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To clarify the distribution and relative risk of different human papillomavirus (HPV) genotypes in cervical preinvasive lesions, 1246 women with abnormal Papanicolaou smear including atypical squamous cell of unknown significance (ASCUS), atypical glandular cell of unknown significance (AGUS), low-grade squamous intraepithelial lesion (LSIL), and high-grade squamous intraepithelial lesion (HSIL) were enrolled in a multicenter, cross-sectional study. Colposcopy and HPV tests with hybrid capture 2 and polymerase chain reaction-reverse line blot were performed. The prevalences of HPV in ASCUS/AGUS-negative histology, ASCUS/AGUS, LSIL, HSIL, and invasive cancer were 33.8%, 38.3%, 74.9%, 84.3% and 100%, respectively, with an overall positive rate of 68.8%. The most common HPV types were HPV 16 (18.5%), 52 (16.5%), 58 (13.2%), 33, 51, 53, 18, 39, 59, 66, MM8, and 31. In comparing the relative risk of HPV infection in different disease status, LSIL and HSIL/carcinoma had a 4.64 (95% CI: 2.98-7.24) and 10.53 (95% CI: 6.69-16.58) folds of risk of high-risk HPV infection than the negative group. The same was true in mixed HPV infection, but not in low-risk type infection. Looking into each high-risk HPV type, the relative infection risks for LSIL and HSIL/carcinoma, in comparison with the negative group, were 1.67 (0.63-4.43) and 8.67 (3.46-21.70), 2017 (1.01-4.68) and 3.04 (1.42-6.47), and 1.40 (0.52-3.77) and 5.22 (2.07-13.19) for HPV type 16, 52 and 58, respectively. The study confirmed the high prevalence and risky nature of HPV 52 and 58 in Taiwanese population and conveyed the need to include these HPV types in vaccine development.

OBJECTIVES:To examine whether older people with abnormal thyroid function are more likely to develop chronic kidney disease (CKD) over a 5-year follow-up period. DESIGN: Retrospective cohort study. SETTING: Health examination data from the Taipei Databank for Public Health Analysis. PARTICIPANTS: Individuals aged 65 and older (N = 41,454). MEASUREMENTS: Thyroid-stimulating hormone (TSH) levels were repeatedly measured, and subjects were categorized into four thyroid function groups (hyperthyroid, euthyroid, subclinical hypothyroid, overt hypothyroid). The risk of incident CKD was evaluated using a stepwise Cox proportional hazards regression model adjusted for sex, baseline age, hypertension, diabetes mellitus (DM), dyslipidemia, hyperuricemia, anemia, obesity, liver function, smoking, and alcohol. RESULTS: Higher TSH levels were associated with greater risk of subsequent CKD. Individuals with subclinical hypothyroidism (hazard ratio (HR) = 1.15, 95% confidence interval (CI) = 1.05-1.26) and those with overt hypothyroidism (HR = 1.27, 95% CI = 1.04-1.55) were more likely than those who were euthyroid to have CKD. Women were more likely to have CKD than men (HR = 1.11, 95% CI = 1.06-1.16). When stratified by gender, subclinical hypothyroidism in women was associated with an increased risk of developing CKD (HR = 1.22; 95% CI = 1.08-1.39). When stratified by DM, subclinical hypothyroidism and overt hypothyroidism were associated with an increased risk of developing CKD in nondiabetics (HR = 1.19; 95% CI = 1.07-1.31; and HR = 1.34; 95% CI = 1.08-1.65, respectively). CONCLUSION: This cohort study of elderly persons in Taipei City found a significant association between hypothyroidism and development of CKD in women and individuals without DM.

To better predict risk of progression of low-grade squamous intraepithelial lesions (LSILs) of the uterine cervix in women with human papillomavirus (HPV) infections, 294 baseline cervical specimens from women with LSILs were evaluated. Specimens were tested for HPV DNA using hybrid capture 2 (HC2) and PCR-reverse line blotting. 65 LSILs with HPV DNA types 16, 18, 52, or 58 were examined for physical status, E2/E6 ratio and viral load at two time points, along with patient age. Women with LSILs whose viral loads increased between baseline and 6 month follow-up had a 45% risk of developing HSIL (OR ¼ 7.6, 95% CI ¼ 1.9 -29.4, Po0.01), as evaluated by real-time PCR and a 44% risk (OR ¼ 6.1, 95% CI ¼ 1. Human papillomavirus (HPV) plays an important role in the carcinogenesis of cervical cancer (Bosch et al, 1995;Walboomers et al, 1999). The most common oncogenic HPV type in preinvasive and cervical cancer is HPV 16, detectable in 21% of women with low-grade squamous intraepithelial lesions (LSILs) (Castle et al, 2005), in more than 50% of women with cervical intraepithelial neoplasia grade 3 (CIN 3), and women with cervical cancer in America and Europe (Bosch et al, 1995;Herrero et al, 2000; Munoz et al, 2003). HPV 18 causes 10 -15% of CIN 3 and cervical cancers (Bosch et al, 1995). In addition, HPV 18 also causes more than 35% of cervical adenocarcinomas, which are difficult to detect by current screening methods (Bosch et al, 1995). Additionally, HPV 52 and 58 are as prevalent as HPV 16 and 18 in patients with preinvasive and cervical cancer in Taiwan and Asian countries (Liaw et al, 1995;Huang et al, 1997;Ho et al, 2005Ho et al, , 2006. Approximately 50% of atypical squamous cells of undetermined significance (ASCUS) and 80% of LSILs are infected by oncogenic types of HPV (ALTS group, 2000;Solomon et al, 2001). HPV DNA testing for patients with ASCUS provides useful information and allows referral of patients for immediate colposcopy to detect highgrade squamous intraepithelial lesions (HSILs) and cancer (Solomon et al, 2001). In contrast, oncogenic HPV DNA testing is not informative for triage of patients with LSILs because a high percentage of LSIL patients are HPV positive (ALTS group, 2000). A repeat Pap smear in 3 -6 months or direct biopsy under colposcopy is generally used in clinical practice. Development of alternative triage strategies for women with LSILs would be valuable in distinguishing women with LSILs that have high probabilities of progression to HSILs from women with LSILs that have spontaneously regressed.As a result of the lack of sufficiently large prospective longitudinal follow-up studies and the different geographic distributions of HPV types, it has not been established how the risk of HSILs differs during transition by physical status of HPV 16, 18, 52, and 58 DNA (integrated versus episomal DNA) during longitudinal follow-up, viral loads (high vs low) and viral load change (increased vs not increased) between baseline and followup among women with LSILs. To examine this issue, we evalu...

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