Controversy still exists over whether the benefits of the available HPV vaccines
outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison
to other vaccines. Concerns about HPV vaccine safety have led some physicians,
healthcare officials and parents to withhold the recommended vaccination from the
target population. The most common reason for not administering the prophylactic HPV
vaccines are concerns over adverse effects. The aim of this review is the assessment
of peer-reviewed scientific data related to measurable outcomes from the use of HPV
vaccines throughout the world with focused attention on the potential adverse
effects. We found that the majority of studies continue to suggest a positive
risk-benefit from vaccination against HPV, with minimal documented adverse effects,
which is consistent with other vaccines. However, much of the published scientific
data regarding the safety of HPV vaccines appears to originate from within the
financially competitive HPV vaccine market. We advocate a more independent monitoring
system for vaccine immunogenicity and adverse effects to address potential conflicts
of interest with regular systematic literature reviews by qualified individuals to
vigilantly assess and communicate adverse effects associated with HPV vaccination.
Finally, our evaluation suggests that an expanded use of HPV vaccine into more
diverse populations, particularly those living in low-resource settings, would
provide numerous health and social benefits.
In this study, patients co-infected with HIV and M. leprae had the typical histological lesions of leprosy. There was evidence of immune activation in patients who received combination antiretroviral therapy, and these patients had BT leprosy and leprosy-upgrading reactions.
Objective
The aim of the current study was to evaluate secretory leukocyte protease inhibitor (SLPI) expression in anal biopsies from HIV-positive (HIV+) individuals, and compare that to anal intraepithelial neoplasia (AIN) diagnoses and human papillomavirus (HPV) status.
Design
This is a cross-sectional study of a cohort of 54 HIV+ (31 males and 23 females) from an AIDS clinic in Rio de Janeiro, Brazil.
Methods
The study material consisted of anorectal tissue biopsies obtained from HIV+ subjects, which were used to construct tissue microarray paraffin blocks for immunohistochemical analysis of SLPI expression. Biopsies were evaluated by an expert pathologist and classified as low-grade anal intraepithelial neoplasia (AIN1), high-grade anal intraepithelial neoplasia (AIN2/3), or normal squamous epithelium. Additionally, DNA from the biopsies was extracted and analyzed for the presence of low- or high-risk HPV DNA.
Results
Histologically normal squamous epithelium from the anorectal region showed strong positive SLPI staining in 17/20 (85%) samples. In comparison, 9/17 (53%) dysplastic squamous epithelial samples from AIN1 patients showed strong SLPI staining, and only 5/17 (29%) samples from AIN2-3 patients exhibited strong SPLI staining, which both were significantly fewer than those from normal tissue (p=0.005). Furthermore, there was a significantly higher proportion of samples in which oncogenic high-risk HPV genotypes were detected in low SLPI expressing tissues than that in tissues with high SLPI expression (p=0.040).
Conclusion
Taken together these results suggest that low SLPI expression is associated with high-risk HPV infections in the development of AIN.
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