Prevalence of human papillomavirus among Croatian women attending regular gynecological visit

Human papillomavirus (HPV) infection has been identified as major risk factor for cervical intraepithelial neoplasia (CIN) and invasive cervical cancer. About 40 HPV viral types are commonly found in the genital tract. Most HPV infections resolve spontaneously, while persistent infection with oncogenic types, namely HPV 16 and 18 is necessary for CIN to occur and progress to cancer. Cervical screening is presently based on the Pap smear that is designed to diagnose precancerous lesions and cervical cancer The aim of this study was to investigate the prevalence of HPV DNA and to determine HPV types distribution among 361 women attending regular gynecological visit. There were 205 women (29+/-8 years old) without determined abnormal cervical lesions and 156 women (34+/-15 years old) with abnormal Pap smear; low grade squamous intraepitehelial lesions (LSIL, n=69), high grade squamous intraepithelial lesions (HSIL, n=72) and atypical squamous cells of undetermined significance (ASCUS, n=15). HPV DNA detection and genotyping was performed by Hybrid Capture 2 assay and additionally by consensus and type-specific primers directed PCR. The overall prevalence of high-risk HPV (hrHPV) in women with abnormal Pap smears was 67.9% (106/156), of which in ASCUS 33.4% (5/15), LSIL 62.3% (43/69) and HSIL 80.6% (58/72). In HPV positive specimens, HPV 16 was found as predominant type in 60.4% cases, followed by HPV 31 (8.5%), HPV 33 (6.6%) and HPV 18 (3.7%). In the group of women without obvious cervical changes the overall hrHPV prevalence was 35.6% with HPV 16 found in 43.8% cases, followed by HPV 31 (17.8%), HPV33 (9.5%) and HPV18 (6.8%). In both study groups, women with and without cervical lesions, the prevalence of HPVof indeterminate type was 14.2% and 13.7%, respectively. Our results indicate that cervical intraepithelial lesions are largely associated with HPV type 16, followed by HPV types 31, 33, 18 and HPV of indeterminate type. Although there is a significant difference in hrHPV DNA prevalence among two groups, no significant differences between particular hrHPV types distribution were observed.     

Prevalence of risk factors associated with human papillomavirus infection in women living with HIV

BACKGROUND: Concurrent infection with HIV and human papillomavirus (HPV) in women is associated with increased rates of cervical dysplasia and shorter survival following the development of cervical cancer. The authors examined risk factors for HPV infection at study entry in HIV-positive women enrolled in the Canadian Women''s HIV Study, a prospective open cohort study. METHODS: Subjects eligible for this analysis included the 375 HIV-positive women in the Canadian Women''s HIV Study for whom HPV test results were available. Questionnaires on behavioural and clinical information, Pap smears, cervicovaginal lavage specimens and vaginal tampon specimens for HPV detection and typing by polymerase chain reaction were obtained at study entry. RESULTS: Overall, 67.2% (252/375) of the women were HPV-positive; the global prevalence of intermediate- and high-risk oncogenic HPV types was 49.1% (184/375). Women with squamous cell dysplasia (32/294) were more likely to have HPV infection than those without dysplasia (90.6% v. 62.6%; p = 0.002). Multivariate logistic regression analysis, with adjustment for number of lifetime partners and history of STD, revealed that the following risk factors were independently associated with HPV infection: CD4 count of less than 0.20 x 10(9)/L (adjusted odds ratio [OR] 1.99 [95% confidence interval (Cl) 1.17-3.37 (p = 0.011)]), non-white race (adjusted OR 2.00 [95% Cl 1.17-3.42 (p = 0.011)]), inconsistent condom use in the 6 months before study entry (adjusted OR 2.02 [95% Cl 1.16-3.50 (p = 0.013)]), and lower age, with women age 30-39 years (adjusted OR 0.51 [95% Cl 0.30-0.87 (p = 0.013)]) and age 40 years or older (adjusted OR 0.52 [95% Cl 0.26-1.01 (p = 0.052)]) compared with women less than 30 years of age. INTERPRETATION: Close monitoring for HPV-related effects is warranted in all HIV-positive women, particularly younger, non-white women who do not always use condoms. Counselling for women living with HIV, particularly younger women, should emphasize the importance of regular cytological screening, with increasing frequency as the CD4 count falls.     

Prevalence of HIV infection among pregnant women in Newfoundland.

OBJECTIVE: To determine the prevalence of HIV infection among pregnant women in Newfoundland. DESIGN: Anonymous unlinked seroprevalence study. SETTING: Newfoundland. PATIENTS: A total of 14911 women receiving prenatal care or undergoing an abortion, representing nearly all pregnancies in Newfoundland from Nov. 1, 1991, to Oct. 31, 1993. OUTCOME MEASURES: HIV antibody status, as determined by enzyme immunoassay of leftover serum samples (initially obtained for routine screening) and confirmation of reactive samples by the Western blot technique, health region of residence, and age group. RESULTS: Of the 14911 serum samples 13 were positive for HIV, for an overall crude prevalence rate of 1 per 1147 or 8.7 per 10000 pregnant women (95% confidence interval [CI] 4.7 to 14.9). Seven of the positive samples were from women residing in the Eastern Health Region of the province, for a crude prevalence rate of 1 per 376 or 26.6 per 10000 pregnant women (95% CI 10.7 to 54.8) for that region. All women found to be HIV positive were 15 to 29 years of age, the peak prevalence (20.8 per 10000 pregnant women [95% CI 9.5 to 39.4]) was observed among those 20 to 24 years. CONCLUSIONS: The overall prevalence rate of 8.7 per 10 000 pregnant women in Newfoundland is the highest provincial rate recorded among those from similar studies in Canada. Although it may be concluded that there are an estimated 125 HIV-positive women of childbearing age in Newfoundland (95% CI 67 to 213), the age-adjusted estimate is 84 (95% CI 36 to 131). This study provides an independent confirmation of an outbreak of HIV infection among women in the Eastern Health Region of the province.     

Genital human papillomavirus infection in women from the Zagreb region

Human papillomavirus (HPV) infection is the most common sexually transmitted infection, especially among young, sexually active individuals. As persistent infection with oncogenic types may lead to cervical cancer, HPV testing is a useful tool to screen for women at risk for subsequent development of cervical cancer. The aim of the study was to determine the prevalence of high-risk HPV (hrHPV) infection in different age groups of cytologically selected women from the Zagreb region, and to evaluate the frequency and results of repeat hrHPV testing. During a one-year study period (November 2005 to November 2006), a total of 3,440 cervical samples from women attending gynecological services of public and private health care systems were received. They were tested for 13 hrHPV genotypes by the polymerase chain reaction based AMPLICOR HPV test (Roche Molecular Systems). The overall prevalence of hrHPV was 34.6%. Most samples were obtained from women aged 21-30 years (44.2%), followed by the 31-40 (27.6%), 41-50 (15.7%), 51-60 (5.3%) and 261 (2.4%) age groups. Out of 3,227 cervical samples obtained from women of known age, 4.9% were obtained from the group of girls younger than 21, in which the highest prevalence of hrHPV (49.4%) was found. A similar prevalence was observed in women aged 21-30 (45.1%). The prevalence gradually decreased with age. During the study period, repeat hrHPV testing was performed in samples from 66 women at different intervals. Out of 28 women that were hrHPV negative on initial testing, only five women turned positive on repeat testing. Out of 38 women that were positive on initial testing, in one-third hrHPV could not be detected on repeat testing. As expected, hrHPV infection was highly prevalent in female adolescents and young women. Further investigation on repeat hrHPV testing is needed to assess virus clearance and rate of newly acquired infection.     

Prevalence of high-risk human papillomavirus type 16/18 infection among women with normal cytology: risk factor analysis and implications for screening and prophylaxis

Objective: To determine the prevalence of high‐risk human papillomavirus (HR‐HPV) 16/18 infection of uterine cervix among women in the reproductive age group, with cytologically normal cervical (Pap) smears; to analyse the risk factors for HR‐HPV acquisition and to address their implications for cervical cancer screening and prophylaxis in a low resource setting. Methods: Cervical samples from 769 cytologically negative women (age 18–45 years) attending a tertiary care centre in Delhi were subjected to HPV DNA testing and HR‐HPV 16/18 and low‐risk (LR)‐HPV 6/11 sub‐typing by polymerase chain reaction. Univariate risk factor analysis was carried out in HR‐HPV positive (n = 86) versus HR‐HPV negative women (n = 683) by chi‐square test. Results: The overall HPV prevalence among cytologically normal women was 16.6%. HR‐HPV16 was detected in 10.1%, whereas HPV18 was detected in 1% of women. HR‐HPV 16/18 comprised 67% of the total HPV positives. There was no decline in HR‐HPV positivity with age, and women aged 40–44 years were at significantly increased risk for HR‐HPV prevalence (P = 0.03). Statistically significant associations of HR‐HPV infection were found with risk factors such as high parity (P = 0.04), cervicitis/hypertrophic cervix (P = 0.01), unhealthy cervix (P = 0.04), rural residence (P = 0.03), low socioeconomic status (P = 0.01) and illiteracy (P = 0.07). Conclusions: Although the sample size was small, based on the observation that HR‐HPV 16 and 18 contributed significantly to the overall HPV prevalence in our setting, we speculate that testing/prophylaxis for these prevalent high‐risk types could perhaps make cervical cancer screening and preventive programmes cost‐effective. Larger community‐based studies on HPV prevalence and persistence are required to validate these findings before definitive recommendations can be made to the policy makers.     

绝经后妇女阴道微生态改变与人乳头瘤病毒感染的相关性

目的 探讨绝经后妇女阴道微生态改变与人乳头瘤病毒(HPV)感染的相关性。 方法 选取2018年3月至2019年3月就诊于周口市中心医院妇科门诊绝经后妇女873例为研究对象,根据感染的HPV DNA基因分型结果分组,检测研究对象阴道分泌物的清洁度、病原体及阴道微生态相关指标,对阴道微生态改变和HPV感染相关性进行统计分析。 结果 873例调查对象中有137例(15.7%)HPV感染者。HPV感染组和未感染组相比较,清洁度(χ2=20.2,P2=17.8,P2=14.0,P2=15.5,P2=8.7,P=0.003)差异有统计学意义,菌群多样性、H2O2阳性率差异无统计学意义(均P>0.05)。多因素回归分析显示清洁度、菌群密集度、pH值异常和白细胞酯酶阳性率异常与HPV感染明显相关(均P结论 绝经后HPV感染患者存在阴道微生态失调,且HPV感染与清洁度、菌群密集度、pH值异常和白细胞酯酶阳性率异常有关。     

Chlamydia trachomatis infection and human papillomavirus in women with cervical neoplasia in Pernambuco-Brazil

Chlamydia trachomatis (CT) is the most common bacterial cause of sexually transmitted disease. High-risk human papillomavirus (HR-HPV) is considered the main etiological agent for cervical neoplasia. Evidences showed that the presence of co-infection of CT and HR-HPV plays a central role in the etiology of cervical intraepithelial neoplasia (CIN) and cervical cancer. The goals of this study were: evaluate the human papillomavirus (HPV) and CT prevalence among Brazilian women with abnormal cytology and provide the effect of this association on the severity of cervical neoplasia. The population of this study was composed by 142 women with incident histological incidence of CIN grades I, II, III or cervical cancer from Recife, Northeast of Brazil. The polymerase chain reaction method on a cervical brush specimen was used to detect both agents and the automatic sequencing method was used for HPV genotyping assay. The prevalence of HPV and CT was 100 and 24.65 %, respectively. Thirteen types of HPV were detected; HPV 16, 18, 31 and 33 were the most common. The most prevalent HPV types were HPV 16 and 18. A significant association between CT positive and HPV 16 infection was found (p < 0.0106; OR = 5.31; 95 % IC 1.59–17.67). In the study population, there was diversity of HPV infections, with high-risk types being the most common. Also, the data collected suggest that CT infection may play an important role in the natural history of HPV infection.     

Association between ABO blood group and osteoporosis among postmenopausal women of North India

The present study is an attempt to examine possible associations between ABO blood groups and the risk of osteoporosis among postmenopausal women of North India. This cross-sectional study involved 250 postmenopausal women from North India, ranging in age from 45 to 80 years. Four anthropometric measurements (height, weight, waist circumference and hip circumference), blood sample (ABO status and haemoglobin concentration) and grip strength (dominant as well as non-dominant hand) of all the participants were taken. Bone mineral density (BMD) was evaluated by using dual energy X-ray absorptiometry (DXA) at lumbar spine (L1–L4) and proximal femur. Analysis of data revealed that at lumbar spine (L1–L4) osteoporosis was more prevalent among individuals with blood group A (31.58%), followed by those with blood group B (29.67%), AB (28.57%) and then blood group O (15%), whereas for proximal femur individuals with blood group AB (21.43%) showed the highest prevalence of osteoporosis followed by a decreasing trend from blood group A (17.54%) to B (12.08%) and then O (5%). Total prevalence of osteoporosis was 26.4% in lumbar spine and 13.2% in proximal femur, indicating that lumbar spine had an elevated risk for osteoporosis among postmenopausal women. All the anthropometric variables, haemoglobin concentration as well as grip strength of individuals with blood group O demonstrated non-significant differences with non-O blood group except for weight and body mass index, where differences were statistically significant. Women with blood group O exhibited significantly higher bone mineral density for lumbar spine (0.90 g/cm² vs. 0.85 g/cm², p < 0.05) and proximal femur (0.87 g/cm² vs. 0.79 g/cm², p < 0.05) as compared to those with non-O blood group, thereby suggesting an increasing risk of osteoporosis among individuals with non-O blood group.     

阴道微生态与高危型人乳头瘤病毒感染及宫颈病变的相关性

目的 探究阴道微生态与高危型人乳头瘤病毒(HR HPV)感染以及宫颈病变之间的相关性,为后续研究提供参考。 方法 选择2018年1月至2019年6月就诊于石河子大学医学院第一附属医院妇科门诊,同时行爱必维(细菌性阴道病五项联合测定试剂盒)检测、HR HPV检测及宫颈组织病理检查的343名妇女作为研究对象,分析相关检测数据并探究阴道微生态与HR HPV感染以及宫颈病变的相关性。 结果 过氧化氢阳性、唾液酸苷酶阳性、白细胞酯酶阳性、乳杆菌数量减少及阴道清洁度3~4度的妇女感染HR HPV及发生宫颈病变的可能性显著大于过氧化氢阴性、唾液酸苷酶阴性、白细胞酯酶阴性、乳杆菌数量较多及阴道清洁度1~2度的妇女,差异均有统计学意义(均P结论 阴道微生态失衡与HR HPV感染以及宫颈病变有一定关联,纠正阴道微生态失衡可一定程度上预防HR HPV感染及宫颈病变。     

Prevalence and correlation of human papillomavirus genotypes with clinical factors in cervical samples from Mexican women

In the last decade, the inclusion of HPV DNA testing in cervical cancer screening has provided one of the best strategies for the prevention and timely detection of HPV. We conducted a high-throughput HPV genotyping study based on MALDI-TOF mass spectrometry to determine the prevalence of 24 HPV genotypes, including oncogenic genotypes, in Mexican women and correlated the results with cytological findings and clinical variables. We likewise identified the risk factors in patients with the HPV infection. Our study included 1000 women from Sonora, Mexico, who participated in cervical cancer screening campaigns and who underwent a Pap smear and HPV DNA test. The results showed that the overall prevalence of HPV was 27.2%, 18.5% with single, and 8.7% multiple infections. The low-risk HPV genotype 6 (8.5%) and oncogenic genotypes 31 (8.1%) and 53 (4.4%) were the most prevalent in the study population. The number of lifetime sexual partners, previous STIs, and age at first intercourse was significantly associated with HPV infection (P ≤ 0.05). Smoking (OR = 1.5609; 95% IC 1.062–2.292) and more than three lifetime sexual partners (OR = 1.609; 95% IC = 1.124–2.303) represented risk factors for HPV infection. Cytological abnormalities were found in 3.4% of the HPV-positive samples. CIN 1–3 occurred in 0.6% of high-risk HPV cases. In general, the prevalence of the HPV genotypes is high in Mexican women with normal cytological findings. This issue highlights the importance of HPV research in seemingly healthy women and could help guide screening strategies for cervical cancer prevention in Mexico.Impact statementWe are submitting data regarding the prevalence and type distribution of the HPV infection and the risk factors associated with it, which may provide a valuable reference to reinforce screening strategies, and to maintain HPV genotype surveillance in Mexico. We discuss the overall prevalence of HPV infection as detected in normal cytological samples stratified by age, different types of infection, and oncogenic capacity. One of the most important findings was that common HPV genotypes detected in healthy women were the genotype numbers: 6, 31, 16, and 56, likewise, smoking and having a history of more than three sexual partners over their lifetime, represented the main risk factors in this study. Furthermore, we found a low frequency of cytological abnormalities and CIN 1–3 in women with HR-HPV.     

Prevalence of high-risk human papillomavirus cervical infection in female kidney graft recipients: an observational study

ABSTRACT: BACKGROUND: Immunosuppressive therapy protects the transplanted organ but predisposes the recipient to chronic infections and malignancies. Transplant patients are at risk of cervical intraepithelial neoplasia (CIN) and cervical cancer resulting from an impaired immune response in the case of primary infection or of reactivation of a latent infection with human papillomavirus of high oncogenic potential (HR-HPV). METHODS: The aim of this study was to assess the prevalence of HR-HPV cervical infections and CIN in 60 female kidney graft recipients of reproductive age in comparison to that in healthy controls. Cervical swabs were analyzed for the presence of HR-HPV DNA. HR-HPV-positive women remained under strict observation and were re-examined after 24 months for the presence of transforming HR-HPV infection by testing for HR-HPV E6/E7 mRNA. All the HR-HPV-positive patients were scheduled for further diagnostic tests including exfoliative cytology, colposcopy and cervical biopsy. RESULTS: The prevalence of HR-HPV did not differ significantly between the study group and the healthy controls (18% vs 25%, p=0.37). There was no correlation between HR-HPV presence and the immunosuppresive regimen, underlying disease, graft function or time interval from transplantation. A higher prevalence of HR-HPV was observed in females who had had [greater than or equal to]2 sexual partners in the past. Among HR-HPV-positive patients, two cases of CIN2+ were diagnosed in each group. In the course of follow-up, transforming HR-HPV infections were detected in two kidney recipients and in one healthy female. Histologic examination confirmed another two cases of CIN2+ developing in the cervical canal. CONCLUSIONS: Female kidney graft recipients of reproductive age are as exposed to HR-HPV infection as are healthy individuals. Tests detecting the presence of HR-HPV E6/E7 mRNA offer a novel diagnostic opportunity in those patients, especially in those cases where lesions have developed in the cervical canal.     

Prevalence of human papillomavirus and herpes simplex virus type 2 infection in Korean commercial sex workers

In order to investigate the prevalence of sexually transmitted viruses such as human papillomavirus (HPV) and herpes simplex virus (HSV) in Korean commercial sex workers (CSWs), we selected 188 CSWs (age range 20-44 years, median age 24 years) who regularly visited one public health center in Seoul, Korea. HPV genotypes were analyzed by using a HPV DNA chip, and an enzyme-linked immunosorbent assay (ELISA) was used to detect type-specific IgG against HSV2 antibody identifying seropositivity for HSV2 infection. Polymerase chain reaction (PCR) was performed with specific primers to detect HPV and HSV1/2 in cervical swabs from the CSWs. The prevalence of HPV infection was 83.5% in 188 cervical swab specimens and the main high-risk HPV genotypes were HPV16, 18, 56, and 58. The principal low-risk HPV genotypes were HPV6 and 11. The prevalence of HSV1/2 DNA was 13.8% and HSV2 seroprevalence was 86.2%. These results suggest that high frequencies of HPV and HSV2 infection might contribute to the rapid spread of STD viruses in CSWs in Korea. Additionally, an understanding of why high-risk HPV genotypes are so prevalent could provide guidelines for prophylactic vaccine development in Korea.     

Prevalence of BK virus and human papillomavirus in human prostate cancer

Polyomaviruses such as the BK virus (BKV), JC virus (JCV) and SV40, as well as the human papillomaviruses (HPV) are frequently detected throughout human populations, causing subclinical persistent infections and inducing oncogenesis in human and other cell lines. To test the involvement of these viruses in prostate tumorigenesis, we investigated the prevalence of BKV, JCV and HPV in a series of human prostatic malignancies. Forty-two samples of diagnosed prostatic malignancies were tested using standard polymerase chain reaction (PCR) protocols. Differentiation between BKV and JCV among the polyomavirus-positive samples was achieved after sequencing analysis of the PCR products. Reconstitution of BKV in vitro was performed and indirect immunofluorescence for the large T-antigen of the virus was applied to confirm the production of progeny virus. Detection and typing of HPV was carried out by PCR. The overall prevalence of polyomaviruses was 19% in the prostate cancer cases. Sequencing analysis of the polyomavirus-positive specimens revealed the presence of BKV in all samples. Reconstitution of the BKV from the BKV-positive prostate samples was successfully achieved in cell culture and progeny viral particles were obtained, confirming the presence of the virus in the human biopsies. HPV was detected in 4.8% of the samples, however, no HPV-11, HPV-16, HPV-18 or HPV-33 types were identified. BKV was frequently detected and could play a relevant role in the development and progression of human prostate cancer, whereas HPV does not seem to be implicated in this type of human neoplasia.     

杭州市萧山区女性HPV感染及分子流行病学研究

目的调查和研究23种HPV基因亚型在杭州市萧山区女性中感染状况以及分子流行病学特点,为预防HPV感染和宫颈癌防治提供依据。方法利用DNA杂交技术检测妇科门诊样本,并进行基因分型,比较不同基因型流行病学特点。结果在15 414例样本中HPV感染者3 230例,感染率为20.95%,其中高危亚型检出2 203例,占感染者的68.20%,低危亚型569例,占17.62%,同时感染高危亚型和低危亚型的458例,占14.18%。单一感染2 295例,占感染者的71.05%,两重感染642例,占19.88%,≥3重的多重感染293例,占9.07%。23个亚型中16型最多,其次为52和58型。≤25年龄段感染比例最高,与其他年龄段感染率比较差异有统计学意义（P〈0.01）。结论高危亚型、单一感染为本地区常见类型,HPV16、52和58为主要感染亚型;HPV感染具有年龄分布特点。     

Risk factors associated with human papillomavirus prevalence and cervical neoplasia among Cameroonian women

BackgroundThis study used community-based cervical cancer screening for high-risk human-papillomavirus (HPV) to determine demographic and lifestyle factors associated with HPV prevalence and cervical intraepithelial neoplasia grade 2 or worse (CIN2+).MethodsWomen (n = 838) aged 25–65 years were recruited in two sequential studies in Cameroon. Demographic and historical data were obtained from participants and specimens were self-collected for HPV-testing using real-time PCR. HPV-positive women underwent biopsy and endocervical curettage. Associations were determined using bivariate analysis and logistic regression.ResultsHPV and self-reported HIV prevalence were 39.0% and 9.2%, respectively. Eighteen (9.3%) CIN2+ lesions were found among HPV-positive women. Housewives had a higher risk of being HPV infected (OR = 1.60, p = 0.010). HIV co-infection (aOR = 3.44, p < 0.001) and hormonal contraception (aOR = 1.97, p = 0.007) were associated with increased HPV prevalence. HPV-positive women who used condoms during sexual intercourse were at lower risk of CIN2+ (aOR = 0.15, p = 0.029). CIN2–3 lesions were found in women younger than 50 years, with a median age of 36 years (31–44). HPV-16/18-positive women had a 4.65-fold increased risk of CIN2+ (p = 0.015).ConclusionsYoung, single women and housewives were at higher risk of HPV infection. Preventive strategies for cervical cancer in low-resource settings should target women aged 30–50 years for HPV screening, and should focus treatment and follow-up on HPV-16/18-positive women. Further studies are needed to clarify if other risk factors require attention.     

Prevalence of Coxiella burnetii infection among humans and domestic animals of Rajasthan State, India

A total number of 1806 sera comprising 1049 humans and 757 animals from four ecologically different areas of Rajasthan State were tested to determine the prevalence of complement-fixing (CF) antibodies to Coxiella burnetii (C burnett). Of the 1049 human and 757 animal sera tested, antibodies to C. burnetii were detected in 195 sera (18.6 per cent) and 187 sera (24.7 per cent), respectively. Among humans, the prevalence of infection with C. burnetii was highest in the desert area of Barmer district and the hilly area of Bundi district, viz 64.5 per cent and 28.2 per cent, respectively. It was slightly lower in the semi-arid and the arid zones of the State, viz Sirohi (20 per cent) and Jalore (13.7 per cent), whereas the irrigated areas of Kota and Jaipur had the lowest prevalence, 9.9 and 8.4 per cent, respectively. Among animals, the highest prevalence was detected in sheep (39.6 per cent), followed by cattle (29.9 per cent) and goats (18.6 per cent).     

Cytomorphological analysis of uterine cervical pap smears in relation to human papillomavirus infection in Indonesian women

Objective: Cervical cancer is the number one cause of cancer-associated death in Indonesian women (30/100,000 annually), where no screening program is present. The Papanicolaou test is widely accepted as an effective screening method for cervical neoplasia detection and often shows certain cytological features associated with human papillomavirus (HPV) infection. Especially in developing countries, cytological investigation is still the method of choice as compared to the frequent use of HPV DNA testing in western countries. Study Design: In the present study, we investigated the validity of the use of cytomorphological changes as a marker for HPV infection. A total of 140 smears collected in three different areas in Indonesia (Jakarta, Tasikmalaya and Bali) were analyzed. HPV DNA testing was performed using INNO-LiPA assays. Results and Conclusions: We found a highly significant association of classical koilocytosis, multinucleated cells, dyskeratosis-parakeratosis, nuclear membrane, enlarged nuclei, moderate/strong hyperchromasia and chromatin pattern with HPV positivity. Using classical and nonclassical cytomorphological parameters we found an overall sensitivity of 42% and a specificity of 90%. The combination of classical and nonclassical parameters led to a higher sensitivity of HPV positivity prediction. These results are of importance for cytologists in developing countries as molecular HPV testing still poses a major financial, logistic and expertise problem.     

Genetic susceptibility to infection with human papillomavirus and development of cervical cancer in women in Brazil

Human papillomavirus (HPV) is considered to be a necessary but not sufficient cause for cervical cancer and, therefore, other factors contribute to the carcinogenic process. A hereditary component for this neoplasia has been reported and several studies indicate that genetic background of the host is important for cervical cancer susceptibility. Among genetic factors that could participate in the susceptibility to this tumor and disease outcome, polymorphic genes of the major histocompatibility complex (MHC), as well as a particular polymorphism in the p53 gene have been intensely investigated. From our analysis of 613 samples in Brazil, we found evidence to indicate that different polymorphic human leukocyte antigen (HLA) genes are involved in the clearance and maintenance of HPV infection. In addition, the homozygous codon 72 p53-Arg gene allele is associated with susceptibility to HPV-associated cervical carcinogenesis. However, supportive and opposing data have been reported in different populations. Therefore, international collaborative studies need to be conducted to define the consistency of the associations described.     

Oncogenic human papillomavirus genital infection in southern Iranian women: population-based study versus clinic-based data

ABSTRACT: BACKGROUND: Epidemiological studies on genital human papilloma viruses infection (HPVs) in general population are crucial for the implementation of health policy guidelines for developing the strategies to prevent the primary and secondary cervical cancer. In different parts of Iran, there is a lack of population-based studies to determine the prevalence of HPV in the general population. The aim of this population-based study is to compare the prevalence rate of genital HPV infection among reproductive women with our previous clinic-based data, which showed a prevalence rate of 5% in women in southern Iran. RESULTS: Using general primers for all genotypes of HPV, of 799 randomly selected women, five (0.63%, 95% CI 0.23-1.55%) tested positive for HPV DNA. Overall, seven different HPV genotypes were detected: six types (16, 18, 31, 33, 51 and 56) were carcinogenic, or "high risk genotypes" and one genotype (HPV-66) was "probably carcinogenic." CONCLUSIONS: In a population-based study, the prevalence of HPV infection among southern Iranian women was lower than that observed worldwide. However, our gynaecological clinic-based study on the prevalence of HPV infection showed results comparable with other studies in the Middle East and Persian Gulf countries. Since gynaecological clinic-based data may generally overestimate HPV prevalence, estimates of prevalence according to clinic-based data should be adjusted downward by the population-based survey estimates.