Age-related distribution of uncommon HPV genotypes in cervical intraepithelial neoplasia grade 3

Giannella, Luca; Rossi, Paolo Giorgi; Carpini, Giovanni Delli; Giuseppe, Jacopo Di; Bogani, Giorgio; Gardella, Barbara; Monti, Ermelinda; Liverani, Carlo Antonio; Ghelardi, Alessandro; Insinga, Salvatore; Raspagliesi, Francesco; Spinillo, Arsenio; Vercellini, Paolo; Roncella, Elena; Ciavattini, Andrea

doi:10.1016/j.ygyno.2021.03.025

Cited by 25 publications

(25 citation statements)

References 37 publications

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“…Age is an important factor because older women are more likely to develop cervical cancer, 21 but younger women are more likely to engage in risky sexual behavior resulting in HPV infection and subsequent premalignant lesions 22 . The prevalence of high‐risk oncogenic HPV also varies by age, 23 with highest rates of HPV 16 and HPV 18 among women less than 25 years old 24,25 . Younger women are more likely to launch a robust immune response and clear their HPV infection, 26 while older age is associated with an increased risk of persistent HPV infection 27 .…”

Section: Discussionmentioning

confidence: 99%

Determinants of cervical cancer screening uptake among women with access to free screening: A community‐based study in peri‐urban Ghana

Tawiah

Konney

Dassah

et al. 2022

Intl J Gynecology & Obste

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Cervical cancer is a leading cause of cancer morbidity and mortality globally. 1 The impact of cervical cancer is especially devastating in low-and middle-income countries. Sub-Saharan Africa contributes more than 85% of the global burden of cervical cancer, with an annual incidence of 34.8 per 100 000 women and mortality of 22.5 per 100 000 women. 2,3 In Ghana, cervical cancer is the second most common cancer among women, with more than 3000 new cases and 2000 deaths annually. 4 Ghanaian women have nearly three times the cumulative risk of dying from cervical cancer compared to the global average. 4

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Section: Discussionmentioning

confidence: 99%

Determinants of cervical cancer screening uptake among women with access to free screening: A community‐based study in peri‐urban Ghana

Tawiah

Konney

Dassah

et al. 2022

Intl J Gynecology & Obste

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“…In this regard, their progression from CIN1 to cancer may take longer to reach an appreciable proportion of pre-invasive/invasive lesions. 37 This slower progression may provide a greater chance of detecting these lesions at a pre-invasive stage in a screening program. On the other hand, these high-grade lesions related to uncommon HPVs may likely have a greater regression chance.…”

Section: Discussionmentioning

confidence: 99%

Trend of HPV 16/18 Genotypes in Cervical Intraepithelial Neoplasia Grade 3: Data for 2007–2018

Giannella

Carpini

Giuseppe

et al. 2021

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Aim In the post-vaccination era, the starting age and time intervals of cervical screening could change (older age and longer screening intervals). This scenario may be achieved by significantly reducing human papillomavirus (HPV) 16/18 prevalence (genotypes included in the current vaccines). In this regard, assessing the trend over time of these HPV infections in high-grade cervical lesions can provide information on the objective. The present study aimed to evaluate the trend of HPV 16/18 over the years 2007–2018 in women with cervical intraepithelial neoplasia (CIN) grade 3. Methods This is a retrospective multi-institutional study including HPV genotyped and unvaccinated women under 30 with CIN3. The sample was divided into the following periods: 2007–2010, 2011–2014, 2015–2018. HPV genotypes were grouped in genotypes 16/18, genotypes 31/33/35/52/58/67 (genetically related to HPV16), genotypes 39/45/59/68/70 (genetically related to HPV18), genotypes 31/33/45/52/58 (high-risk types included in the nonavalent vaccine), possibly carcinogenic HPV (genotypes 26/30/53/67/70/73/82/85), low-risk HPV (genotypes 6/11/40/42/43/44/54/55/61). The trend between periods and HPV genotypes was measured using the Cochran–Armitage test for trend. Results The final analysis included 474 participants. HPV 16/18 prevalence decreased significantly over the years (77.8% vs 68.9% vs 66.0%, respectively, Ptrend=0.027). Possibly carcinogenic HPV (genotypes 26/30/53/67/70/73/82/85) showed a significant negative prevalence trend over time (4.9% vs 1.1% vs 1.3%, respectively, Ptrend=0.046). Finally, there was a significant positive trend over the years for high-risk HPV genotypes 31/33/45/52/58 in women under 25 (9.9% vs 17.0% vs 24.0%, respectively, Ptrend=0.048). Conclusion The prevalence of CIN3 lesions related to HPV 16/18 genotypes decreased over time from 2007 to 2018. These data highlight a herd effect of the HPV vaccine. However, fifteen years after HPV vaccine introduction, we are still a long way from herd immunity. The increase in high-risk types 31/33/45/52/58 will need to be reassessed when the nonavalent vaccine impact will be more reliable.

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“…This already starts at sexual maturity, which might be an explanation for the significantly higher percentage of spontaneous regression in cHSIL in women under 30 [ 17 , 108 ]. Moreover a retrospective cohort study reports that in younger patients the prevalence of hrHPV genotypes is higher compared to women >50 years before treatment whereas HPV persistence and recurrence after treatment is higher with increasing age [ 109 ]. Immunosenescence may be an important determinant of hrHPV and cHSIL persistence [ 105 ], however studies comparing the systemic and local immunity in cHSIL lesions at different ages are lacking.…”

Section: Importance Of Clinical Parameters and Hpv Genotype In The Na...mentioning

confidence: 99%

Importance of the Immune Microenvironment in the Spontaneous Regression of Cervical Squamous Intraepithelial Lesions (cSIL) and Implications for Immunotherapy

Muntinga

Steenwijk

Bekkers

et al. 2022

JCM

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Cervical high-grade squamous intraepithelial lesions (cHSILs) develop as a result of a persistent high-risk human papilloma virus (hrHPV) infection. The natural course of cHSIL is hard to predict, depending on a multitude of viral, clinical, and immunological factors. Local immunity is pivotal in the pathogenesis, spontaneous regression, and progression of cervical dysplasia; however, the underlying mechanisms are unknown. The aim of this review is to outline the changes in the immune microenvironment in spontaneous regression, persistence, and responses to (immuno)therapy. In lesion persistence and progression, the immune microenvironment of cHSIL is characterized by a lack of intraepithelial CD3+, CD4+, and CD8+ T cell infiltrates and Langerhans cells compared to the normal epithelium and by an increased number of CD25+FoxP3+ regulatory T cells (Tregs) and CD163+ M2 macrophages. Spontaneous regression is characterized by low numbers of Tregs, more intraepithelial CD8+ T cells, and a high CD4+/CD25+ T cell ratio. A ‘hot’ immune microenvironment appears to be essential for spontaneous regression of cHSIL. Moreover, immunotherapy, such as imiquimod and therapeutic HPV vaccination, may enhance a preexisting pro-inflammatory immune environment contributing to lesion regression. The preexisting immune composition may reflect the potential for lesion regression, leading to a possible immune biomarker for immunotherapy in cHSILs.

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Age-related distribution of uncommon HPV genotypes in cervical intraepithelial neoplasia grade 3

Cited by 25 publications

References 37 publications

Determinants of cervical cancer screening uptake among women with access to free screening: A community‐based study in peri‐urban Ghana

Determinants of cervical cancer screening uptake among women with access to free screening: A community‐based study in peri‐urban Ghana

Trend of HPV 16/18 Genotypes in Cervical Intraepithelial Neoplasia Grade 3: Data for 2007–2018

Importance of the Immune Microenvironment in the Spontaneous Regression of Cervical Squamous Intraepithelial Lesions (cSIL) and Implications for Immunotherapy

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