Human T‐Cell lymphotropic virus type I and severe neoplasia of the cervix in jamaica

Abstract

Human T-cell lymphotropic virus type I (HTLV-I) was associated with carcinoma of the cervix in Japan in a recent study that compared hospital cases with healthy population-based controls. To test this relationship in women more alike for cervical neoplasia risk factors (including sexual behavior and human papilloma virus; HPV), we enrolled consecutive patients from a colposcopy clinic in Kingston, Jamaica (an HTLV-I endemic area). Patients underwent Pap smear, colposcopy, biopsy and cervical swab for detection of HPV by polymerase chain reaction. Cases were defined as women with CIN-3 or invasive cancer (CIN-3/CA). Controls included all patients with either CIN-I or koilocytotic atypia, atypical squamous cells of undetermined significance or benign cervical pathology (all but one had at least inflammatory changes). Patients with CIN-2 were excluded to minimize risk of case-control misclassification. Cases were much more likely to be HTLV-I seropositive than controls. Although mean age differed significantly between cases (mean age = 39 years) and controls (mean age = 33 years), control for age did not explain the relation of CIN-3/CA with HTLV-I. Among HPV DNA positive subjects the age-adjusted association was not diminished but lost statistical significance. HTLV-I seroprevalence may be independently associated with progression to severe neoplasia of the cervix.

A cluster of vulvar cancer and vulvar intraepithelial neoplasia in young Australian Indigenous women

“…This is likely to be an HPV-dependent mechanism, where declining immunity is associated with increased HPV DNA proliferation, resulting in an increased risk of HPV-related cancers. There is evidence that immunosuppressive conditions such as diabetes, infection with HIV, or HTLV-1 increase the risk of lower genital tract neoplasia [23][24][25].…”

Cross‐sectional analysis of oncogenic HPV viral load and cervical intraepithelial neoplasia

“…1 Since the majority of cervical lesions regress to normal cytology after a period of 12 months from presumed first infection, it is thought that the remaining cervical lesions persist due to environmental, host and viral cofactors that have a pleiotropic effect on HPV viral replication, the immune system and tissue microenvironment. [2][3][4][5][6][7][8][9][10] Recent studies suggest that HPV16 viral load may be a possible molecular biomarker in the natural history of HPV infection. Using a semi-quantitative measure of HPV16 DNA levels, several observational studies have found a high correlation between high viral load and high-grade intra-epithelial lesions.…”

Evidence of a higher prevalence of HPV infection in HTLV-1-infected women: a cross-sectional study

“…In Japan, a cross-sectional study 22 observed higher prevalence of HTLV-1 infection in patients with cervical cancer, assigning a threefold higher risk for this malignancy. In Jamaica, a case-control study suggested that HTLV-1 infection was a risk factor for progression of cervical intraepithelial neoplasia 23 . However, another study performed in that same area did not confirm this association 24 .…”

“…infection among HTLV-infected and uninfected groups when women were stratified into age ranges (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), 36-45, 46-55, and 56-65 years). Four positive cases of HPV infection (18.2%) were observed in HTLV-infected women with 46-55 years, whereas none was found in the control group at same age (p = 0.31) (data not shown).…”

“…A higher frequency of HPV infection and an increased risk of cervical cancer are found in immunosuppressed women, as can be observed in human immunodeficiency virus (HIV)-infected patients [19][20][21] . The studies that assessed the association of HPV infection in HTLV-1 patients have not reached a consensus on the epidemiological aspects of this co-infection [22][23][24][25] . The aim of this study was to determine the prevalence of HPV infection in HTLV-1-infected women in the City of Salvador, Bahia, Brazil, and to establish the risk factors involved in this co-infection.…”