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Miyaji KT, Infante V, Picone CDM, Levi JE, de Oliveira ACS, Lara AN, Tacla M, Dillner J, Kann H, Eklund C, Castanheira CP, Mayaud P, Sartori AMC. Human Papillomavirus (HPV) seroprevalence, cervical HPV prevalence, genotype distribution and cytological lesions in solid organ transplant recipients and immunocompetent women in Sao Paulo, Brazil. PLoS One 2022; 17:e0262724. [PMID: 35051227 PMCID: PMC8775251 DOI: 10.1371/journal.pone.0262724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Solid organ transplant (SOT) recipients are at increased risk of Human Papillomavirus (HPV) persistent infection and disease. This study aimed to evaluate HPV seroprevalence, cervical HPV prevalence, genotype distribution, and frequency of HPV-related cervical lesions in SOT recipients in comparison to immunocompetent women. Methods Cross-sectional study including SOT and immunocompetent women aged 18 to 45 years who denied previous HPV-related lesions. Cervical samples were screened for HPV-DNA by a polymerase chain reaction (PCR)-based DNA microarray system (PapilloCheck®) and squamous intraepithelial lesions (SIL) by liquid-based cytology. A multiplexed pseudovirion-based serology assay (PsV-Luminex) was used to measure HPV serum antibodies. Results 125 SOT and 132 immunocompetent women were enrolled. Cervical samples were collected from 113 SOT and 127 immunocompetent women who had initiated sexual activity. HPV-DNA prevalence was higher in SOT than in immunocompetent women (29.6% vs. 20.2%, p = 0.112), but this difference was not statistically significant. High-risk (HR)-HPV was significantly more frequent in SOT than in immunocompetent women (19.4% vs. 7.9%, p = 0.014). Simultaneous infection with ≥2 HR-HPV types was found in 3.1% of SOT and 0.9% of immunocompetent women. HPV seropositivity for at least one HPV type was high in both groups: 63.8% of 105 SOT and 69.7% of 119 immunocompetent women (p = 0.524). Low-grade (LSIL) and high-grade SIL (HSIL) were significantly more frequent in SOT (9.7% and 5.3%, respectively) than in immunocompetent women (1.6% and 0.8%, respectively) (p = 0.001). Conclusions These results may reflect the increased risk of HPV persistent infection and disease progression in SOT women due to chronic immunosuppression.
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Affiliation(s)
- Karina Takesaki Miyaji
- Departamento de Molestias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
- Clinica de Molestias Infecciosas e Parasitarias do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, Brazil
- Centro de Referencia para Imunobiológicos Especiais, HC-FMUSP, Sao Paulo, Brazil
- * E-mail:
| | - Vanessa Infante
- Departamento de Molestias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
- Clinica de Molestias Infecciosas e Parasitarias do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, Brazil
| | - Camila de Melo Picone
- Clinica de Molestias Infecciosas e Parasitarias do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, Brazil
| | - José Eduardo Levi
- Laboratório de Investigação Medica – Virologia, Instituto de Medicina Tropical (IMT)/HC, FMUSP, Sao Paulo, Brazil
| | | | - Amanda Nazareth Lara
- Clinica de Molestias Infecciosas e Parasitarias do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, Brazil
- Centro de Referencia para Imunobiológicos Especiais, HC-FMUSP, Sao Paulo, Brazil
| | - Maricy Tacla
- Clínica de Ginecologia, HC-FMUSP, Sao Paulo, Brazil
| | - Joakim Dillner
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hanna Kann
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Carina Eklund
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | | | - Philippe Mayaud
- London School of Tropical Medicine and Hygiene (LSTMH), London, England
| | - Ana Marli Christovam Sartori
- Departamento de Molestias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
- Clinica de Molestias Infecciosas e Parasitarias do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, Brazil
- Centro de Referencia para Imunobiológicos Especiais, HC-FMUSP, Sao Paulo, Brazil
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Bogale AL, Belay NB, Medhin G, Ali JH. Molecular epidemiology of human papillomavirus among HIV infected women in developing countries: systematic review and meta-analysis. Virol J 2020; 17:179. [PMID: 33198743 PMCID: PMC7670609 DOI: 10.1186/s12985-020-01448-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background Although, there is a variable burden of human papillomavirus (HPV) in women infected with HIV in developing countries, there are few studies that attempted to surmise such variable evidences. This review aimed to estimate the pooled prevalence of HPV genotype distribution and risk factors contributing to HPV infection among women infected with HIV in low- and middle-income countries. Methods We conducted a systematic review and meta-analysis of studies conducted in developing countries and reported HPV prevalence. We searched electronic databases: PubMed/Medline, SCOPUS, ScienceDirect, Excerpta Medical Database from Elsevier, Web of science, Cumulative Index of Nursing and allied Health Sciences and Google scholar databases to retrieve primary studies published in English language till 11th August 2019. We used random-effects model to estimate the pooled prevalence of HPV genotypes, and funnel plot to assess publication bias. The registration number of this review study protocol is CRD42019123549. Results We included nineteen studies with a total of 8,175 participants in this review. The prevalence of HPV was extremely heterogeneous across the studies (χ2= 3782.80, p value < 0.001, I2 = 99.6%). The estimated pooled prevalence of all HPV genotypes was 63.0% (95% CI: 48.0–78.0) while the pooled prevalence of high risk and low risk HPV genotypes were 51.0% (95% CI: 38.0–63.0) and 28.0% (95% CI: 12.0–43.0), respectively. The pooled prevalence of HPV genotype 16 was 20%, while genotype 18 and 52 were 15% and 13%, respectively. Different risk factors reported for HPV infection and the frequently reported were low CD4 count below 200 cells/mm3 and high HIV viral load.
Conclusion The pooled prevalence of HPV among HIV infected women in low- and middle-income countries was considerable and the proportion of high risk HPV genotypes were high when compared with low risk genotypes. Therefore, it is essential for the HPV prevention program to prevent the double burden of HPV and HIV in women.
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Affiliation(s)
- Agajie Likie Bogale
- Ethiopian Public Health Institute, and Addis Ababa University, P.O. Box 1242, Addis Ababa, Ethiopia.
| | - Nega Berhe Belay
- Department of Tropical and Infectious Diseases, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Department of Tropical and Infectious Diseases, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Jemal Haidar Ali
- School of Public Health, College of Health Sciences, Addis Ababa University, 1000, P.O. Box 27285, Addis Ababa, Ethiopia
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Geretti AM, Brook G, Cameron C, Chadwick D, French N, Heyderman R, Ho A, Hunter M, Ladhani S, Lawton M, MacMahon E, McSorley J, Pozniak A, Rodger A. British HIV Association Guidelines on the Use of Vaccines in HIV-Positive Adults 2015. HIV Med 2018; 17 Suppl 3:s2-s81. [PMID: 27568789 DOI: 10.1111/hiv.12424] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | | | | | | | | | | | | | | | - Mark Lawton
- Royal Liverpool University Hospital, Liverpool, UK
| | - Eithne MacMahon
- Guy's & St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | | | - Anton Pozniak
- Chelsea and Westminster Hospital, NHS Foundation Trust, London, UK
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HIV is an important risk factor for human papillomavirus types 16 and 18 seropositivity among sexually active men who have sex with men. Sex Transm Dis 2015; 42:129-34. [PMID: 25668644 DOI: 10.1097/olq.0000000000000244] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether HIV infection is a main risk factor for human papillomavirus (HPV)-16 and HPV-18 seropositivity in men who have sex with men (MSM), and what other risk factors are associated with HPV-16 and HPV-18 seropositivity in this population. METHODS Men who have sex with men visiting a sexually transmitted infection (STI) clinic in Amsterdam in 2008 to 2009 answered questions concerning demographics and sexual behavior. Sera were tested for HPV antibodies to the major HPV capsid protein L1 by Luminex-based multiplex serology. As it is known that site of exposure is associated with seropositivity, this analysis was restricted to MSM who reported receptive anal sex during the preceding 6 months. Using multivariable logistic regression, we examined whether HIV was associated with HPV serostatus. RESULTS Included in the study were 415 HIV-negative and 205 HIV-positive MSM reporting receptive anal sex. Median age of the study population was 39 years (interquartile range, 31-44). Human papillomavirus seroprevalence differed significantly between HIV-negative and HIV-positive MSM: 31% versus 65% (P < 0.001) for HPV-16 and 28% versus 51% (P < 0.001) for HPV-18. After adjusting for important risk factors HPV-16 (adjusted odds ratio, 2.80; 95% confidence interval, 1.75-4.49) and HPV-18 (adjusted odds ratio, 1.78; 95% confidence interval, 1.11-2.85), seropositivity was significantly more common in HIV-positive than in HIV-negative MSM. We could not identify other consistent risk factors for HPV-16 and HPV-18 seropositivity. CONCLUSIONS HIV infection is an important risk factor for HPV-16 and HPV-18 seropositivity among MSM reporting receptive anal sex in the preceding 6 months.
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Castilho JL, Levi JE, Luz PM, Cambou MC, Vanni T, de Andrade A, Derrico M, Veloso VG, Grinsztejn B, Friedman RK. A cross-sectional study of high-risk human papillomavirus clustering and cervical outcomes in HIV-infected women in Rio de Janeiro, Brazil. BMC Cancer 2015; 15:478. [PMID: 26100400 PMCID: PMC4477502 DOI: 10.1186/s12885-015-1486-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 06/09/2015] [Indexed: 01/22/2023] Open
Abstract
Background In Brazil, the rate of cervical cancer remains high despite the availability of screening programs. With ongoing vaccine development and implementation, information on the prevalence of specific HPV types is needed, particularly among high-risk populations, such as HIV-infected women. Methods We performed a study of HIV-infected women in Rio de Janeiro, Brazil, who underwent cervical HPV genotype testing between 2005-2013. We examined the prevalence of high-risk HPV types and the patterns of high-risk HPV type clustering. Using logarithmic binomial regression, we estimated the risk of abnormal cytology by HPV genotype result. Results Of the 562 women included, 498 (89 %) had at least one HPV type detected. 364 women (65 %) had at least one high-risk HPV type detected and 181 (32 %) had more than one high-risk type detected. HPV 58 was the most frequent HPV type detected overall (prevalence 19.8 % [95 % confidence interval 16.4–23.1]), followed by HPV 53 (prevalence 15.5 % [12.5–18.5]) and HPV 16 (prevalence 13 % [10.2–15.8]). Women infected with more than one high-risk HPV type were younger, had lower CD4+ lymphocyte counts, and were more likely to be infected with HPV 16 or 18. In adjusted analyses, presence of more than one high-risk HPV type was associated with a two-fold increased risk of abnormal cytology after adjusting for presence of individual high-risk type, age, and CD4+ lymphocyte count (adjusted prevalence ratios 1.88–2.07, all p <0.001). No single high-risk HPV type was statistically associated with abnormal cytology after adjusting for the presence of more than one high-risk HPV type. Conclusions In the largest study of cervical HPV genotypes among HIV-infected women in Latin America, infection by high-risk HPV types other than 16 or 18 and infection by more than one high-risk HPV types were common. Infection by more than one high-risk type was more strongly associated with abnormal cervical cytology than any individual high-risk HPV type, highlighting the need for multi-valent HPV vaccines.
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Affiliation(s)
- Jessica L Castilho
- Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, USA.
| | - José Eduardo Levi
- Virology Lab, Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil.
| | - Paula M Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
| | - Mary Catherine Cambou
- Division of Infectious Diseases and Program in Global Health, David Geffen School of Medicine at UCLA, Los Angeles, USA.
| | - Tazio Vanni
- Departamento de Ciência e Tecnologia, Ministério da Saúde, Brasília, Brazil.
| | - Angela de Andrade
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
| | - Mônica Derrico
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
| | - Valdiléa G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
| | - Ruth K Friedman
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
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Martins AES, Lucena-Silva N, Garcia RG, Welkovic S, Barboza A, Menezes MLB, Maruza M, Tenório T, Ximenes RAA. Prevalence of human papillomavirus infection, distribution of viral types and risk factors in cervical samples from human immunodeficiency virus-positive women attending three human immunodeficiency virus-acquired immune deficiency syndrome reference centres in northeastern Brazil. Mem Inst Oswaldo Cruz 2014; 109:738-47. [PMID: 25317701 PMCID: PMC4238765 DOI: 10.1590/0074-0276140070] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 06/20/2014] [Indexed: 01/27/2023] Open
Abstract
Human immunodeficiency virus (HIV)-positive patients have a greater prevalence of coinfection with human papillomavirus (HPV) is of high oncogenic risk. Indeed, the presence of the virus favours intraepithelial squamous cell lesion progression and may induce cancer. The aim of this study was to evaluate the prevalence of HPV infection, distribution of HPV types and risk factors among HIV-positive patients. Cervical samples from 450 HIV-positive patients were analysed with regard to oncotic cytology, colposcopy and HPV presence and type by means of polymerase chain reaction and sequencing. The results were analysed by comparing demographic data and data relating to HPV and HIV infection. The prevalence of HPV was 47.5%. Among the HPV-positive samples, 59% included viral types of high oncogenic risk. Multivariate analysis showed an association between HPV infection and the presence of cytological alterations (p = 0.003), age greater than or equal to 35 years (p = 0.002), number of partners greater than three (p = 0.002), CD4⁺ lymphocyte count < 200/mm³ (p = 0.041) and alcohol abuse (p = 0.004). Although high-risk HPV was present in the majority of the lesions studied, the low frequency of HPV 16 (3.3%), low occurrence of cervical lesions and preserved immunological state in most of the HIV-positive patients were factors that may explain the low occurrence of precancerous cervical lesions in this population.
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Affiliation(s)
- Albert Eduardo Silva Martins
- Laboratório de Imunogenética, Centro de Pesquisas Aggeu
Magalhães-Fiocruz, Recife PE, Brasil
- Laboratório de Biologia Molecular, Departamento de Oncologia
Pediátrica, Hospital de Ensino, Instituto de Medicina Integral Professor Fernando
Figueira, Recife, PE, Brasil
| | - Norma Lucena-Silva
- Laboratório de Imunogenética, Centro de Pesquisas Aggeu
Magalhães-Fiocruz, Recife PE, Brasil
- Laboratório de Biologia Molecular, Departamento de Oncologia
Pediátrica, Hospital de Ensino, Instituto de Medicina Integral Professor Fernando
Figueira, Recife, PE, Brasil
| | - Renan Gomes Garcia
- Laboratório de Imunogenética, Centro de Pesquisas Aggeu
Magalhães-Fiocruz, Recife PE, Brasil
| | - Stefan Welkovic
- Centro Integrado de Saúde Amaury de MedeirosFaculdade de Ciências
Médicas, Universidade de Pernambuco Recife, PE, Brasil
| | - Aureliana Barboza
- Departamento Materno-Infantil, Faculdade de Ciências Médicas,
Universidade de Pernambuco, Recife, PE, Brasil
| | - Maria Luiza Bezerra Menezes
- Departamento Materno-Infantil, Faculdade de Ciências Médicas,
Universidade de Pernambuco, Recife, PE, Brasil
| | - Magda Maruza
- Hospital Correia Picanço, Secretaria de Saúde de Pernambuco, Recife,
PE, Brasil
| | - Terezinha Tenório
- Departamento Materno-Infantil, Universidade Federal de Pernambuco,
Recife, PE, Brasil
| | - Ricardo AA Ximenes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco,
Recife, PE, Brasil
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Soares CC, Georg I, Lampe E, Lewis L, Morgado MG, Nicol AF, Pinho AA, Salles RCS, Teixeira SLM, Vicente ACP, Viscidi RP, Gomes SA. HIV-1, HBV, HCV, HTLV, HPV-16/18, and Treponema pallidum infections in a sample of Brazilian men who have sex with men. PLoS One 2014; 9:e102676. [PMID: 25083768 PMCID: PMC4118852 DOI: 10.1371/journal.pone.0102676] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 06/21/2014] [Indexed: 11/20/2022] Open
Abstract
Background Men who have sex with men (MSM) are more vulnerable to blood-borne infections and/or sexually-transmitted infections (STI). This study was conducted to estimate the prevalences of mono and co-infections of HIV-1 and other blood-borne/STIs in a sample of MSM in Campinas, Brazil. Methods Responding Driven Sampling (RDS) was used for recruitment of MSM. Serum samples collected from 558 MSM were analyzed for the presence of serological markers for HIV-1, HBV, HCV, HTLV, HPV-16/18, and T. pallidum infections. Results The highest prevalences of infection in serum samples were found for HPV-16 and 18 (31.9% and 20.3%, respectively). Approximately 8% of the study population showed infection with HIV-1, and within that group, 27.5% had recently become infected with HIV-1. HBV infection and syphilis were detected in 11.4% and 10% of the study population, respectively, and the rates of HTLV and HCV infection were 1.5% and 1%, respectively. With the exception of HTLV, all other studied infections were usually found as co-infections rather then mono-infections. The rates of co-infection for HCV, HPV-18, and HIV-1 were the highest among the studied infections (100%, 83%, and 85%, respectively). Interestingly, HTLV infection was usually found as a mono-infection in the study group, whereas HCV was found only as a co-infection. Conclusions The present findings highlight the need to educate the MSM population concerning their risk for STIs infections and methods of prevention. Campaigns to encourage vaccination against HBV and HPV could decrease the rates of these infections in MSM.
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Affiliation(s)
- Caroline C. Soares
- Laboratório de Virologia Molecular, IOC, Fiocruz, Rio de Janeiro, Brasil
| | - Ingebourg Georg
- Laboratório de Análises Clínicas, Seção Imunodiagnóstico, IPEC, Fiocruz, Rio de Janeiro, Brasil
| | - Elisabeth Lampe
- Laboratório de Referência Nacional para Hepatites Virais, IOC, Fiocruz, Rio de Janeiro, Brasil
| | - Lia Lewis
- Laboratório de Referência Nacional para Hepatites Virais, IOC, Fiocruz, Rio de Janeiro, Brasil
| | - Mariza G. Morgado
- Laboratório de AIDS e Imunologia Molecular, IOC, Fiocruz, Rio de Janeiro, Brasil
| | - Alcina F. Nicol
- Laboratório Interdisciplinar de Pesquisas Médicas, IOC, Fiocruz, Rio de Janeiro, Brasil
| | - Adriana A. Pinho
- Pós-doutoranda do laboratório de Educação em Ambiente e Saúde do Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brasil
| | | | | | | | - Raphael P. Viscidi
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Selma A. Gomes
- Laboratório de Virologia Molecular, IOC, Fiocruz, Rio de Janeiro, Brasil
- * E-mail:
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