple HPV infections were 16, 18, and 39. In the follow-up samples, 38% of patients had not cleared the initially detected HPV infection, and these were considered persistent. We found here an association between multiple HPV infections and high viral loads with and infection persistence. Our findings suggest there are benefits in ascertaining viral load and multiple HPV infections status of HR-HPV infections for predicting the risk of persistence, a requirement for developing CC. These findings contribute to our understanding of HPV epidemiology and may allow screening programs to better assess the cancer-developing risks associated with individual HR-HPV infections.
Collapse
Affiliation(s)
- Mariel A. Oyervides-Muñoz
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Antonio A. Pérez-Maya
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Celia N. Sánchez-Domínguez
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro Monterrey, 64460 Nuevo León, Mexico; (M.A.O.-M.); (A.A.P.-M.); (C.N.S.-D.)
| | - Anais Berlanga-Garza
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Mauro Antonio-Macedo
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Lezmes D. Valdéz-Chapa
- Departamento de Ginecología y Obstetricia, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico; (A.B.-G.); (M.A.-M.); (L.D.V.-C.)
| | - Ricardo M. Cerda-Flores
- Facultad de Enfermería, Universidad Autónoma de Nuevo León, Av. Dr. José Eleuterio González 1500, Mitras Centro, 64460 Nuevo León, Mexico;
| | - Victor Trevino
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, 3000 Av. Morones Prieto, Colonia Los Doctores, 64710 Nuevo León, Mexico;
| | - Hugo A. Barrera-Saldaña
- Vitagénesis SA. Blvd. Puerta del Sol 1005. Colinas de San Jerónimo. Monterrey, 64630 Nuevo León, Mexico
| | - María L. Garza-Rodríguez
- Centro Universitario contra el Cancer, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero S/N, Mitras Centro, 64460 Nuevo León, Mexico
| |
Collapse
|
11
|
Murall CL, Alizon S. Modelling the evolution of viral oncogenesis. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180302. [PMID: 30955498 DOI: 10.1098/rstb.2018.0302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Most human oncogenic viruses share several characteristics, such as being DNA viruses, having long (co)evolutionary histories with their hosts and causing either latent or chronic infections. They can reach high prevalences while causing relatively low case mortality, which makes them quite fit according to virulence evolution theory. After analysing the life histories of DNA oncoviruses, we use a mathematical modelling approach to investigate how the virus life cycle may generate selective pressures favouring or acting against oncogenesis at the within-host or at the between-host level. In particular, we focus on two oncoprotein activities, namely extending cell life expectancy and increasing cell proliferation rate. These have immediate benefits (increasing viral population size) but can be associated with fitness costs at the epidemiological level (increasing recovery rate or risk of cancer) thus creating evolutionary trade-offs. We interpret the results of our nested model in light of the biological features and identify future perspectives for modelling oncovirus dynamics and evolution. This article is part of the theme issue 'Silent cancer agents: multi-disciplinary modelling of human DNA oncoviruses'.
Collapse
Affiliation(s)
- Carmen Lía Murall
- Laboratoire MIVEGEC (UMR CNRS 5290, IRD 224, UM) , 34090 Montpellier , France
| | - Samuel Alizon
- Laboratoire MIVEGEC (UMR CNRS 5290, IRD 224, UM) , 34090 Montpellier , France
| |
Collapse
|
12
|
Vonsky M, Shabaeva M, Runov A, Lebedeva N, Chowdhury S, Palefsky JM, Isaguliants M. Carcinogenesis Associated with Human Papillomavirus Infection. Mechanisms and Potential for Immunotherapy. BIOCHEMISTRY (MOSCOW) 2019; 84:782-799. [PMID: 31509729 DOI: 10.1134/s0006297919070095] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Human papillomavirus (HPV) infection is responsible for approximately 5% of all cancers and is associated with 30% of all pathogen-related cancers. Cervical cancer is the third most common cancer in women worldwide; about 70% of cervical cancer cases are caused by the high-risk HPVs (HR HPVs) of genotypes 16 and 18. HPV infection occurs mainly through sexual contact; however, viral transmission via horizontal and vertical pathways is also possible. After HPV infection of basal keratinocytes or ecto-endocervical transition zone cells, viral DNA persists in the episomal form. In most cases, infected cells are eliminated by the immune system. Occasionally, elimination fails, and HPV infection becomes chronic. Replication of HPVs in dividing epithelial cells is accompanied by increased expression of the E6 and E7 oncoproteins. These oncoproteins are responsible for genomic instability, disruption of the cell cycle, cell proliferation, immortalization, and malignant transformation of HPV-infected cells. Besides, E6 and E7 oncoproteins induce immunosuppression, preventing the detection of HPV-infected and transformed cells by the immune system. HPV integration into the genome of the host cell leads to the upregulation of E6 and E7 expression and contributes to HPV-associated malignization. Prophylactic HPV vaccines can prevent over 80% of HPV-associated anogenital cancers. The vaccine elicits immune response that prevents initial infection with a given HPV type but does not eliminate persistent virus once infection has occurred and does not prevent development of the HPV-associated neoplasias, which necessitates the development of therapeutic vaccines to treat chronic HPV infections and HPV-associated malignancies.
Collapse
Affiliation(s)
- M Vonsky
- Institute of Cytology, Russian Academy of Sciences, St. Petersburg, 194064, Russia. .,Almazov National Medical Research Center, St. Petersburg, 197341, Russia
| | - M Shabaeva
- Pavlov First St. Petersburg State Medical University, St. Petersburg, 197022, Russia.
| | - A Runov
- Institute of Cytology, Russian Academy of Sciences, St. Petersburg, 194064, Russia.,Almazov National Medical Research Center, St. Petersburg, 197341, Russia.,Gamaleya Federal Research Center for Epidemiology and Microbiology, Moscow, 123098, Russia
| | - N Lebedeva
- Gamaleya Federal Research Center for Epidemiology and Microbiology, Moscow, 123098, Russia. .,Moscow Regional Center of AIDS and Infectious Diseases Prevention and Treatment, Moscow, 129110, Russia
| | - S Chowdhury
- University of California, San Francisco School of Medicine, San Francisco, CA 94143, USA
| | - J M Palefsky
- University of California, San Francisco School of Medicine, San Francisco, CA 94143, USA.
| | - M Isaguliants
- Gamaleya Federal Research Center for Epidemiology and Microbiology, Moscow, 123098, Russia. .,Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products, Russian Academy of Sciences, Moscow, 108819, Russia.,Karolinska Institutet, Department of Microbiology, Tumor and Cell Biology, Stockholm, SE-171 77, Sweden.,Riga Stradins University, Department of Pathology, Riga, LV-1007, Latvia
| |
Collapse
|
13
|
Berggrund M, Gustavsson I, Aarnio R, Hedlund-Lindberg J, Sanner K, Wikström I, Enroth S, Olovsson M, Gyllensten U. HPV viral load in self-collected vaginal fluid samples as predictor for presence of cervical intraepithelial neoplasia. Virol J 2019; 16:146. [PMID: 31771594 PMCID: PMC6880361 DOI: 10.1186/s12985-019-1253-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/13/2019] [Indexed: 12/19/2022] Open
Abstract
Objective This study was performed to evaluate the use of high-risk HPV (hrHPV) viral load in screening tests for cervical cancer to predict persistent infection and presence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Methods We followed women between 30 and 60 years of age who performed self-sampling of vaginal fluid and subsequently a hrHPV test. Women who were hrHPV positive in their screening test repeated the hrHPV test 3–6 months later and were included in the present study. Results Our results show that women with a persistent HPV16 infection had higher HPV viral load in their primary screening test than women with transient infections (p = 5.33e-03). This was also true for sum of viral load for all hrHPV types in the primary screening test (p = 3.88e-07). 48% of women with persistent HPV16 infection and CIN2+ had an increase in HPV16 titer in the follow-up test, as compared to only 20% of women with persistent infection but without CIN2+ lesions. For the sum of all hrHPV types, 41% of women with persistent infection and CIN2+ had an increase in titer as compared to 26% of women without CIN2 + . Conclusions The results show that hrHPV viral load in the primary screening HPV test is associated with the presence of CIN2+ and could be used in triaging hrHPV positive women for different follow-up strategies or recall times. Serial testing of hrHPV viral load has the potential to distinguish women with CIN2+ lesions from women with persistent infection but without CIN2+ lesions.
Collapse
Affiliation(s)
- Malin Berggrund
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Inger Gustavsson
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Riina Aarnio
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Julia Hedlund-Lindberg
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Karin Sanner
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Ingrid Wikström
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Stefan Enroth
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Ulf Gyllensten
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Biomedical Center, Uppsala University, Box 815, 75108, Uppsala, Sweden.
| |
Collapse
|
14
|
Zheng JJ, Song JH, Yu CX, Wang F, Wang PC, Meng JW. Difference in vaginal microecology, local immunity and HPV infection among childbearing-age women with different degrees of cervical lesions in Inner Mongolia. BMC WOMENS HEALTH 2019; 19:109. [PMID: 31405377 PMCID: PMC6689872 DOI: 10.1186/s12905-019-0806-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/29/2019] [Indexed: 12/29/2022]
Abstract
Background This study aims to investigate the difference in vaginal microecology, local immunity and HPV infection among childbearing-age women with different degrees of cervical lesions. Methods A total of 432 patients were included in this study. Among these patients, 136 patients had LSIL, 263 patients had HSIL and 33 patients had CSCC. These patients were assigned as the research groups. In addition, 100 healthy females were enrolled and assigned as the control group. Results The microbiological indexes of vaginal secretions were evaluated. Furthermore, the concentrations of SIgA, IgG, IL-2 and IL-10 in vaginal lavage fluid, as well as the presence of HPV, mycoplasma and Chlamydia in cervical secretions, were detected. The results is that: (1) Differences in evaluation indexes of vaginal microecology among all research groups and the control group were statistically significant (P < 0.0001). As the degree of cervical lesions increased, the number of Lactobacillus decreased, and there was an increase in prevalence of bacterial imbalance, and the diversity, density and normal proportion of bacteria was reduced. Furthermore, the incidence of HPV, trichomonads, clue cell and Chlamydia infection increased. Moreover, the positive rate of H2O2 decreased, while the positive rates of SNa and GADP increased. (2) Differences in the ratio of IL-2 and IL-10 in the female genital tract among all research groups and the control group were statistically significant (P < 0.0001). Conclusions As the degree of cervical lesions increased, IL-2 decreased, IL-10 increased and IL-2/IL-10 decreased, while SIgA and IgG were elevated. The reduction of dominant Lactobacillus in the vagina, impairment of H2O2 function, flora ratio imbalance, pathogen infections, reduction in IL-2/IL-10 ratio, and changes in SIgA and IgG levels could all be potential factors that influenced the pathogenicity of HPV infection and the occurrence and development of cervical lesions.
Collapse
Affiliation(s)
- Jing-Jing Zheng
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 of TongDao North Street, HuiMin District, Huhhot, 010059, Inner Mongolia, China
| | - Jing-Hui Song
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 of TongDao North Street, HuiMin District, Huhhot, 010059, Inner Mongolia, China.
| | - Cong-Xiang Yu
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 of TongDao North Street, HuiMin District, Huhhot, 010059, Inner Mongolia, China
| | - Fei Wang
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 of TongDao North Street, HuiMin District, Huhhot, 010059, Inner Mongolia, China
| | - Peng-Cheng Wang
- Department of Obstetrics and Gynecology, Inner Mongolia Maternal and Child Health Care Hospital, Huhhot, 010020, Inner Mongolia, China
| | - Jing-Wei Meng
- Department of Obstetrics and Gynecology, Inner Mongolia Maternal and Child Health Care Hospital, Huhhot, 010020, Inner Mongolia, China
| |
Collapse
|
15
|
Kremer WW, Berkhof J, Bleeker MC, Heideman DA, van Trommel NE, van Baal MW, Verhoeve HR, Meijer CJ, Kenter GG. Role of FAM19A4/ miR124-2 methylation analysis in predicting regression or non-regression of CIN2/3 lesions: a protocol of an observational longitudinal cohort study. BMJ Open 2019; 9:e029017. [PMID: 31289088 PMCID: PMC6629415 DOI: 10.1136/bmjopen-2019-029017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The clinical course of high-grade cervical intraepithelial neoplasia (CIN2/3) is characterised by a high spontaneous regression rate. Histological assessment is unable to differentiate between CIN2/3 lesions likely to regress and those likely to persist or progress. Most CIN2/3 lesions are treated by surgical excision, leading to overtreatment of a substantial proportion. In this prospective study, we evaluate the value of DNA methylation of host cell genes, which has shown to be particularly sensitive for the detection of advanced CIN2/3 and cervical cancer, in the prediction of regression or non-regression of CIN2/3 lesions. METHODS AND ANALYSIS This is a multicentre observational longitudinal study with 24-month follow-up. Women referred for colposcopy with an abnormal cervical scrape, who have been diagnosed with CIN2/3 and a small cervical lesion (≤50% of cervix) will be asked to participate. Participants will be monitored by 6-monthly cytological and colposcopic examination. In case of clinical progression, participants will receive treatment and exit the study protocol. At baseline and during follow-up, self-sampled cervicovaginal brushes and cervical scrapes will be collected for high-risk human papillomavirus (HPV) testing and FAM19A4/miR124-2 methylation analysis. A colposcopy-directed biopsy will be taken from all participants at the last follow-up visit. The primary study endpoint is regression or non-regression at the end of the study based on the histological diagnosis. Regression is defined as CIN1 or less. Non-regression is defined as CIN2 or worse. The secondary study endpoint is defined as HPV clearance (double-negative HPV test at two consecutive time-points). The association between methylation status and regression probability will be evaluated by means of χ2 testing. ETHICS AND DISSEMINATION Ethics approval was obtained in all participating clinics. Results of the main study will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NTR6069; Pre-results.
Collapse
Affiliation(s)
- Wieke W Kremer
- Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Johannes Berkhof
- Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Maaike Cg Bleeker
- Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Daniëlle Am Heideman
- Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Nienke E van Trommel
- Centre for Gynaecological Oncology Amsterdam, Antoni van Leeuwenhoek-Netherlands Cancer Institute and Amsterdam UMC, Amsterdam, The Netherlands
| | | | | | - Chris Jlm Meijer
- Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Gemma G Kenter
- Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Centre for Gynaecological Oncology Amsterdam, Antoni van Leeuwenhoek-Netherlands Cancer Institute and Amsterdam UMC, Amsterdam, The Netherlands
| |
Collapse
|
16
|
Depuydt CE, Donders GGG, Verstraete L, Vanden Broeck D, Beert JFA, Salembier G, Bosmans E, Ombelet W. Infectious human papillomavirus virions in semen reduce clinical pregnancy rates in women undergoing intrauterine insemination. Fertil Steril 2019; 111:1135-1144. [DOI: 10.1016/j.fertnstert.2019.02.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/25/2019] [Accepted: 02/01/2019] [Indexed: 01/12/2023]
|
17
|
Xi LF, Schiffman M, Hughes JP, Galloway DA, Koutsky LA, Kiviat NB. Changes in DNA Level of Oncogenic Human Papillomaviruses Other Than Types 16 and 18 in Relation to Risk of Cervical Intraepithelial Neoplasia Grades 2 and 3. Cancer Epidemiol Biomarkers Prev 2019; 28:1388-1394. [PMID: 31101617 DOI: 10.1158/1055-9965.epi-18-0802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/19/2018] [Accepted: 05/09/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Epidemiologic data addressing clinical relevance of viral load fluctuation of oncogenic types other than human papillomavirus (HPV) types 16 and 18 are limited. METHODS A type-stratified set of infections by non-HPV16/18 oncogenic types that were detected at ≥2 visits was randomly selected from women who were enrolled in a clinical trial and followed every 6 months for 2 years for detection of HPV and cervical intraepithelial neoplasia grades 2 and 3 (CIN2/3). Type-specific viral load was measured on both first and last HPV-positive cervical swab samples. RESULTS CIN2/3 was initially confirmed at the last HPV-positive visit for 67 of 439 infections. The increase in risk of CIN2/3 was associated with high, relative to low, viral load at both first and last positive visits [ORadjusted = 3.67; 95% confidence interval (CI), 1.19-11.32] and marginally associated with a change of viral load from low to high levels (ORadjusted = 3.15; 95% CI, 0.96-10.35) for infection by species group alpha-9 non-HPV16 oncogenic types but not species group alpha-5-7 non-HPV18 oncogenic types. Among women with an initial diagnosis of CIN2/3 at the first positive visit, CIN2/3 was more frequently redetected at the last positive visit for infections with, compared with without, high DNA load of species group alpha-9 non-HPV16 oncogenic types at both visits (P exact = 0.04). CONCLUSIONS In agreement with data on baseline viral load, the viral load change-associated risk of CIN2/3 differs by HPV species groups. IMPACT These findings underscore the importance of distinguishing species groups in future studies of clinical relevance of HPV DNA load.
Collapse
Affiliation(s)
- Long Fu Xi
- Department of Pathology, School of Medicine, University of Washington, Seattle, Washington.
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland
| | - James P Hughes
- Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, Washington
| | - Denise A Galloway
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Laura A Koutsky
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington
| | - Nancy B Kiviat
- Department of Pathology, School of Medicine, University of Washington, Seattle, Washington
| |
Collapse
|
18
|
Clinical performance of Anyplex II HPV28 by human papillomavirus type and viral load in a referral population. PLoS One 2019; 14:e0210997. [PMID: 30673759 PMCID: PMC6343909 DOI: 10.1371/journal.pone.0210997] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/04/2019] [Indexed: 11/28/2022] Open
Abstract
Anyplex II HPV28 (`Anyplex`) is a semi-quantitative DNA PCR assay divided into set A, comprising 14 high risk (hr)HPV types; and set B, comprising 5 possibly hrHPV types and 9 low risk (lr)HPV types. We compared the ability of Anyplex to that of Hybrid Capture 2 (HC2) and PreTect HPV-Proofer (`Proofer`) to detect cervical intraepithelial neoplasia grade two or worse (CIN2+) by HPV types and viral load. This cross-sectional study included 296 women referred to colposcopy with abnormal cervical cytology and/or persistent HPV infection. CIN2+ was identified in 175/296 women. Liquid based cytology samples were used to perform HPV testing. The sensitivity of Anyplex to detect CIN2+ was 98.9% (95% CI 95.9–99.9) and specificity 43.0% (95% CI 34.0–52.3). Restricting to medium and high viral loads in Anyplex set A, sensitivity and specificity were 97.1% (95% CI 93.5–99.1) and 59.5% (95% CI 50.2–68.3) with positive (PPV) and negative predictive value (NPV) 77.6% and 93.5%, respectively, comparable to HC2. Restricting Anyplex to the hrHPV types in Proofer, HPV16, 18, 31, 33 and 45, sensitivity and specificity for CIN2+ were 85.1% (95% CI 79.0–90.1) and 71.1% (95% CI 62.1–79.0), comparable to Proofer`s. When adding HPV52 and 58, the sensitivity for CIN2+ was 92.6% (95% CI 87.6–96.0) and CIN3+ 96.5% (95% CI 92.0–98.8). No value of Anyplex set B was found in detecting CIN2+. In conclusion, the clinical performance of medium and high viral loads in Anyplex set A was comparable to HC2. Restricting the test to the 7 hrHPV types included in the 9-valent HPV-vaccine, HPV16, 18, 31, 33, 45, 52 and 58, satisfies the international criteria for cervical cancer screening with relative sensitivity compared to HC2 for CIN2+ and CIN3+ of 0.98 and 1.01, respectively. Detecting all 28 Anyplex HPV types adds no benefit in a referral population.
Collapse
|
19
|
Murall CL, Jackson R, Zehbe I, Boulle N, Segondy M, Alizon S. Epithelial stratification shapes infection dynamics. PLoS Comput Biol 2019; 15:e1006646. [PMID: 30673699 PMCID: PMC6361466 DOI: 10.1371/journal.pcbi.1006646] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/04/2019] [Accepted: 11/16/2018] [Indexed: 02/07/2023] Open
Abstract
Infections of stratified epithelia contribute to a large group of common diseases, such as dermatological conditions and sexually transmitted diseases. To investigate how epithelial structure affects infection dynamics, we develop a general ecology-inspired model for stratified epithelia. Our model allows us to simulate infections, explore new hypotheses and estimate parameters that are difficult to measure with tissue cell cultures. We focus on two contrasting pathogens: Chlamydia trachomatis and Human papillomaviruses (HPV). Using cervicovaginal parameter estimates, we find that key infection symptoms can be explained by differential interactions with the layers, while clearance and pathogen burden appear to be bottom-up processes. Cell protective responses to infections (e.g. mucus trapping) generally lowered pathogen load but there were specific effects based on infection strategies. Our modeling approach opens new perspectives for 3D tissue culture experimental systems of infections and, more generally, for developing and testing hypotheses related to infections of stratified epithelia.
Collapse
Affiliation(s)
| | - Robert Jackson
- Probe Development and Biomarker Exploration, Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
- Biotechnology Program, Lakehead University, Thunder Bay, Ontario, Canada
| | - Ingeborg Zehbe
- Probe Development and Biomarker Exploration, Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
- Department of Biology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Nathalie Boulle
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - Michel Segondy
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - Samuel Alizon
- Laboratoire MIVEGEC (UMR CNRS 5290, IRD, UM), Montpellier, France
| |
Collapse
|
20
|
Depuydt* CE, Donders GGG, Verstraete L, Vanden Broeck D, Beert JFA, Salembier G, Bosmans E, DhontT N, Van Der Auwera I, Vandenborne K, Ombelet W. Time has come to include Human Papillomavirus (HPV) testing in sperm donor banks. Facts Views Vis Obgyn 2018; 10:201-205. [PMID: 31367292 PMCID: PMC6658204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
HPV is well known as a potential cause of cervical cancer. Less well known is its link to temporal subfertility that is caused by binding of infectious virions to the spermatozoa's head which induces sperm-DNA damage and causes a reduction in clinical pregnancy rates in women receiving HPV positive semen. This impact on the global fertility burden remains greatly underestimated and underexplored. This risk of reduced fertility due to infectious HPV in sperm is especially important when donor sperm insemination is considered, since testing for the presence of HPV virions before use seems warranted. We tested 514 donor sperm samples from 3 different sperm banks for 18 different HPV types. Overall 3.9% (20/514) of tested donor sperm was positive for HPV, with different prevalence among the 3 different sperm banks (3.6% bank A, 3.1% bank B and 16.7% bank C). Also the HPV virion per spermatozoon ratio in donor samples was similar across the different sperm banks (95% CI 0,01 to 1,07 HPV virions/spermatozoon). When HPV positive donor sperm was used, no clinical pregnancies resulted, whereas when HPV negative donor sperm was used the clinical pregnancy rate was 14.6%. From both a cost/benefit and a safety point of view we recommend that donor sperm should always be tested for HPV before using it for insemination.
Collapse
Affiliation(s)
- CE Depuydt*
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium;,Intermediate structure for human body material, AML, Sonic Healthcare, Antwerp, Belgium
| | - GGG Donders
- Femicare, Clinical Research for Women, Tienen, Belgium;,Department of Obstetrics and Gynecology, Regional Hospital Heilig Hart, Tienen, Belgium;,University Hospital Antwerpen, Antwerp, Belgium
| | - L Verstraete
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium;,Intermediate structure for human body material, AML, Sonic Healthcare, Antwerp, Belgium
| | - D Vanden Broeck
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium; 7,National Reference Centre for HPV, Brussels, Belgium;,Department of Obstetrics and Gynecology, International Centre for Reproductive Health, Ghent University, Ghent
| | - JFA Beert
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium;,Intermediate structure for human body material, AML, Sonic Healthcare, Antwerp, Belgium;,Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium; 7
| | - G Salembier
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium; 7
| | - E Bosmans
- Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, Antwerp, Belgium;,Intermediate structure for human body material, AML, Sonic Healthcare, Antwerp, Belgium
| | - N DhontT
- Genk Institute for Fertility Technology, ZOL Hospitals, Genk, Belgium
| | - I Van Der Auwera
- Genk Institute for Fertility Technology, ZOL Hospitals, Genk, Belgium
| | - K Vandenborne
- Genk Institute for Fertility Technology, ZOL Hospitals, Genk, Belgium
| | - W Ombelet
- Genk Institute for Fertility Technology, ZOL Hospitals, Genk, Belgium;,UHasselt, Faculty of Medicine and Life Sciences, LCRC, Diepenbeek, Belgium
| |
Collapse
|
21
|
Van Schandevyl S, Coorevits L, Boelens J, Traen A, Bingé L, Praet M, Van Dorpe J, Padalko E. Detection of human papillomavirus 67 single infection in high‐grade cervical lesions: Case report and review of literature. Diagn Cytopathol 2018; 47:251-254. [DOI: 10.1002/dc.24067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 07/17/2018] [Accepted: 07/23/2018] [Indexed: 01/09/2023]
Affiliation(s)
| | - Liselotte Coorevits
- Department of Laboratory MedicineGhent University Hospital Ghent Belgium
- Department of Clinical Chemistry, Microbiology and ImmunologyGhent University Ghent Belgium
| | - Jerina Boelens
- Department of Laboratory MedicineGhent University Hospital Ghent Belgium
- Department of Clinical Chemistry, Microbiology and ImmunologyGhent University Ghent Belgium
| | | | | | - Marleen Praet
- Department of PathologyGhent University and Ghent University Hospital Ghent Belgium
| | - Jo Van Dorpe
- Department of PathologyGhent University and Ghent University Hospital Ghent Belgium
| | - Elizaveta Padalko
- Department of Laboratory MedicineGhent University Hospital Ghent Belgium
- Department of Clinical Chemistry, Microbiology and ImmunologyGhent University Ghent Belgium
- School of Life SciencesHasselt University Diepenbeek Belgium
| |
Collapse
|
22
|
Ermel A, Shew ML, Imburgia TM, Brown M, Qadadri B, Tong Y, Brown DR. Redetection of human papillomavirus type 16 infections of the cervix in mid-adult life. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2018; 5:75-79. [PMID: 29355777 PMCID: PMC5886910 DOI: 10.1016/j.pvr.2018.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/20/2017] [Accepted: 01/12/2018] [Indexed: 01/21/2023]
Abstract
PURPOSE To assess whether HPV 16 originally detected in adolescent women can be redetected in adulthood. METHODS A convenience sample of 27 adult women with known HPV 16 detection during adolescence was assessed for HPV 16 redetection. A comparison of the long control region (LCR) DNA sequences was performed on some of the original and redetected HPV 16 isolates. RESULTS Median age at reenrollment was 27.5 years (interquartile range of 26.7-29.6). Reenrollment occurred six years on average after the original HPV 16 detection. Eleven of 27 women had HPV 16 redetected. Some of these HPV 16 infections had apparently cleared during adolescence. LCR sequencing was successful in paired isolates from 6 women; in 5 of 6 cases the redetected HPV 16 isolates were identical to those detected during adolescence, CONCLUSIONS: HPV 16 may be episodically detected in young women, even over long time periods. HPV 16 redetection with identical LCR sequences suggests low-level persistent infection rather than true clearance, although newly acquired infection with an identical HPV 16 isolate cannot be excluded. However, this study suggests that a new HPV 16-positive test in a clinical setting may not indicate a new infection.
Collapse
Affiliation(s)
- Aaron Ermel
- Department of Internal Medicine, Indiana University School of Medicine, USA
| | - Marcia L Shew
- Department of Pediatrics, Indiana University School of Medicine, USA
| | - Teresa M Imburgia
- Department of Pediatrics, Indiana University School of Medicine, USA
| | - Matt Brown
- Department of Internal Medicine, Indiana University School of Medicine, USA
| | - Brahim Qadadri
- Department of Internal Medicine, Indiana University School of Medicine, USA
| | - Yan Tong
- Department of Biostatistics, Indiana University School of Medicine, USA
| | - Darron R Brown
- Department of Internal Medicine, Indiana University School of Medicine, USA; Department of Immunology and Microbiology, Indiana University School of Medicine, USA.
| |
Collapse
|
23
|
Van Keer S, Tjalma WAA, Pattyn J, Biesmans S, Pieters Z, Van Ostade X, Ieven M, Van Damme P, Vorsters A. Human papillomavirus genotype and viral load agreement between paired first-void urine and clinician-collected cervical samples. Eur J Clin Microbiol Infect Dis 2018; 37:859-869. [PMID: 29417310 PMCID: PMC5916996 DOI: 10.1007/s10096-017-3179-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/25/2017] [Indexed: 02/03/2023]
Abstract
The performance and acceptability of first-void urine as specimen for the detection of HPV DNA in a Belgian referral population was evaluated using an optimized sample collection and processing protocol. One hundred ten first-void urine and cervical samples were collected from 25- to 64-year-old women who were referred for colposcopy (January-November 2016). Paired samples were analyzed by the Riatol qPCR HPV genotyping assay. Acceptability data were gathered through questionnaires (NCT02714127). A higher high-risk HPV DNA prevalence was observed in first-void urine (n = 76/110) compared to cervical samples (n = 73/110), with HPV31 and HPV16/31 being most prevalent correspondingly. For both any and high-risk HPV DNA, good agreement was observed between paired samples (Cohen's Kappa of 0.660 (95% CI: 0.486-0.833) and 0.688 (95% CI: 0.542-0.835), respectively). In addition, significant positive correlations in HPV copies (per microliter of DNA extract) between paired samples were observed for HPV16 (rs = 0.670; FDR (false discovery rate)-adjusted p = 0.006), HPV18 (rs = 0.893; FDR-adjusted p = 0.031), HPV31 (rs = 0.527; FDR-adjusted p = 0.031), HPV53 (rs = 0.691; FDR-adjusted p = 0.017), and HPV68 (rs = 0.569; FDR-adjusted p = 0.031). First-void urine sampling using a first-void urine collection device was preferred over a clinician-collected cervical sample. And mostly, first-void urine sampling at home was favored over collection at the clinic or the general practitioner's office. First-void urine sampling is a highly preferred, non-invasive method that ensures good agreement in HPV DNA (copies) with reference cervical samples. It is particularly interesting as a screening technique to reach non-participants, and its clinical performance should be further evaluated.
Collapse
Affiliation(s)
- Severien Van Keer
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk (Antwerp), 2610, Belgium.
| | - Wiebren A A Tjalma
- Multidisciplinary Breast Clinic, Unit Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Antwerp University Hospital (UZA), Edegem, Belgium
- Molecular Imaging, Pathology, Radiotherapy, Oncology (MIPRO), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk (Antwerp), Belgium
| | - Jade Pattyn
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk (Antwerp), 2610, Belgium
| | - Samantha Biesmans
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk (Antwerp), 2610, Belgium
| | - Zoë Pieters
- Centre for Statistics, I-Biostat, Hasselt University, Hasselt, Belgium
- CHERMID; Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk (Antwerp), Belgium
| | - Xaveer Van Ostade
- Laboratory of Proteinscience, Proteomics & Epigenetic Signalling (PPES), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Wilrijk (Antwerp), Belgium
| | - Margareta Ieven
- Laboratory of Medical Microbiology (LMM); Vaccine & Infectious Disease Institute (VAXINFECTIO); Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk (Antwerp), Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk (Antwerp), 2610, Belgium
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk (Antwerp), 2610, Belgium
| |
Collapse
|
24
|
Xiong YQ, Mo Y, Luo QM, Huo ST, He WQ, Chen Q. The Risk of Human Papillomavirus Infection for Spontaneous Abortion, Spontaneous Preterm Birth, and Pregnancy Rate of Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis. Gynecol Obstet Invest 2018; 83:417-427. [DOI: 10.1159/000482008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/05/2017] [Indexed: 01/11/2023]
|
25
|
Serial measurement of type-specific human papillomavirus load enables classification of cervical intraepithelial neoplasia lesions according to occurring human papillomavirus-induced pathway. Eur J Cancer Prev 2018; 26:156-164. [PMID: 26890987 DOI: 10.1097/cej.0000000000000241] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This retrospective study examined whether human papillomavirus (HPV) type-specific viral load changes measured in two or three serial cervical smears are predictive for the natural evolution of HPV infections and correlate with histological grades of cervical intraepithelial neoplasia (CIN), allowing triage of HPV-positive women. A cervical histology database was used to select consecutive women with biopsy-proven CIN in 2012 who had at least two liquid-based cytology samples before the diagnosis of CIN. Before performing cytology, 18 different quantitative PCRs allowed HPV type-specific viral load measurement. Changes in HPV-specific load between measurements were assessed by linear regression, with calculation of coefficient of determination (R) and slope. All infections could be classified into one of five categories: (i) clonal progressing process (R≥0.85; positive slope), (ii) simultaneously occurring clonal progressive and transient infection, (iii) clonal regressing process (R≥0.85; negative slope), (iv) serial transient infection with latency [R<0.85; slopes (two points) between 0.0010 and -0.0010 HPV copies/cell/day], and (v) transient productive infection (R<0.85; slope: ±0.0099 HPV copies/cell/day). Three hundred and seven women with CIN were included; 124 had single-type infections and 183 had multiple HPV types. Only with three consecutive measurements could a clonal process be identified in all CIN3 cases. We could clearly demonstrate clonal regressing lesions with a persistent linear decrease in viral load (R≥0.85; -0.003 HPV copies/cell/day) in all CIN categories. Type-specific viral load increase/decrease in three consecutive measurements enabled classification of CIN lesions in clonal HPV-driven transformation (progression/regression) and nonclonal virion-productive (serial transient/transient) processes.
Collapse
|
26
|
Dong L, Wang MZ, Zhao XL, Feng RM, Hu SY, Zhang Q, Smith JS, Qiao YL, Zhao FH. Human papillomavirus viral load as a useful triage tool for non-16/18 high-risk human papillomavirus positive women: A prospective screening cohort study. Gynecol Oncol 2017; 148:103-110. [PMID: 29169614 DOI: 10.1016/j.ygyno.2017.11.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE ASCCP cervical cancer screening guidelines recommend triaging high-risk human papillomavirus (hrHPV) positive women with cytology and genotyping, but cytology is often unavailable in resource-limited areas. We compared the long-term risk of cervical cancer and precancers among type-specific hrHPV-positive women triaged by viral load to cytology and visual inspection with acetic acid (VIA). METHODS A cohort of 1742 Chinese women was screened with cytology, VIA, and Hybrid Capture 2 (HC2) test and followed for ten years. All HC2-positive samples were genotyped. Viral load was measured by HC2 relative light units/cutoff (RLU/CO). Ten-year cumulative incidence rate (CIR) of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) for type-specific hrHPV viral load was estimated using Kaplan-Meier methods. RESULTS Baseline hrHPV viral load stratified by specific genotypes was positively correlated with prevalent cytological lesions. Ten-year CIR of CIN2+ was associated with cytological lesions and viral load. Among HPV 16/18-positive women, ten-year CIR of CIN2+ was high, even with normal cytology (15.3%), normal VIA (32.4%), viral load with RLU/CO<10 (23.6%) or RLU/CO<100 (33.8%). Among non-16/18 hrHPV positive women, ten-year CIR of CIN2+ was significantly stratified by cytology grade of atypical squamous cell of undetermined significance or higher (2.0% VS. 34.6%), viral load cutoffs at 10 RLU/CO (5.1% VS. 27.2%), at 100 RLU/CO (11.0% VS. 35.5%), but not by VIA (19.1% VS. 19.0%). CONCLUSIONS Our findings support the guidelines in referring all HPV16/18 positive women to colposcopy and suggest triaging non-16/18 hrHPV positive women using viral loads in resource-limited areas where cytology screening was inaccessible.
Collapse
Affiliation(s)
- Li Dong
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China; Institutes of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Margaret Z Wang
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA; UJMT Fogarty Consortium, NIH Fogarty International Center, Bethesda, MD, USA
| | - Xue-Lian Zhao
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Rui-Mei Feng
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Shang-Ying Hu
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Qian Zhang
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - You-Lin Qiao
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Fang-Hui Zhao
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China.
| |
Collapse
|
27
|
Alizon S, Murall CL, Bravo IG. Why Human Papillomavirus Acute Infections Matter. Viruses 2017; 9:v9100293. [PMID: 28994707 PMCID: PMC5691644 DOI: 10.3390/v9100293] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 09/25/2017] [Accepted: 10/02/2017] [Indexed: 02/06/2023] Open
Abstract
Most infections by human papillomaviruses (HPVs) are `acute', that is non-persistent. Yet, for HPVs, as for many other oncoviruses, there is a striking gap between our detailed understanding of chronic infections and our limited data on the early stages of infection. Here we argue that studying HPV acute infections is necessary and timely. Focusing on early interactions will help explain why certain infections are cleared while others become chronic or latent. From a molecular perspective, descriptions of immune effectors and pro-inflammatory pathways during the initial stages of infections have the potential to lead to novel treatments or to improved handling algorithms. From a dynamical perspective, adopting concepts from spatial ecology, such as meta-populations or meta-communities, can help explain why HPV acute infections sometimes last for years. Furthermore, cervical cancer screening and vaccines impose novel iatrogenic pressures on HPVs, implying that anticipating any viral evolutionary response remains essential. Finally, hints at the associations between HPV acute infections and fertility deserve further investigation given their high, worldwide prevalence. Overall, understanding asymptomatic and benign infections may be instrumental in reducing HPV virulence.
Collapse
Affiliation(s)
- Samuel Alizon
- MIVEGEC (UMR CNRS 5290, UR IRD 224, UM), 911 avenue Agropolis, 34394 Montpellier CEDEX 5, France.
| | - Carmen Lía Murall
- MIVEGEC (UMR CNRS 5290, UR IRD 224, UM), 911 avenue Agropolis, 34394 Montpellier CEDEX 5, France.
| | - Ignacio G Bravo
- MIVEGEC (UMR CNRS 5290, UR IRD 224, UM), 911 avenue Agropolis, 34394 Montpellier CEDEX 5, France.
| |
Collapse
|
28
|
Concordance of HPV load and HPV mRNA for 16 carcinogenic/possibly carcinogenic HPV types in paired smear/tissue cervical cancer specimens. Arch Virol 2017; 162:3313-3327. [PMID: 28717857 DOI: 10.1007/s00705-017-3452-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
Abstract
HPV types with high viral load are associated with cervical abnormalities. However, viral load measurements and concordance of HPV loads and viral mRNA have not been demonstrated for all high-risk/possibly high-risk (HR-/pHR-)HPV types in cervical cancer (CxCa). Especially, the biological role of co-infecting HR-/pHR-HPV types with low viral load has not been thoroughly investigated. Using BSGP5+/6+-PCR/MPG genotyping, we analyzed viral loads for all currently defined 51 mucosal HPV types in 74 cervical smears from patients with CxCa and compared this data with HPV DNA and mRNA status in these patients' corresponding CxCa tissues. All cervical smear/tissue pairs were HPV DNA+. Overall HPV type agreement within pairs was 99% (complete agreement in 50%, partial agreement in 49%, and complete disagreement in 1% of cases). The proportion of multiple HPV types was significantly higher in smears compared to tissues (p<0.0001). High load HPV infections (>1 copy/cell) were found in 88% of HPV DNA+ smears, and were significantly associated with the presence of respective HPV DNA (kappa=0.685, CI: 0.567-0.803), and HPV mRNA (kappa=0.693, CI: 0.566-0.820) in CxCa tissues. In total, 93% (67/72) of high load HR-/pHR-HPV infections identified in smears were also present in corresponding CxCa tissues, and 93% (62/67) of these were HPV mRNA+. On the other hand, 78% (42/54) of low load HR-/pHR-HPV infections identified in smears were not detectable in tissues, including 11 out of 15 low load HPV16 infections. This data demonstrates that the presence of high HPV loads in CxCa smears predicts biologically active HR-/pHR-HPV types in tumor tissues.
Collapse
|
29
|
Van Keer S, Pattyn J, Tjalma WAA, Van Ostade X, Ieven M, Van Damme P, Vorsters A. First-void urine: A potential biomarker source for triage of high-risk human papillomavirus infected women. Eur J Obstet Gynecol Reprod Biol 2017; 216:1-11. [PMID: 28689156 DOI: 10.1016/j.ejogrb.2017.06.036] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/18/2017] [Accepted: 06/24/2017] [Indexed: 12/14/2022]
Abstract
Great interest has been directed towards the use of first-void urine as a liquid biopsy for high-risk human papillomavirus DNA testing. Despite the high correlations established between urinary and cervical infections, human papillomavirus testing is unable to distinguish between productive and transforming high-risk infections that have the tendency to progress to cervical cancer. Thus far, investigations have been primarily confined to the identification of biomarkers for triage of high-risk human papillomavirus-positive women in cervicovaginal specimens and tissue biopsies. This paper reviews urinary biomarkers for cervical cancer and triage of high-risk human papillomavirus infections and elaborates on the opportunities and challenges that have emerged regarding the use of first-void urine as a liquid biopsy for the analysis of both morphological- (conventional cytology and novel immunohistochemical techniques) and molecular-based (HPV16/18 genotyping, host/viral gene methylation, RNA, and proteins) biomarkers. A literature search was performed in PubMed and Web of Science for studies investigating the use of urine as a biomarker source for cervical cancer screening. Five studies were identified reporting on biomarkers that are still in preclinical exploratory or clinical assay development phases and on assessments of non-invasive (urine) samples. Although large-scale validation studies are still needed, we conclude that methylation of both host and viral genes in urine has been proven feasible for use as a molecular cervical cancer triage and screening biomarker in phase two studies. This is especially promising and underscores our hypothesis that human papillomavirus DNA and candidate human and viral biomarkers are washed away with the initial, first-void urine, together with exfoliated cells, debris and impurities that line the urethra opening. Similar to the limitations of self-collected cervicovaginal samples, first-void urine will likely not fulfil the high-quality cellularity standards required for morphological biomarkers. Molecular biomarkers will likely overcome this issue to yield high-throughput, objective, and reproducible results. When using proper sampling, transport, storage, preanalytical biomarker concentration techniques, and clinically validated assays, first-void urine is expected to be a valuable source of molecular biomarkers for cervical cancer screening. Furthermore, as first-void urine can be easily and non-invasively collected, it is a highly preferred technique among women and offers the ability to test both primary high-risk human papillomavirus and biomarkers in the same sample. In addition, the use of first-void urine confers opportunities to reduce loss-to follow-up and non-adherence to screening subjects.
Collapse
Affiliation(s)
- Severien Van Keer
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Jade Pattyn
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Wiebren A A Tjalma
- Multidisciplinary Breast Clinic, Unit Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Molecular Imaging, Pathology, Radiotherapy, Oncology (MIPRO), Faculty of Medicine and Health Sciences, Antwerp University Hospital (UZA)-University of Antwerp, Belgium
| | - Xaveer Van Ostade
- Proteomics, Proteinscience, Proteomics & Epigenetic Signalling (PPES), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Belgium
| | - Margareta Ieven
- Laboratory of Medical Microbiology (LMM), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.
| |
Collapse
|
30
|
Mittal S, Basu P, Muwonge R, Banerjee D, Ghosh I, Sengupta MM, Das P, Dey P, Mandal R, Panda C, Biswas J, Sankaranarayanan R. Risk of high-grade precancerous lesions and invasive cancers in high-risk HPV-positive women with normal cervix or CIN 1 at baseline-A population-based cohort study. Int J Cancer 2017; 140:1850-1859. [PMID: 28108997 DOI: 10.1002/ijc.30609] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/19/2016] [Accepted: 01/03/2017] [Indexed: 11/11/2022]
Abstract
Infection with high-risk human papillomavirus (HR-HPV) is transient and clears on its own in majority of the women. Only a few women who have persistent infection may finally develop cervical intraepithelial neoplasia (CIN) or cervical cancer in later years. The risk of progression in the HR-HPV-positive women with normal cervix or low-grade lesion on colposcopy and histopathology at baseline is less studied. We performed a longitudinal study on 650 HR-HPV-positive women with colposcopy and/or histopathology-proved normal or CIN1 diagnosis at baseline to assess the cumulative risk of development of high-grade CIN. After a mean follow-up of 2.1 person years of observation (PYO) (range 0.1-5.1), the cumulative incidence of CIN2+ (6.4%; 3.0/100 PYO) was significantly higher in women who had persistent HR-HPV infection compared to those who cleared the infection (adjusted HR 6.28; 95% CI 2.87-13.73). The risk of viral persistence in women aged 50-60 years was two times higher compared to women aged 40-49 years and three times higher compared to women aged 30-39 years. The probability of having persistent infection increased progressively with higher viral load at baseline (adjusted HR 3.29, 95% CI 2.21-4.90 for RLU ≥100; adjusted HR 2.69, 95% CI 1.71-4.22 for RLU 10-100). Women with increasing viral load at follow-up had four times higher risk of developing CIN2 or worse lesions as compared to those with decreasing load (20.9% vs 4.8%; p < 0.001). In the context of developing countries where cytology or genotyping triaging is not feasible, colposcopy referral of HR-HPV-positive women with advancing age, viral persistence, and increasing viral load may be considered.
Collapse
Affiliation(s)
- Srabani Mittal
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Partha Basu
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Richard Muwonge
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | | | - Ishita Ghosh
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | | | - Pradip Das
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Priatosh Dey
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Ranajit Mandal
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Chinmay Panda
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Jaydip Biswas
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Rengaswamy Sankaranarayanan
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| |
Collapse
|
31
|
A metabolite profiling method for diagnosis of precancerous cervical lesions and HPV persistence. Bioanalysis 2017; 9:601-608. [DOI: 10.4155/bio-2017-0012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Aim: With the advent of rapid metabolic profiling techniques and of portable mass spectrometers we examined whether cells distinguished by their cytology and persistence of human papillomavirus infection, could be easily differentiated by their metabolite profile. Materials & methods: Direct injection electrospray mass spectrometry was used in a nontargeted double-blind experiment. Samples were collected from women diagnosed with one of two grades of cervical cytology and exhibiting either human papilloma virus persistence or clearance. Cell extracts were prepared using a DNA extraction procedure and the resulting supernatant, normally discarded, was analyzed. Data were interpreted using principal component analysis. Results: The results indicate strongly that a simple metabolite profiling method could be used to rapidly identify women at increased risk of cervical cancer.
Collapse
|
32
|
Fu Xi L, Schiffman M, Ke Y, Hughes JP, Galloway DA, He Z, Hulbert A, Winer RL, Koutsky LA, Kiviat NB. Type-dependent association between risk of cervical intraepithelial neoplasia and viral load of oncogenic human papillomavirus types other than types 16 and 18. Int J Cancer 2017; 140:1747-1756. [PMID: 28052328 DOI: 10.1002/ijc.30594] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/03/2016] [Accepted: 12/05/2016] [Indexed: 01/31/2023]
Abstract
Studies of the clinical relevance of human papillomavirus (HPV) DNA load have focused mainly on HPV16 and HPV18. Data on other oncogenic types are rare. Study subjects were women enrolled in the atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) triage study who had ≥1 of 11 non-HPV16/18 oncogenic types detected during a 2-year follow-up at 6-month intervals. Viral load measurements were performed on the first type-specific HPV-positive specimens. The association of cervical intraepithelial neoplasia grades 2-3 (CIN2/3) with type-specific HPV DNA load was assessed with discrete-time Cox regression. Overall, the increase in the cumulative risk of CIN2/3 per 1 unit increase in log10 -transformed viral load was statistically significant for four types within species 9 including HPV31 (adjusted hazard ratio [HR adjusted ] = 1.32: 95% confidence interval [CI], 1.14-1.52), HPV35 (HR adjusted = 1.47; 95% CI, 1.23-1.76), HPV52 (HR adjusted = 1.14; 95% CI, 1.01-1.30) and HPV58 (HR adjusted = 1.49; 95% CI, 1.23-1.82). The association was marginally significant for HPV33 (species 9) and HPV45 (species 7) and was not appreciable for other types. The per 1 log10 -unit increase in viral load of a group of species 9 non-HPV16 oncogenic types was statistically significantly associated with risk of CIN2/3 for women with a cytologic diagnosis of within normal limits, ASC-US, or LSIL at the first HPV-positive visit but not for those with high-grade SIL. Findings suggest that the viral load-associated risk of CIN2/3 is type-dependent, and mainly restricted to the species of HPV types related to HPV16, which shares this association.
Collapse
Affiliation(s)
- Long Fu Xi
- Department of Pathology, School of Medicine, University of Washington, Seattle, WA.,Department of Epidemiology, University of Washington, Seattle, WA
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Yang Ke
- Key Laboratory of Carcinogenesis and Translational Research, Peking University School of Oncology, Beijing, People's Republic of China
| | - James P Hughes
- Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA
| | - Denise A Galloway
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Zhonghu He
- Key Laboratory of Carcinogenesis and Translational Research, Peking University School of Oncology, Beijing, People's Republic of China
| | - Ayaka Hulbert
- Department of Pathology, School of Medicine, University of Washington, Seattle, WA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Laura A Koutsky
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Nancy B Kiviat
- Department of Pathology, School of Medicine, University of Washington, Seattle, WA
| |
Collapse
|
33
|
Depuydt CE, Beert J, Bosmans E, Salembier G. Human Papillomavirus (HPV) virion induced cancer and subfertility, two sides of the same coin. Facts Views Vis Obgyn 2016; 8:211-222. [PMID: 28210481 PMCID: PMC5303699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In the natural history of HPV infections, the HPV virions can induce two different pathways, namely the infec- tious virion producing pathway and the clonal transforming pathway. An overview is given of the burden that is associated with HPV infections that can both lead to cervical cancer and/or temporal subfertility. That HPV infections cause serious global health burden due to HPV-associated cancers is common knowledge, but that it is also responsible for a substantial part of idiopathic subfertility is greatly underestimated. The bulk of the detected HPV DNA whether in men or women is however infectious from origin. Because the dissociation between HPV viruses and HPV virions or infection and disease remains difficult for clinicians as well as for HPV detection, we propose a review of the different effects caused by the two different HPV virion induced pathways, and highlight the mechanisms that are responsible for causing transient subfertility and cancer.
Collapse
Affiliation(s)
- CE Depuydt
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium
| | - J Beert
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium,Intermediate structure human body material, AML, Sonic Healthcare, Antwerp, Belgium
| | - E Bosmans
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium
| | - G Salembier
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium
| |
Collapse
|
34
|
Depuydt CE, Thys S, Beert J, Jonckheere J, Salembier G, Bogers JJ. Linear viral load increase of a single HPV-type in women with multiple HPV infections predicts progression to cervical cancer. Int J Cancer 2016; 139:2021-32. [PMID: 27339821 DOI: 10.1002/ijc.30238] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 05/01/2016] [Accepted: 06/06/2016] [Indexed: 01/21/2023]
Abstract
Persistent high-risk human papillomavirus (HPV) infection is strongly associated with development of high-grade cervical intraepithelial neoplasia or cancer (CIN3+). In single type infections, serial type-specific viral-load measurements predict the natural history of the infection. In infections with multiple HPV-types, the individual type-specific viral-load profile could distinguish progressing HPV-infections from regressing infections. A case-cohort natural history study was established using samples from untreated women with multiple HPV-infections who developed CIN3+ (n = 57) or cleared infections (n = 88). Enriched cell pellet from liquid based cytology samples were subjected to a clinically validated real-time qPCR-assay (18 HPV-types). Using serial type-specific viral-load measurements (≥3) we calculated HPV-specific slopes and coefficient of determination (R(2) ) by linear regression. For each woman slopes and R(2) were used to calculate which HPV-induced processes were ongoing (progression, regression, serial transient, transient). In transient infections with multiple HPV-types, each single HPV-type generated similar increasing (0.27copies/cell/day) and decreasing (-0.27copies/cell/day) viral-load slopes. In CIN3+, at least one of the HPV-types had a clonal progressive course (R(2) ≥ 0.85; 0.0025copies/cell/day). In selected CIN3+ cases (n = 6), immunostaining detecting type-specific HPV 16, 31, 33, 58 and 67 RNA showed an even staining in clonal populations (CIN3+), whereas in transient virion-producing infections the RNA-staining was less in the basal layer compared to the upper layer where cells were ready to desquamate and release newly-formed virions. RNA-hybridization patterns matched the calculated ongoing processes measured by R(2) and slope in serial type-specific viral-load measurements preceding the biopsy. In women with multiple HPV-types, serial type-specific viral-load measurements predict the natural history of the different HPV-types and elucidates HPV-genotype attribution.
Collapse
Affiliation(s)
- Christophe E Depuydt
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium
| | - Sofie Thys
- Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
| | - Johan Beert
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium.,Intermediate Structure for Human Body Material, AML, Sonic Healthcare, Antwerp, Belgium
| | - Jef Jonckheere
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium
| | - Geert Salembier
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium
| | - Johannes J Bogers
- Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium.,Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
35
|
Vorsters A, Van Keer S, Biesmans S, Hens A, De Coster I, Goossens H, Ieven M, Van Damme P. Long-Term Follow-up of HPV Infection Using Urine and Cervical Quantitative HPV DNA Testing. Int J Mol Sci 2016; 17:ijms17050750. [PMID: 27196899 PMCID: PMC4881571 DOI: 10.3390/ijms17050750] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/26/2016] [Accepted: 05/09/2016] [Indexed: 11/16/2022] Open
Abstract
The link between infection with high-risk human papillomavirus (hrHPV) and cervical cancer has been clearly demonstrated. Virological end-points showing the absence of persistent HPV infection are now accepted as a way of monitoring the impact of prophylactic vaccination programs and therapeutic vaccine trials. This study investigated the use of urine samples, which can be collected by self-sampling at home, instead of cervical samples for follow-up of an HPV intervention trial. Eighteen initially HPV DNA-positive women participating in an HPV therapeutic vaccine trial were monitored during a three-year follow-up period. A total of 172 urine samples and 85 cervical samples were collected. We obtained a paired urine sample for each of the 85 cervical samples by recovering urine samples from six monthly gynaecological examinations. We performed a small pilot study in which the participating women used a urine collection device at home and returned their urine sample to the laboratory by mail. All samples were analyzed using quantitative real-time HPV DNA PCR. A good association (κ value of 0.65) was found between the presence of HPV DNA in urine and a subsequent cervical sample. Comparisons of the number of HPV DNA copies in urine and paired cervical samples revealed a significant Spearman rho of 0.676. This correlation was superior in women with severe lesions. The HPV DNA results of the small pilot study based on self-collected urine samples at home are consistent with previous and subsequent urine and/or cervical results. We demonstrated that urine sampling may be a valid alternative to cervical samples for the follow-up of HPV intervention trials or programs. The potential clinical value of urine viral load monitoring should be further investigated.
Collapse
Affiliation(s)
- Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Severien Van Keer
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Samantha Biesmans
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Annick Hens
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Ilse De Coster
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium.
- Clinical Microbiology, Antwerp University Hospital, 2650 Edegem, Belgium.
| | - Margareta Ieven
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium.
- Clinical Microbiology, Antwerp University Hospital, 2650 Edegem, Belgium.
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Belgium.
| |
Collapse
|
36
|
El-Zein M, Richardson L, Franco EL. Cervical cancer screening of HPV vaccinated populations: Cytology, molecular testing, both or none. J Clin Virol 2015; 76 Suppl 1:S62-S68. [PMID: 26631958 DOI: 10.1016/j.jcv.2015.11.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/12/2015] [Accepted: 11/15/2015] [Indexed: 12/13/2022]
Abstract
Cervical cancer control includes primary prevention through vaccination to prevent human papillomavirus (HPV) infection and secondary prevention through screening to detect and treat cervical precancerous lesions. This review summarizes the evidence for the population impact of vaccines against oncogenic HPV types in reducing the prevalence of cervical precancerous lesions. We examine the gradual shift in screening technology from cervical cytology alone to cytology and HPV cotesting, and finally to the recognition that HPV testing can serve alone as the new screening paradigm, particularly in the initial post-vaccination era. We should expect an impact on screening performance and practices, as cohorts of HPV-vaccinated girls and adolescents reach cervical cancer screening age. In preparation for changes in the screening paradigm for the vaccination era, we propose that policymaking on cervical cancer screening should mirror current practices with other cancers as benchmarks. Cervical precancerous lesions will become a very rare condition following the widespread implementation of HPV vaccines with broader coverage in the number of preventable oncogenic types. Irrespective of screening technology, the false positive results will far outnumber the true positive ones, a tipping point that will herald a new period when the harms from cervical cancer screening will outweigh its benefits. We present a conceptual framework to guide decision making when we reach this point within 25-30 years.
Collapse
Affiliation(s)
- Mariam El-Zein
- Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada
| | - Lyndsay Richardson
- Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.
| |
Collapse
|
37
|
Association of Human Papillomavirus 31 DNA Load with Risk of Cervical Intraepithelial Neoplasia Grades 2 and 3. J Clin Microbiol 2015; 53:3451-7. [PMID: 26292291 DOI: 10.1128/jcm.01279-15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/10/2015] [Indexed: 11/20/2022] Open
Abstract
The association between human papillomavirus 31 (HPV31) DNA loads and the risk of cervical intraepithelial neoplasia grades 2 and 3 (CIN2-3) was evaluated among women enrolled in the atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) triage study (ALTS), who were monitored semiannually over 2 years and who had HPV31 infections detected at ≥1 visit. HPV31 DNA loads in the first HPV31-positive samples and in a random set of the last positive samples from women with ≥2 HPV31-positive visits were measured by a real-time PCR assay. CIN2-3 was histologically confirmed at the same time as the first detection of HPV31 for 88 (16.6%) of 530 women. After adjustment for HPV31 lineages, coinfection with other oncogenic types, and the timing of the first positive detection, the odds ratio (OR) per 1-log-unit increase in viral loads for the risk of a concurrent diagnosis of CIN2-3 was 1.5 (95% confidence interval [CI], 1.2 to 1.9). Of 373 women without CIN2-3 at the first positive visit who had ≥1 later visit, 44 had subsequent diagnoses of CIN2-3. The initial viral loads were associated with CIN2-3 diagnosed within 6 months after the first positive visit (adjusted OR, 1.5 [95% CI, 1.0 to 2.4]) but were unrelated to CIN2-3 diagnosed later. For a random set of 49 women who were tested for viral loads at the first and last positive visits, changes in viral loads were upward and downward among women with and without follow-up CIN2-3 diagnoses, respectively, although the difference was not statistically significant. Results suggest that HPV31 DNA load levels at the first positive visit signal a short-term but not long-term risk of CIN2-3.
Collapse
|
38
|
Depuydt CE, Verstraete L, Berth M, Beert J, Bogers JP, Salembier G, Vereecken AJ, Bosmans E. Human Papillomavirus Positivity in Women Undergoing Intrauterine Insemination Has a Negative Effect on Pregnancy Rates. Gynecol Obstet Invest 2015; 81:41-6. [DOI: 10.1159/000434749] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/02/2015] [Indexed: 11/19/2022]
|