Human Papillomavirus (HPV) Infections and the Importance of HPV Vaccination

Factors affecting cervical cancer screening and human papilloma virus vaccination among Middle Eastern refugee women in Türkiye: indicators for social workers and nurses

BACKGROUND

This study aimed to generate knowledge regarding factors affecting cervical cancer screening and human papillomavirus vaccination that can be used practically by social workers and nurses while working with Middle Eastern refugee women living in Türkiye.

METHODS AND RESULTS

This study involved the administration of a self-reported questionnaire to 227 female migrants. It identified sociodemographic variables, such as age, marital status, and education level, that influenced the participation of these women in preventive practices against cervical cancer. Despite their cultural beliefs, financial constraints, and language hurdles, the findings indicated that the likelihood of involvement in screening and vaccination for cervical cancer was greater among refugee women if they were well-informed and assisted.

CONCLUSIONS

The results of this study suggest the necessity for specific training programs and improved initiatives for healthcare access to prevent cervical cancer among vulnerable groups. Healthcare providers can support preventive measures more effectively if these concerns are addressed with consideration of the sociocultural elements and language issues among Middle Eastern refugee women. Although some limitations associated with self-reported data collection methods may have introduced response bias, this study showed how social workers and nurses can act as facilitators to prevent cervical cancer.

Prevalence and genotype distribution of human papillomavirus in individuals referred to a laboratory in Urmia, Iran

BACKGROUND AND AIM

Human papillomavirus (HPV) is a major contributor to sexually transmitted infections, especially common in sexually active populations. Although the majority of HPV infections resolve naturally, certain cases can develop into different types of cancer. This study focused on evaluating the prevalence and distribution of HPV genotypes across males and females of different age groups who visited a laboratory in Urmia, Iran.

MATERIALS AND METHODS

Samples from the genital area were obtained from participants in the study. DNA extraction was performed using the Favorgen extraction kit (Favorgen, Taiwan), followed by genotyping through Real-Time PCR. Genotypes were determined using the MehrViru HPV genotyping kit (MehrViru, Iran). Additionally, demographic details, including age, were analyzed in conjunction with the statistical virological data.

RESULTS

Between 2022 and 2023, a total of 447 individuals, including both referred and routine visitors, attended the laboratory, comprising 431 females and 16 males. Of these, 195 tested positive for HPV, resulting in an overall prevalence rate of 43.6%. Among the positive cases, 90 individuals (46.2%) were infected with a single HPV genotype, while 105 cases (53.8%) had multiple genotype infections. The most common genotypes identified were HPV-6 (41.0%), HPV-16 (15.4%), HPV-56 (10.8%), and HPV-90 (10.8%). The least genotype identified was HPV-43, which was detected in 5 cases (2.6%). Additionally, our analysis revealed that women under 30 who tested positive were predominantly infected with the LR genotype, a pattern also seen in the four men in the same age group, all of whom were infected with the LR genotype.

CONCLUSION

Our findings underscore the significant presence of HPV among both females and males visiting the laboratory in Urmia, particularly in individuals under 30 years old. The identification of HPV-6 and HPV-16 as the most prevalent genotypes highlights the importance of age-specific intervention strategies. Although vaccination programs cover HPV-6 and HPV-16, HPV-56 is not included, which underscores the need for comprehensive screening and preventive measures to address the potential long-term impacts of HPV-related diseases.

The role of lipids and lipids lowering drugs in human papillomavirus (HPV) and HPV-associated cancers

Both women and men are now confronted with the grave threat of cancers caused by the human papillomavirus (HPV). It is estimated that 80% of women may encounter HPV over their lives. In the preponderance of cases involving anal, head and neck, oral, oropharyngeal, penile, vaginal, vulvar, and cervical malignancies, high-risk HPV (HR-HPV) is the causative agent. In 2019, HPV is believed to have been the cause of 620,000 new cases of cancer in women and 70,000 new cases of cancer in men worldwide. The bulk of the 530,000 cervical cancer cases (~ 270,000 fatalities) caused by HPV infection (86% of cases, 88% of deaths) happen in poor nations each year. Lipid metabolism is crucial in HPV infection and cancer development related to HPV. One of the most noticeable metabolic abnormalities in cancer is lipid metabolism reprogramming, in which cancer cells dysregulate lipid metabolism to obtain sufficient energy, building blocks for cell membranes, and signaling molecules necessary for invasion, metastasis, proliferation, and survival. Moreover, HPV proteins' stimulation of lipid production in infected cells will probably have a significant effect on oncogenesis. In addition, lipids are critical in producing cellular energy, the epithelial-mesenchymal transition (EMT) process, and therapy resistance of HPV-related cancers (HRCs). Therefore, lipids are essential in HPV infection and HRC development and may also be an important target for new approaches associated with treatments during HPV infection or cancer development. This review study looked at the role of lipids and lipid-lowering drugs in HPV and related cancers.

Epidemiological distribution of high-risk human papillomavirus genotypes and associated factors among patients with esophageal carcinoma at Bugando medical center in Mwanza, Tanzania

BACKGROUND

Esophageal carcinoma is a growing concern in regions that have a high incidence of human papillomavirus (HPV) infection such as East Africa. HPV, particularly the high-risk genotypes, is increasingly recognized as a risk factor for esophageal carcinoma. We set out to investigate the prevalence and associated factors of high-risk HPV in formalin-fixed paraffin-embedded (FFPE) tissue blocks with esophageal carcinoma at Bugando Medical Center, a tertiary referral hospital in Mwanza, Tanzania, East Africa.

METHODS

A total of 118 esophageal carcinoma FFPE tissue blocks, collected from January 2021 to December 2022, were analyzed. Genomic DNA was extracted from these tissues, and multiplex polymerase chain reaction (PCR) was performed to detect HPV using degenerate primers for the L1 region and type-specific primers for detecting HPV16, HPV18, and other high-risk HPV genotypes. Data were collected using questionnaires and factors associated with high-risk HPV genotypes were analyzed using STATA version 15 software.

RESULTS

Of the 118 patients' samples investigated, the mean age was 58.3 ± 13.4 years with a range of 29-88 years. The majority of the tissue blocks were from male patients 81/118 (68.7%), and most of them were from patients residing in Mwanza region 44/118 (37.3%). Esophageal Squamous Cell Carcinoma (ESCC) was the predominant histological type 107/118 (91.0%). Almost half of the tissue blocks 63/118 (53.3%) tested positive for high-risk HPV. Among these, HPV genotype 16 (HPV16) was the most common 41/63 (65.1%), followed by HPV genotype 18 (HPV18) 15/63 (23.8%), and the rest were other high-risk HPV genotypes detected by the degenerate primers 7/63 (11.1%). The factors associated with high-risk HPV genotypes were cigarette smoking (p-value < 0.001) and alcohol consumption (p-value < 0.001).

CONCLUSION

A substantial number of esophageal carcinomas from Bugando Medical Center in Tanzania tested positive for HPV, with HPV genotype 16 being the most prevalent. This study also revealed a significant association between HPV status and cigarette smoking and alcohol consumption. These findings provide important insights into the role of high-risk HPV in esophageal carcinoma in this region.

Parental Knowledge, Attitudes, and Perceptions Impacting Willingness to Vaccinate Against the Human Papillomavirus in Trinidad

Background Cervical cancer remains a major cause of morbidity and mortality in young women in Trinidad and Tobago. This study aimed to determine the knowledge, attitudes, perceptions, and beliefs of Trinidadian parents toward human papillomavirus (HPV) vaccination. In addition, factors predictive of willingness to vaccinate were explored. Methodology In this cross-sectional study conducted between March and May 2019, a paper-based survey was self-administered to parents of children in the 5-12-year age group in seven geographically representative Trinidadian primary schools. Results Of the 420 questionnaires distributed, 160 were returned completed (38% response rate). General knowledge that HPV causes cervical cancer and genital warts and is spread by sexual contact was common among 81%, 71%, and 81% of parents, respectively. At least 40% of the respondents expressed uncertainty about the vaccine's long-lasting health problems and its effectiveness in preventing genital warts and cervical cancer. Half of the parents were unsure if the vaccine was harmful. The perceptions that vaccine safety data are fabricated, drug companies cover up the dangers of vaccines, vaccine efficacy data are often fabricated, people are deceived about vaccine efficacy and safety, and conspiracy beliefs were held by 15.5%, 26.1%, 13%, 21.7%, and 28.5% of parents, respectively. There was a negative correlation between knowledge and conspiracy belief scores (ρ = -0.30, p < 0.001). Overall, 45.3% of parents were willing to immunize their children against HPV. Being informed about HPV by a health professional (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.5-5.8), knowledge of the benefits (OR = 4.6, 95% CI = 2.2-9.6), and a health professional offering the option of vaccination (OR = 3.7, 95% CI = 1.7-8.0) were associated with significantly increased odds of parents willing to vaccinate their child. The agreement that vaccine safety data are often fabricated (OR = 0.31, 95% CI = 0.12-0.84), pharmaceutical companies cover up the dangers of vaccines (OR = 0.14, 95% CI = 0.06-0.37), waiting at the clinic being time-consuming (OR = 0.37, 95% CI = 0.15-0.89), and the beliefs that adolescents are too young to get a vaccine to prevent sexually transmitted disease (OR = 0.16, 95% CI = 0.11-0.83) were associated with a significantly decreased willingness to vaccinate. Conclusions While general knowledge about HPV was high, there remain several areas for parental education regarding the HPV vaccine. Misbeliefs need to be addressed and multilevel interventions are needed to improve HPV vaccine uptake in our setting.

Design and Analytical Evaluation of a Rapid Plasma Screening Assay for Circulating Human Papillomavirus DNA via Thermostable Enzyme Chemistries

Infection with oncogenic strains of human papillomavirus (HPV), such as HPV-16 and HPV-18, can lead to malignant progression and tumorigenesis. As an adjunct to traditional invasive tissue sampling methods, the use of modern thermostable enzyme chemistries can aid in the development of innovative assay workflows to extract and detect circulating HPV DNA (cHPV-DNA) in liquid biopsies. In this work, we first successfully generated a model system to replicate fragmented cHPV-DNA in human plasma. Using this model system, we designed a novel thermostable enzyme chemistry-based cHPV-DNA assay for rapid clinical HPV screening and robustly evaluated its analytical assay performance. Our findings demonstrated that the use of thermostable enzymes provided faster cHPV-DNA extraction and amplification, leading to an overall three-fold improvement in overall assay time as compared to the current standard assay workflow and achieving clinically relevant levels of analytical specificity, sensitivity, and precision for accurate cHPV-DNA detection with excellent 100% sensitivity and specificity in contrived human plasma specimens. In summary, we have devised a rapid laboratory workflow to facilitate the emerging use of liquid biopsies for minimally invasive, rapid, and scalable HPV DNA testing. With facile assay modifications, our thermostable enzyme-based cHPV-DNA assay can be utilized for the detection of other clinically high-risk HPV genotypes.

Recent Progress on Optical Biosensors Developed for Nucleic Acid Detection Related to Infectious Viral Diseases

Optical biosensors have many advantages over traditional analytical methods. They enable the identification of several biological and chemical compounds directly, instantly, and without the need of labels. Their benefits include excellent specificity, sensitivity, compact size, and low cost. In this review, the main focus is placed on the nucleic acid-based optical biosensor technologies, including colorimetric, fluorescence, surface plasmon resonance (SPR), Evanescent-Wave Optical, Fiber optic and bioluminescent optical fibre. The fundamentals of each type of biosensor are briefly explained, and particular emphasis has been placed on the achievements which have been gained in the last decade on the field of diagnosis of infectious viral diseases. Concluding remarks concerning the perspectives of further developments are discussed.

Chemotherapy-Induced Hepatotoxicity in HIV Patients

Human immunodeficiency virus (HIV) affects more than 37 million people globally, and in 2020, more than 680,000 people died from HIV-related causes. Recently, these numbers have decrease substantially and continue to reduce thanks to the use of antiretroviral therapy (ART), thus making HIV a chronic disease state for those dependent on lifelong use of ART. However, patients with HIV have an increased risk of developing some type of cancer compared to patients without HIV. Therefore, treatment of patients who are diagnosed with both HIV and cancer represents a complicated scenario because of the risk associated with drug-drug interaction (DDIs) and related toxicity. Selection of an alternative chemotherapy or ART or temporarily discontinuation of ART constitute a strategy to manage the risk of DDIs. Temporarily withholding ART is the less desirable clinical plan but risks and benefits must be considered in each scenario. In this review we focus on the hepatotoxicity associated with a simultaneous treatment with ART and chemotherapeutic drugs and mechanisms behind. Moreover, we also discuss the effect on the liver caused by the association of immunotherapeutic drugs, which have recently been used in clinical trials and also in HIV patients.

Should men be exempted from vaccination against human papillomavirus? Health disparities regarding HPV: the example of sexual minorities in Poland

Introduction

Social campaigns concerning vaccinations against human papillomavirus (HPV) in Poland are mainly addressed to women. In addition to cervical cancer, anal, penile, and oropharyngeal cancers can be caused by the virus, which clearly affects men as well. HPV vaccinations are voluntary and mostly not refunded in Poland.

Methods

A survey was published on social media’s group gathering males and contained questions concerning epidemiological data, knowledge about HPV, and opinions of HPV vaccination. A questionnaire was enriched with educational note regarding HPV-dependent cancers and available vaccines against HPV in Poland.

Results

Because of age limitations, 169 males (115 heterosexuals, 48 homosexuals) aged 14-39 were chosen for the study. Seventyfive percent of straight and 88% of gay men were aware of HPV, but less than 4 and 17% (respectively) were vaccinated against the virus. Main sources of knowledge about HPV were the Internet (61%), media (28%) and relatives (27%). HPV infection was linked with the development of anal and oropharyngeal cancers by 28, and 37% of heterosexual males, compared with 56.3 and 43.8% of homosexual males. The majority of respondents (88%) indicated that all genders should be vaccinated, although only 57% were aware of HPV vaccination availability in Poland.

Conclusions

The men are at risk of HPV-related cancers and the danger is poorly understood amongst Polish men. Despite awareness of HPV vaccines, the vaccination rate is low. Consequently, there is a serious need to broaden educational campaignes with a special attention to LGBTQ+ communities.

The potential applications of T cell receptor (TCR)-like antibody in cervical cancer immunotherapy

Cervical cancer is ranked as the fourth most common cancer in women worldwide. Monoclonal antibody has created a new dimension in the immunotherapy of many diseases, including cervical cancer. The antibody's ability to target various aspects of cervical cancer (oncoviruses, oncoproteins, and signaling pathways) delivers a promising future for efficient immunotherapy. Besides, technologies such as hybridoma and phage display provide a fundamental platform for monoclonal antibody generation and create the opportunity to generate novel antibody classes including, T cell receptor (TCR)-like antibody. In this review, the current immunotherapy strategies for cervical cancer are presented. We have also proposed a novel concept of T cell receptor (TCR)-like antibody and its potential applications for enhancing cervical cancer therapeutics. Finally, the possible challenges in TCR-like antibody application for cervical cancer therapeutics have been addressed, and strategies to overcome the challenges have been highlighted to maximize the therapeutic benefits.

The role of viruses in adenocarcinoma development

Cancer is a leading public health issue that accounts for million deaths around the world every year. Human cancers contain over 100 types, which are categorized into different groups. Adenocarcinoma is one of those categories of cancer that begins from the glans and involves various tissues such as lung, esophagus, pancreas, prostate and colorectal. A range of risk factors has been identified for the development and progression of adenocarcinomas. One of these risk factors are viruses that serves special mechanisms to affect important host cell factors and tumorigenic pathways, contributing in development and promotion of adenocarcinomas. Here, we summarized the main viruses and their mechanisms implicated in the course of various adenocarcinomas development.

Molecular Detection and Typing of Human Papillomavirus in Men from Northwestern Mexico

BACKGROUND

A few studies of Human Papillomavirus (HPV) distribution and frequency have shown a real context of infection in men. The study aimed to know the HPV types distribution in men from Northwestern Mexico, in general, per age and year.

METHODS

A total of 1,769 males were recruited from 5 years (2011-2015), from an HPV PCR testing laboratory service. Penile scraps from urethral meatus and coronal sulcus were taken for DNA isolation. There were detected 32 high and low-risk HPV types by HPV Type 3.5 LCD-Array system.

RESULTS

A high frequency of HPV-6 and HPV-66 and a reduced frequency of HPV-18 and HPV-11 was detected. Young men had a high risk of HPV infection regarding men aged 40 years and older. The theoretical coverage for the HPV vaccine in men was calculated, where the bivalent vaccine showed coverage of 21.66% in high-risk HPV positive cases.

CONCLUSION

The men from Northwestern Mexico have a different distribution of high and low-risk HPV types and high risk of HPV infection in younger men, with a theoretical coverage for HPV bivalent vaccine of 1 of 10 positive men for any HPV type.

The effectiveness of vaccination to prevent the papillomavirus infection: a systematic review and meta-analysis

Our purpose was to determine the effectiveness and harms of vaccination in patients with any sexual history to prevent the prevalence of papillomavirus infection. A search strategy was conducted in the MEDLINE, CENTRAL, EMBASE and LILACS databases. Searches were also conducted in other databases and unpublished literature. The risk of bias was evaluated with the Cochrane Collaboration's tool. Analysis of fixed effects was conducted. The primary outcome was the infection by any and each human papillomavirus (HPV) genotype, serious adverse effects and short-term adverse effects. The measure of the effect was the risk difference (RD) with a 95% confidence interval (CI). The planned interventions were bivalent vaccine/tetravalent/nonavalent vs. placebo/no intervention/other vaccines. We included 29 studies described in 35 publications. Bivalent HPV vaccine offers protection against HPV16 (RD −0.05, 95% CI −0.098 to −0.0032), HPV18 (RD −0.03, 95% CI −0.062 to −0.0004) and HPV16/18 genotypes (RD of −0.1, 95% CI −0.16 to −0.04). On the other side, tetravalent HPV vaccine offered protection against HPV6 (RD of −0.0500, 95% CI −0.0963 to −0.0230), HPV11 (RD −0.0198, 95% CI −0.0310 to −0.0085). Also, against HPV16 (RD of −0.0608, 95% CI −0.1126 to −0.0091) and HPV18 (RD of −0.0200, 95% CI −0.0408 to −0.0123). There was a reduction in the prevalence of HPV16, 18 and 16/18 genotypes when applying the bivalent vaccine, with no increase in adverse effects. Regarding the tetravalent vaccine, we found a reduction in the prevalence of HPV6, 11, 16 and 18 genotypes, with no increase in adverse effects.

Sociodemographic Predictors of Anal Cancer Screening and Follow-up in Human Immunodeficiency Virus-Infected Individuals

BACKGROUND

Anal cancer in the United States is generally rare; however, human immunodeficiency virus (HIV)-infected individuals are 28 times more likely to be given a diagnosis of anal cancer than the general population.

OBJECTIVE

The aim of this study was to examine the rates and sociodemographic predictors of anal cancer screening and follow-up anoscopy in a sample of HIV-infected individuals.

METHODS

Data for this study (n = 200) were derived from a retrospective chart review of randomly selected HIV-infected individuals. Data analyses included Pearson's correlation coefficient statistic to examine bivariate associations and logistic regression modeling for prediction of anal Papanicolaou test screening and follow-up anoscopy.

RESULTS

Screening rates and follow-up after an abnormal anal Pap test were low. Women were less likely to be screened for anal cancer (odds ratio [OR], 0.244; P = .007). Men who have sex with men were almost 4 times more likely to be screened for anal cancer (OR, 3.7; P = .02). Men who have sex with men were 6 times more likely to have follow-up after an abnormal anal Pap test compared with heterosexual men or women of any sexual orientation (OR, 6.88; P = .002).

CONCLUSIONS

High-risk groups for anal cancer should be targeted for preventative measures as part of a cancer prevention plan to decrease the personal and clinical burden associated with anal cancer.

IMPLICATIONS FOR PRACTICE

Cancer prevention is a multistep process that requires screening and follow-up efforts, where healthcare providers play a vital role in these efforts. Findings from this study can inform strategies to improve screening and follow-up rates in HIV-infected individuals.

Knowledge of Human Papillomavirus, Risk of Anogenital Cancers, and Benefits of Vaccination: A Medical Student Survey in Saudi Arabia

Background Human papillomavirus (HPV) is one of the most common sexually transmitted infections and plays a significant role in the development of anogenital cancer. However, there is a lack of awareness on the subject in Saudi Arabia and very few documented studies on the knowledge and awareness of medical students regarding HPV. Methods A cross-sectional study utilizing a survey distributed to 306 medical students of both genders was utilized. A self-administrated questionnaire was distributed to all participants to assess their knowledge of HPV and their attitude towards HPV vaccination. Data analysis was performed using SPSS v 24 (IBM Corp., Armonk, NY, US) and RStudio v 1.14 (Boston, US). Results Most of the respondents (72.2%) had a high level of knowledge regarding HPV, with 47.84% of the respondents being aware of the risks associated with HPV and having a positive attitude towards HPV. Female respondents had better awareness and knowledge as compared to male students. However, there was a lack of knowledge regarding the duration and frequency of HPV infection, which could have an effect on the attitude of medical students towards vaccination. The results obtained by using Pearson's correlation coefficient showed a statistically significant correlation between the attitude towards HPV and the knowledge regarding HPV (p-value < 0.05). Conclusion Better awareness and knowledge regarding HPV and its risks correlate with a better attitude towards HPV. The medical school curriculum was found to be a primary source of information for students on the awareness of HPV. Therefore, more about HPV and the benefits associated with vaccination against HPV should be included in the curriculum in all years of medical school.

Characteristics of HPV-unvaccinated undergraduate health students in Switzerland, a cross sectional study

Background

Human Papillomavirus (HPV) vaccination, intended for young women aged 11-14 years old, has been introduced in Switzerland in 2007. Ten years after its introduction, only a few studies have explored the reasons associated with uptake and non-uptake of the vaccination. Our objective was to identify the sociodemographic characteristics of a population of vaccinated and unvaccinated undergraduate healthcare female students, to define the reasons of non-uptake of vaccination, and compare our findings with those found in other Swiss cantons.

Methods

Between January and November 2017, women studying in Health Sciences School and Medical School in Geneva, aged 18-31 years old, were recruited in a large trial assessing HPV prevalence. As part of a smaller, observational study nested in this larger trial, women were invited to complete a questionnaire. Self-reported HPV vaccination uptake or non-uptake, as well as knowledge and attitude about HPV vaccination were assessed. T-Test and Chi square test were used to compare characteristics of vaccinated and unvaccinated women.

Results

Overall, 409 women were recruited in the study. The majority of them (69.1%) reported having been vaccinated for HPV, while 30.9% of them had never received any dose of the HPV vaccine. The only factor associated with a higher vaccination rate was the participants' origin, as women from Geneva were more represented in the vaccinated group than women from other Swiss regions or countries. Unvaccinated women were more likely to consider HPV vaccination as less important than the vaccinated ones (50.4% vs 3.5% p < 0.001).

Conclusion

Although no typical profile can be established in this studied population of unvaccinated women, a lack of information was a major reason of non-uptake of vaccination among the study participants. An effort by health authorities and carefully designed messages are essential to increase the population's awareness over cervical cancer and its prevention.

Trial registration

The trial was registered under cliniclatrials.gov with the identifier: NCT03474211.

Practice parameters for the diagnosis and treatment of anal intraepithelial neoplasia (AIN) on behalf of the Italian Society of Colorectal Surgery (SICCR)

Squamous cell carcinoma (SCC) of the anus is a human papilloma virus (HPV) related malignancy that is preceded by anal intraepithelial neoplasia (AIN) making this cancer, at least theoretically, a preventable disease. In the past 10 years the diagnosis, management and nomenclature of AIN has dramatically changed. Increased life expectancy in human immunodeficiency virus (HIV) positive patients due to highly active antiretroviral therapy (HAART) has caused an increase in the incidence of SCC of the anus. While many experts recommend screening and treatment of anal high-grade squamous intraepithelial lesion (HSIL), there is no consensus on the optimal management these lesions. Therefore, there is a need to review the current evidence on diagnosis and treatment of AIN and formulate recommendations to guide management. Surgeons who are members of the Italian Society of Colorectal Surgery (SICCR) with a recognized interest in AIN were invited to contribute on various topics after a comprehensive literature search. Levels of evidence were classified using the Oxford Centre for Evidence-based Medicine of 2009 and the strength of recommendation was graded according to the United States (US) preventive services task force. These recommendations are among the few entirely dedicated only to the precursors of SCC of the anus and provide an evidence-based summary of the current knowledge about the management of AIN that will serve as a reference for clinicians involved in the treatment of patients at risk for anal cancer.

New Insights in the Pathogenesis of HPV Infection and the Associated Carcinogenic Processes: The Role of Chronic Inflammation and Oxidative Stress

Human papillomavirus (HPV) is a small double-stranded DNA virus with tropism for epithelial cells. To this date, over 150 genotypes are known and are classified into two major groups, low-risk and high-risk strains, depending on the ability of the virus to induce malignant transformation. The host's immunity plays a central role in the course of the infection; therefore, it may not be clinically manifest or may produce various benign or malignant lesions. The pathogenic mechanisms are complex and incompletely elucidated. Recent research suggests the role of chronic inflammation and oxidative stress (OS) in the pathogenesis of HPV infection and the associated carcinogenic processes. Chronic inflammation induces OS, which in turn promotes the perpetuation of the inflammatory process resulting in the release of numerous molecules which cause cell damage. Reactive oxygen species exert a harmful effect on proteins, lipids, and nucleic acids. Viral oncogenes E5, E6, and E7 are involved in the development of chronic inflammation through various mechanisms. In addition, HPV may interfere with redox homeostasis of host cells, inducing OS which may be involved in the persistence of the infection and play a certain role in viral integration and promotion of carcinogenesis. Knowledge regarding the interplay between chronic inflammation and OS in the pathogenesis of HPV infection and HPV-induced carcinogenesis has important consequences on the development of new therapeutic strategies.

HPV vaccination in male physicians: A survey of gynecologists and otolaryngology surgeons' attitudes towards vaccination in themselves and their patients

OBJECTIVE

Attitudes and barriers towards HPV vaccination were explored in a population of male surgeons in Gynecology and Otolaryngology in Ontario, Canada.

MATERIALS/METHODS

An internet-based survey was distributed to male residents and physicians affiliated with the departments of Obstetrics and Gynecology, and Otolaryngology at six Ontario universities. The survey consisted of 16 questions (3 demographic, 3 workplace exposure, 6 regarding personal vaccination, and 3 regarding patient vaccination). Subgroup analyses examined differences between residents versus staff physicians and gynecologists versus otolaryngologists.

RESULTS

Most respondents (51/63, 81.0%) had not been vaccinated against HPV, yet would consider vaccination in the future (41/51, 80.4%). Significantly more residents would consider vaccination compared to staff physicians (p = .03). Personal protection from benign HPV disease was the most common motivating factor (25/59, 42.4%) among participants. A notable barrier to vaccination was "age over recommendations" (9/44, 20.4%). Most participants would recommend the HPV vaccine to both male patients (49/62, 79.0%) and male partners of female patients (47/62, 75.8%).

CONCLUSIONS

This study demonstrates male gynecologists and otolaryngologists had largely favorable attitudes towards HPV vaccination though few had received vaccination. These findings may be used to increase HPV vaccine uptake among male health care professionals and their patients.