Persistent infection with high-risk human papilloma viruses: cohort study, Mérida, Venezuela

Abstract

Cervical lesions have been associated with infection by high-risk human papilloma virus (high-risk HPV). In 409 women aged >15 years high-risk HPV lesions were identified. In a cohort of this population persistent infection was compared with cytological, colposcopic, and histological lesions. Cervical scrapes were taken and DNA was isolated. HPV was detected by PCR in the E6/E7 region. Genotyping was performed by PCR nested multiple E6/E7. HPV was detected in a 37.40% (153/409), high-risk HPV in 86% (153/178), HPV18 46.64% (83/178), HPV16 34.28% (61/178). Among these 53.93% (96/178) were multiple infections, and HPV18/16 (30/96) was the most frequent 31.25%. The cytology showed changes in 15% of positive patients. A 49.67% in women positive for HPV infection showed abnormalities in the colposcopic study, a relationship that turned out to be statistically significant ( p < 0.0019 test χ2). Among all 85% of the women were younger than 45 years of age. Fifty-seven patients were evaluated 15 months after the base study, with initial prevalence of morbidity 49.12% (28/57) and at the end 10.53% (6/57), showing in 89.29% (25/28) negative for HR-HPV infection, 10.34% (3/28) showed persistence of infection, 17.54% (10/57) presented cytological alterations, with 80% of positivity for HPV, and a regression of 100% (10/10) of the previously identified lesions. With colposcopy, 50% (14/28) presented alterations related to HPV, of these 85.71% (12/14) showed regression of such an alteration. The cumulative incidence for HPV was 10.34% (3/29). The incidence rate was 4.23% (3/71), which is equal to 4.23 new cases of HPV infection per 100 people, per year of follow-up. In conclusion, the present work shows a high frequency of infection by high-risk HPV, with predominance of HPV18 and 16 and in general for multiple infections. Colposcopy was better predictor than the Pap smear for infection. The follow-up study revealed a low percentage of persistent infection, and a high frequency of negativity for viral infection, high regression of cytological and colposcopic lesions, a low cumulative and incidence rate similar to that reported by other Latin American countries and higher than the European countries.

Diagnostic screening of HPV genotypes in 555 Ecuadorian mestizo women of seven provinces, and comparison with other Latino American populations

“…This heterogeneous virus's family includes more than 200 genotypes; among which, more than 40 types of HPV can be easily spread through the genital tract. Fourteen HPV genotypes (16,18,31,33,35,39,45,51,52,56,58,59, 66 and 68) are considered pathogenic or high risk to cause cervical cancer [1]. Although most sexually active women become infected with HPV at least once in their lifetime, less than 10% of women are persistently infected, and it is the persistent infection with a high-risk HPV genotype that contributes to the development of cervical cancer.…”

“…HPV can also be grouped into high risk and low risk categories based on their oncogenic potential. Among the 14 high-risk HPV genotypes (16,18,31,33,35,39,45,51,52,56,58,59, 66, and 68), the two most common (16 and 18) are the factors that cause 71% of cervical cancers, in developed countries. Two genotypes of low risk HPV (6 and 11) contribute to the formation of genital warts, most of which require treatment [6,7].…”

“…The objective of this study is to show the prevalence of HPV genotypes in Ecuadorian mestizo women [13], in comparison with other studies at Latin America [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] (see table 3).…”

High Rate of Infection by Only Oncogenic Human Papillomavirus in Amerindians

“…HPV prevalence among Venezuelan women with normal cytologies has been reported to be 22 to 37% ( N = 238 and N = 409, respectively) ( 13 ), with seven HPV types detected, including 23% HPV18 and 15% HPV16, followed by HPV31, HPV52, HPV45, HPV58, and HPV56 (<0.5%) ( 14 ). Among Venezuelan CC patients, the most common types are 68% HPV16 and 12% HPV18 followed by HPV33, -45, -31, -35, -58, -52, -26, -53, and -66 (<6.3%) ( 13 ).…”

Asociación del virus del papiloma humano con enfermedades oculares del segmento anterior y los párpados

“…Mediante ensayos de hibridación y restricción, se demostró que los virus que aislaron de las diferentes muestras clínicas no eran todos idénticos, así que se procedió a clasificarlos por tipos (1, 2, 3, 4 y así de forma sucesiva), según se descubrían nuevos subtipos del virus. De esta manera, se han reconocido más de 100 genotipos de VPH que causan un diverso rango de lesiones epiteliales, los cuales se han agrupado en 16 géneros; el VPH se agrupa en 5 de estos géneros (3,4).…”