Human papillomavirus is one of the most common sexually transmitted diseases worldwide. The natural history of oral HPV infection is unclear, and its risk factors have not been explored. Immunocompromised individuals, as exemplified by HIV patients, are at high risk for HPV-related diseases. The mean of this study is to determine the prevalence ofHPV in the oral tract of HIV-1-positive male subjects and its association with risk factors. A total of 283 oral wash samples from HIV-1-positive men were tested. The oral fluid samples were used for DNA extraction and conventional PCR amplification; HPV genotyping was performed by hybridization. HPV genotyping revealed that nine samples (3.5%) were positive for HPV DNA; the major high-risk HPV types identified were 51 and 66. Worldwide studies have shown a variable prevalence of oral HPV. The diversity of genotypes and the high prevalence of multiple infections in HIV-infected subjects can be better explained by the effects of HIV-induced immunosuppression. The most important risk factors are unprotected sexual intercourse, but other factors for this infection have been described elsewhere including smoking, age and HIV-positive serostatus. In this study, smoking was the most important risk factor for acquiring oral HPV in HIV-1-infected subjects in Brazil.

IntroductionInfection with Human papillomavirus (HPV) has been reported as one of the most prevalent agent sexually transmitted diseases, but its true prevalence in men is not precisely known, mainly due to the near absence of symptoms. Moreover, few studies evaluating the post-vaccination immune response have been performed to date in men, hence the hypotheses tested in this study can be important to enable a better understanding of both the immunopathogenesis and the response to vaccination in HIV-infected patients, and to help in the elaboration of strategies of vaccination against HPV in the HIV-infected population.ObjectivesTo analyze the specific response to antigens of HPV vaccine in HIV-infected men.MethodsA total of 25 HIV-infected male patients who met the inclusion criteria during the data collection period were vaccinated; however, six (30%) had anti-HPV at baseline, and were not considered further in the analysis. Therefore, 19 HIV-infected individuals were included in the study, along with five healthy, HPV-seronegative controls.ResultsPatients infected with HIV-1 were subdivided into two groups, A and B, according to their T CD4 cells count at the time of vaccination, namely: Group A: CD4>500; Group B: CD4<500. The proportion of seroconversion after immunization with three doses of a bivalent anti-HPV vaccine was 92%.ConclusionHIV-infected patients as well as HIV negative controls responded to anti-HPV vaccination, regardless of their T CD4 cells count and HIV plasma viral load. These results demonstrate that anti-HPV immunization in HIV-infected males is effective and should be encouraged, thus helping to decrease the risk of infection, mortality and morbidity of diseases associated with HPV in men.

Como dizia Manoel de Barros " A importância de uma coisa só pode ser medida pelo encantamento que a coisa nos produz" iii AGRADECIMENTOS Em primeiro lugar a Deus, por inúmeras bênçãos recebidas em todos os dias da minha vida, sem Ele eu não teria conseguido. Ao meu orientador Dr Jorge Casseb, que me concedeu a oportunidade de ser sua aluna, e depositando sua confiança, só tenho a agradecer pelos ensinamentos, paciência, e por me ajudar nessa etapa da minha vida. Aos meus queridos PACIENTES, sem vocês esse trabalho não seria concretizado! Agradeço a confiança que depositaram no meu trabalho, me ajudando inúmeras vezes que precisei chamá-los, à vocês todo meu carinho e respeito. A Dra Luisa Villa e Antonieta, meu muito obrigada por me receberem em seu laboratório, e dispor do tempo para a colaboração do nosso trabalho. A minha Mãe Pedrina, pelo amor, carinho e compreensão, nos momentos bons e árduos desta jornada, por incentivar e apoiar incondicionalmente todos meus projetos de vida. Ao meu pai José, ao meu irmão Aderlan, pelo seu carinho, por sempre esta ao meu lado em todos os momentos, sempre acreditando e me fortalecendo nas minhas decisões, sendo o alicerce do meu crescimento, meus sobrinhos Kauã e Amanda pelos mais belos sorrisos. Aos meus familiares, tias Ely e Adilma que foram meu alicerce aqui em São Paulo, aos meus avôs, tios, primos que sempre me apoiaram e me incentivaram nessa minha jornada acadêmica. Aos meus irmãos de coração Suely, Sandro e Anselmo, que sempre me apoiaram e me ajudaram nessa minha jornada, meu refúgio de finais de semanas, as melhores risadas e companheirismo, amo vocês. Aos meus queridos amigos Annacelly, Vanessa, Julia, Simara, Luan, Tainá, Barbara, obrigada por sempre acreditar e me incentivar. A minha querida amiga Karen, que sempre esteve comigo me apoiando desde o recrutamento dos pacientes, nos experimentos, nas disciplinas realizadas, nos congressos, discussões e trocas de artigos, almoços, conversas, choros e risadas...