Prevalence of beta-HPV varied by anatomic site of infection. Biological properties of beta-HPV types detected at mucosal sites and their role in disease pathogenesis should be examined.

Background Chlamydia trachomatis infection is highly prevalent among young women in the United States. Prevention of long-term sequelae of infection, including tubal factor infertility, is a primary goal of chlamydia screening and treatment activities. However, the population attributable fraction of tubal factor infertility associated with chlamydia is unclear, and optimal measures for assessing tubal factor infertility and prior chlamydia in epidemiologic studies have not been established. Black women have increased rates of chlamydia and tubal factor infertility compared to white women, but have been underrepresented in prior studies of the association of chlamydia and tubal factor infertility. Objectives To estimate the population attributable fraction of tubal factor infertility associated with Chlamydia trachomatis infection by race (black, non-black), and assess how different definitions of C. trachomatis seropositivity and tubal factor infertility affect population attributable fraction estimates. Study Design We conducted a case-control study, enrolling infertile women attending infertility practices in Birmingham, AL and Pittsburgh, PA during October 2012–June 2015. Tubal factor infertility case status was primarily defined by unilateral or bilateral fallopian tube occlusion (cases) or bilateral fallopian tube patency (controls) on hysterosalpingogram. Alternate tubal factor infertility definitions incorporated history suggestive of tubal damage or were based on laparoscopic evidence of tubal damage. We aimed to enroll all eligible women, with an expected ratio of one and three controls per case for black and non-black women, respectively. We assessed C. trachomatis seropositivity with a commercial assay and a more sensitive research assay; our primary measure of seropositivity was defined as positivity on either assay. We estimated C. trachomatis seropositivity and calculated C. trachomatis-TFI odds ratios and population attributable fraction, stratified by race. Results We enrolled 107 black women (47 cases, 60 controls) and 620 non-black women (140 cases, 480 controls). C. trachomatis seropositivity by either assay was 81% (95% confidence interval 73%, 89%) among black and 31% (95% confidence interval 28%, 35%) among non-black participants (P<0.001). Using the primary C. trachomatis seropositivity and tubal factor infertility definitions, no significant association was detected between chlamydia and tubal factor infertility among blacks (odds ratio 1.22, 95% confidence interval 0.45, 3.28) or non-blacks (odds ratio 1.41, 95% confidence interval 0.95, 2.09), and the estimated population attributable fraction was 15% (95% confidence interval −97%, 68%) among blacks and 11% (95% confidence interval −3%, 23%) among non-blacks. Use of alternate serologic measures and tubal factor infertility definitions impacted the magnitude of the chlamydia-tubal factor infertility association, and resulted in a significant association among non-blacks. Conclusions Low population attributable fraction estimate...

HPV-6 B1 variants are more prevalent in genital swabs that precede GW development, and confer an increased risk for GW. Further research is warranted to understand the possible involvement of B1 variants in the progression to clinically relevant lesions.

HPV-11 and HPV-6 are the etiological agents of about 90 % of genital warts (GWs). The intra-typic variability of HPV-11 and its association with infection persistence and GW development remains undetermined. Here, HPV infection in men (HIM) participants who had an HPV-11 genital swab and/or GW, preceded or not by a normal skin genital swab were analysed. Genomic variants were characterized by PCR-sequencing and classified within lineages (A, B) and sublineages (A1, A2, A3, A4). HPV-11 A2 variants were the most frequently detected in the genital swab samples from controls and in both genital swabs and GW samples from cases. The same HPV-11 variant was detected in the GW sample and its preceding genital swab. There was a lack of association between any particular HPV-11 variant and the increased risk for GW development.

Background: Studies in women have shown an increased risk of human immunodeficiency virus (HIV) acquisition with prior human papilloma virus (HPV) infection; however, few studies have been conducted among men. Our objective was to assess whether HPV-related external genital lesions (EGLs) increase risk of HIV seroconversion among men.Methods: A total of 1379 HIV-negative men aged 18 to 70 years from the United States, Mexico, and Brazil were followed for up to 7 years and underwent clinical examination for EGLs and blood draws every 6 months. Human immunodeficiency virus seroconversion was assessed in archived serum. Cox proportional hazards and marginal structural models assessed the association between EGL status and time to HIV seroconversion.Results: Twenty-nine participants HIV seroconverted during follow-up.Older age was associated with a lower hazard of HIV seroconversion. We found no significant difference in the risk of HIV seroconversion between men with and without EGLs (adjusted hazard ratio, 0.94; 95% confidence interval, 0.32-2.74). Stratified analyses focusing on men that have sex with men found no association between EGLs and HIV seroconversion risk (hazards ratio, 0.63; 95% confidence interval, 0.00-1.86).Conclusions: External genital lesions were not associated with higher risk for HIV seroconversion in this multinational population, although statistical power was limited as there were few HIV seroconversions. Results may differ in populations at higher risk for HIV.

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Results Sixty-six (49%) women seroconverted; of 54 tested on day zero, 46 (85%) were positive and 8 (15%) were negative and then positive when next tested (median 90 days). Of 12 seroconverters not tested on day zero, 11 (92%) were seropositive when next tested (median, 157 days). Nineteen (28%) of 69 non-seroconverters had no IgG testing beyond day zero and could not be assessed for delayed seroconversion. Of 52 seroconverters with subsequent testing, 27 (52%) remained persistently IgG-positive through the last test (median 248 days after seroconversion). Persistent IgG-positivity occurred in 61% (22/36) of those who were ever cHSP60-positive and 37% (6/16) of those who were not (NS), and in 56% (19/34) of those with only one Ct-PCR-positive visit and 50% (9/18) of those with more than one Ct-PCR-positive visit (NS). Conclusions Anti-MOMP IgG antibodies developed in half of women with incident Ct infection and persisted in half of them. Although persistence was more common in those who were cHSP60-positive (suggesting complicated infection), the difference was not statistically significant. Background Chlamydia trachomatis infection increases above gonorrhoea and syphilis, ranking first among the STDs. Molecular epidemiological researches have shown the predominant genotypes vary between regions, periods and population subgroups. However, serovars E, D and F are the most prevalent serovars. It is unclear whether the epidemiological characteristics were contributed to geography or pathogenicity. We explored the pathogenic diversity of different C. trachomatis serovars in mouse genital infection. Methods One hundred of female BALB/C mice were divided into serovar E, F, H, J and K groups. The mice in study group treated by medroxyprogesterone acetate were inoculated 10 7 C. trachomatis into genital tract. C. trachomatis was detected by culture, direct immunofluorescence assay (DFA) and PCR in the cervicovaginal secretion. On the days 7 and 35 after inoculation, inflammation of the cervix, uterus and oviduct were examined by HE stain, and expressions of cHSP60 and CPAF in the uterus and fallopian tube were detected by ELISA. Results The inflammatory of the cervical mucosa was more severe in serovar E group compared with J, K and H groups on day 7 postinoculation. Accordingly, cHSP60 and CPAF expression increased significantly in E group compared with other experimental and control groups. On day 35 post-inoculation, the histo-pathological changes of the genital tract were obvious in J, K and H groups, characterised with uterine swelling, pyometra and effusion, fallopian expansion, hydrops, fibrosis and stenosis. cHSP60 and CPAF expression in H group was superior to that in other groups. Positive correlation between cHSP60 and CPAF expression was present on day 7 and 35 post-inoculation, respectively. Conclusion There existed pathogenic diversity among different C. trachomatis servoars in mouse genital infection. The expression of inflammatory cytokines of cHSP60 and CPAF during Chlamydial infection might partially ...

20 Background: Moffitt Cancer Center (MCC) has developed evidence-based cancer care pathways which are integrated into the Electronic Health Record (EHR). We retrospectively compared the 1 year (yr) total cost of care in patients (pts) with newly diagnosed prostate cancer (PCA) treated at MCC based on EHR tool utilization and pathway alignment. Methods: Using existing Cancer Registry data, we retrospectively identified all pts presenting with newly diagnosed PCA between 7/1/2015-6/30/2017 who received all 1st course treatment (tx) at MCC. Pts direct costs were tracked for 1 yr from the Cancer Registry “date of 1st contact.” Tx was categorized as either radiation (RT) +/- hormone tx (HT), surgery (S) +/- HT, active surveillance only (ASO), HT only, palliative care, chemotherapy (CT), or mixed (a combination of S, RT, or CT). Pathway alignment was either electronically tracked through the EHR pathway tool or determined through manual chart review for pts tx’ed off the pathway tool. Results: 477 pts met inclusion criteria, including men with: low or favorable intermediate (n=259); unfavorable intermediate, high, or very high (n=186); and metastatic (n=32) risk group PCA. The majority (n=396, 83%) had tx in alignment with a pathway. The major tx modalities on pathway were S-HT (n=139), RT-HT (n=113), or ASO (n=110) and off pathway were RT-HT (n=52, 64%), S-HT (n=10), or ASO (n=9). Overall, treatment in alignment with a pathway was significantly associated with lower 1 yr total cost compared to off pathway tx (p <0.001) with a mean difference of $5,500 per pt yr. Conclusions: Clinical pathway alignment was significantly associated with less aggressive therapy and lower 1 yr cost of care for PCA pts treated at MCC. Cost of care was highly associated with tx modality selected. Further analyses are needed to understand the association between pathway alignment, patient risk factors and tx modality selection.