Genotypic prevalence of human papillomavirus infection during normal pregnancy: A cross‐sectional study

Kim, Yun Hwan; Park, Joong Shin; Norwitz, Errol R.; Park, Jeong Woo; Kim, Sun Min; Lee, Seung Mi; Park, Chan Wook; Kim, Byoung Jae; Koo, Ja Nam; Oh, Ig Hwan; Song, Yong Sang

doi:10.1111/jog.12155

Cited by 16 publications

(13 citation statements)

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“…The most common and important neoplastic driver of the lower uterine tract, human papillomavirus (HPV), 1 has been detected in the uterine cervix of 15-25% of pregnant women [2][3][4][5][6] and a cervical HPV infection during pregnancy has been associated with a higher incidence of spontaneous abortions, [7][8][9] premature rupture of the membranes, 10 spontaneous preterm labor, 11,12 pre-eclampsia, 13 and placental 'villitis' not otherwise specified. 12 HPV DNA has been detected in the placenta and amniotic fluid.…”

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confidence: 99%

“…12 HPV DNA has been detected in the placenta and amniotic fluid. 7,11,[14][15][16][17] HPV strains 6,11,16,18, and 31 have been shown to replicate in trophoblast cell lines, [18][19][20] where HPV infection decreased trophoblast number and trophoblast-endometrial cell adhesion in vitro. 19,20 We investigated for the presence of HPV in the placenta and carried out a histopathological and molecular cross-sectional study of 339 placentae from complicated and uncomplicated pregnancies.…”

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A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications

et al. 2015

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Viral infections are known to adversely affect pregnancy, but scant attention has been given to human papilloma virus (HPV) infection. We aimed to determine the molecular and histopathological features of placental HPV infection, in association with pregnancy complications including fetal growth restriction, pre-maturity, pre-eclampsia, and diabetes. Three hundred and thirty-nine placentae were selected based on the presence or absence of pregnancy complications. Five independent methods were used to identify HPV in the placenta, namely, immunohistochemistry for L1 viral capsid, in situ hybridization to high-risk HPV DNA, PCR, western blotting, and transmission electron microscopy. Pregnancy complications and uterine cervical smear screening results were correlated with placental HPV histopathology. In this study, which was deliberately biased towards complications, HPV was found in the decidua of 75% of placentae (253/339) and was statistically associated with histological acute chorioamnionitis (P o0.05). In 14% (35/253) of the HPV positive cases, HPV L1 immunoreactivity also occurred in the villous trophoblast where it was associated with a lymphohistiocytic villitis (HPV-LHV), and was exclusively of high-risk HPV type. HPV-LHV significantly associated with fetal growth restriction, preterm delivery, and pre-eclampsia (all P o0.05). All cases of pre-eclampsia (20/20) in our cohort had high-risk placental HPV. A further 55 cases (22%, 55/253) of HPV positive placentae had minimal villous trophoblast HPV L1 immunoreactivity, but a sclerosing pauci-immune villitis, statistically associated with diabetes (49.1%, 27/55, Po 0.05). For women with placental HPV, 33% (69/207) had an HPV-related positive smear result before pregnancy compared with (9.4% 8/85) of women with HPV-negative placentae (P = 0.0001). Our findings support further investigations to determine if vaccination of women and men will improve pregnancy outcomes. Modern Pathology (2015Pathology ( ) 28, 1369Pathology ( -1382 doi:10.1038/modpathol.2015 published online 21 August 2015 In the immune and hormonal modulated milieu of pregnancy, viruses are well known to infect the placenta, developing fetus, and neonate. The most common and important neoplastic driver of the lower uterine tract, human papillomavirus (HPV), 1 has been detected in the uterine cervix of 15-25% of pregnant women 2-6 and a cervical HPV infection during pregnancy has been associated with a higher incidence of spontaneous abortions, 7-9 premature rupture of the membranes, 10 spontaneous preterm labor, 11,12 pre-eclampsia, 13 and placental 'villitis' not otherwise specified. 12 HPV DNA has been detected in the placenta and amniotic fluid. 7,11,[14][15][16][17]11,16,18,and 31 have been shown to replicate in trophoblast cell lines, [18][19][20] where HPV infection decreased trophoblast number and trophoblast-endometrial cell adhesion in vitro. 19,20 We investigated for the presence of HPV in the placenta and carried out a histopathological and molecular cross-sectional study of 339 ...

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A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications

et al. 2015

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“…No difference in HPV clearance was found between the two groups. From cervical swabs obtained from 960 women in each trimester and postpartum, Kim et al [10] found a significantly higher prevalence of HPV and HR-HPV in the second trimester of pregnancy. The effect of a second pregnancy on maternal carriage and outcome of HR-HPV was assessed prospectively as part of the Finnish Family HPV Study [11].…”

Section: Hpv In Pregnant and Non-pregnant Womenmentioning

confidence: 97%

“…Genital warts, which in 90% of cases are caused by HPV-6 and 11, can cause both physical and psychological morbidity for infected individuals [6]. In addition, HPV may informahealthcare.com 10 have a causative role in many cancers of the head and neck (mainly tonsilar) in which HPV-16 is the most prevalent serotype [7]. While the oncogenic potential of some serotypes of HPV is well recognized, the possible role of HPV in pregnancy remains uncertain and requires further investigation.…”

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confidence: 99%

The potential role of HPV vaccination in the prevention of infectious complications of pregnancy

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Expert Review of Vaccines

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There is now incontrovertible evidence that HPV is the cause of almost all cases of genital warts, cervical dysplasia and cervical cancer. Moreover the current review of the recent literature on HPV in relation to pregnancy found strong indications that HPV plays an important role in adverse outcomes of pregnancy. HPV may contribute to infertility and may increase the risk of miscarriage. Recent studies indicate a significant rate of vertical transmission of HPV between mother and child but whether the mode of delivery makes a difference to the risk of transmission remains unknown. HPV infection appears to be correlated with both spontaneous preterm birth and preterm prelabor rupture of the membranes.

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“…2 Malignant transformation appears to require the presence of additional cofactors such as pregnancy, smoking and immunosuppression. 3 Whether pregnancy predisposes to HPV infection and/or malignant transformation is not known. A number of investigators have proposed that the physiological and hormonal changes in pregnancy may modulate immune function leading to changes in the behavior of HPV infection.…”

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Human papillomavirus genotype prevalence and distribution among Moroccan pregnant women

et al. 2015

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Background: Human papillomavirus (HPV) is the major etiologic agent of invasive cervical cancer, vulvar and vaginal cancer. It has been estimated that, worldwide, 70% of cervical cancers are due to HPV-16 and HPV-18. Malignant transformation appears to require the presence of additional cofactors such as pregnancy, smoking and immunosuppression. The aim of the present study was to determine the prevalence and distribution of HPV genotypes among Moroccan women. Methods: Between January 1, 2011, and December 31, 2012, 277 cervical samples collected from confirmed women who attended the department of gynecology and obstetrics at Mohamed V Military teaching hospital, Rabat, Morocco, were analyzed in the laboratory of virology for HPV in vitro diagnosis and genotyping and for cytology in laboratory of pathology. Results: High-risk HPV DNA was detected in 101 (36%) samples, with higher prevalence in women ≥45 (43%) years. The overall prevalence of HPV infection and multiple infections in the study samples was 76% and 21%, respectively. The most frequent HPV genotypes were HPV-16 (31%). Human papillomavirus DNA detection was inversely related to maternal age. The risk of HPV infection was significantly reduced in women aged older than 30 years. The history of gynaecological problem showed significant association with the HPV positive test. Conclusion: In Morocco, the diagnosis of cervical lesions rests exclusively on the cytology-based screening that offers substantial protection, although current coverage is low. The introduction of HPV DNA testing in cervical cancer management will greatly benefit early stage HPV detection and help prevent development of cervical lesions and cancer. Screening pregnant women offer a significant opportunity for the Moroccan National Program against cervical cancer to control.

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Genotypic prevalence of human papillomavirus infection during normal pregnancy: A cross‐sectional study

Abstract: The second trimester may be the most vulnerable period in high-risk HPV infections, which necessitates future investigations.

Cited by 16 publications

References 21 publications

A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications

A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications

The potential role of HPV vaccination in the prevention of infectious complications of pregnancy

Human papillomavirus genotype prevalence and distribution among Moroccan pregnant women

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