Persistence or Clearance of Human Papillomavirus Infections in Women in Ouro Preto, Brazil

Persistent genital infection with high-risk (HR) human papillomavirus (HPV) is a prerequisite for cervical cancer development. The aim of this study was to identify factors associated with type-specific persistence of HR HPV infections. From a population-based cohort of 40,399 women participating in cervical cancer screening established during 2002-2005, we selected all HR HPV-positive women (N 5 7,778). During follow-up (2005During follow-up ( -2008, we collected cervical samples from these women and tested them for HPV DNA to determine type-specific HR HPV persistence in the interval 1-4.5 years after enrolment. Data on hospitalisations, prescriptions and socioeconomic factors were obtained from nationwide registers. Women with abnormal cytology at baseline or who had undergone conisation during follow-up were excluded. Factors associated with persistence were identified by logistic regression analysis. The overall rate of HR HPV persistence was 31.4%. The risk for persistence was significantly increased among women with a previous episode of genital warts (OR, 1.35; 95% CI, 1.04-1.74), current use of oral contraceptives (OR, 1.35; 95% CI, 1.13-1.63) or use of systemic glucocorticoids (OR, 2.04; 95% CI, 1.16-3.56). The number of pregnancies or births or use of a hormonal intrauterine device, hormonal therapy or nonsteroidal antiinflammatory drugs was not associated with risk for HR HPV persistence. A history of genital warts and current use of oral contraceptives or systemic glucocorticoids increased the risk, potentially indicating a decreased immune response to HPV infection. These findings suggest that host immune response characteristics are important in HR HPV persistence and consequently in cervical cancer development.Human papillomavirus (HPV) is one of the most frequent sexually transmitted infections. Most cases of genital HPV infection are transient and regress spontaneously, but some become persistent and can eventually progress to cervical cancer. As persistence of high-risk (HR) genital HPV infection is considered a prerequisite for cervical cancer development, 1 it is important to increase knowledge about the factors associated with persistence of HR HPV infections. In investigating risk factors for cervical cancer development, the steps in cervical carcinogenesis must be distinguished, i.e., between HPV acquisition, HPV persistence and progression to high-grade intraepithelial lesions or cervical cancer and persistence must be defined, as the definitions of HPV persistence vary, depending on the interval between examinations and the frequency of testing.It is well established that smoking, high parity and use of oral contraceptives increase the risk for cervical cancer.2 Furthermore, these factors as well as aspects of sexual behaviour including other sexually transmitted infections and impaired host immune response have been suggested to act by increasing the risk for HPV persistence. 3 An impaired immune response, as in HIV-infected individuals, has been found consistently to be a strong risk ...

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“…Neither pregnancy nor parity was associated with HR HPV persistence, as reported in other studies of pregnancy and parity . Nubbenhuis et al .…”

Section: Discussionmentioning

confidence: 67%

Factors associated with type‐specific persistence of high‐risk human papillomavirus infection: A population‐based study

Stensen

Kjær

Jensen

et al. 2015

Intl Journal of Cancer

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“…[3] There is evidence that most HPV infections are transient and clear spontaneously within 12À24 months after the first detection. [3] Persistent HPV infection with elevated risk of cervical cancer occurs in only a small percentage of the virusinfected women. [3] The aim of this study was to assess the correlation between HPV infections and CIN.…”

Section: Introductionmentioning

confidence: 99%

“…[3] Persistent HPV infection with elevated risk of cervical cancer occurs in only a small percentage of the virusinfected women. [3] The aim of this study was to assess the correlation between HPV infections and CIN.…”

Section: Introductionmentioning

confidence: 99%

Causative relations between human papilloma virus infection and cervical intraepithelial neoplasia

Kovachev

Slavov

2016

Biotechnology & Biotechnological Equipment

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The aim of this study was to assess the correlation between human papilloma virus (HPV) infections and cervical intraepithelial neoplasia (CIN). The study included 421 women (aged 18À45 years) who were examined gynecologicaly; their medical history and Pap smear results were collected and colposcopy and HPV tests were performed. In those cases where colposcopy and cytological evidence of atypism was found, biopsy or abrasion from the uterine cervix was performed. The GenoFlow HPV Array Test Kit was used to analyse the HPV status in cervical samples collected during the study. The obtained results showed that, one/more HPV genotypes were identified in 42% (177/421) and HPV(¡) in 58% (244/421) of the examined women. In the HPV(C) group, CIN was diagnosed in 57 (13.5%) women, whereas, in the HPV(¡) group, in 44 (10.5%) women. There was a significant dependence between HPV(C) status and development of CIN (p D 0.001), but the statistical analysis did not reveal sufficient positive predictive value or precision (p > 0.05), i.e. probability that (randomly selected) HPV(C) patients have CIN; neither sensitivity (p > 0.05), i.e. probability that (randomly selected) CIN patients are HPV(C); nor specificity (p > 0.05), i.e. probability that (randomly selected) women without CIN are HPV(¡). These results indicate that infection with HPV is probably not the only cause for development of CIN.

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“…Under normal physiological circumstances, 90% of HPV infections resolve naturally within 24 months, dependent on the HPV subtype, and the remaining 10% spontaneously persist to invasive cancer (Bodily and Laimonis, 2011;Cubie, 2013;Miranda et al, 2013).…”

Section: Etiology Of Cervical Cancermentioning

confidence: 99%

“…Thus, the persistence of hr-HPV occurs as a result of synergistic interaction with other HPV-related risk factors, such as early onset of sexual activity, alcohol, smoking, malnutrition, sexually transmitted infection, as well as HIV infection (Miranda et al, 2013). The most virulent subtypes are HPV 16 and 18, which collectively account for 80% of invasive cervical cancer cases (De Villiers et al, 2004).…”

Section: Etiology Of Cervical Cancermentioning

confidence: 99%

Genetic Susceptibility for Cervical Cancer in African Populations: What Are the Host Genetic Drivers?

Kuguyo

Tsikai

Thomford

et al. 2018

OMICS: A Journal of Integrative Biology

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Human papillomavirus (HPV) is an essential but not a sufficient cervical cancer etiological factor. Cancer promoters, such as host genetic mutations, significantly modulate therapeutic responses and susceptibility. In cervical cancer, of interest have been viral clearing genes and HPV oncoprotein targets, for which conflicting data have been reported among different populations. This expert analysis evaluates cervical cancer genetic susceptibility biomarkers studied in African populations. Notably, the past decade has seen Africa as a hotbed of biomarker and precision medicine innovations, thus potentially informing worldwide biomarker development strategies. We conducted a critical literature search in PubMed/MEDLINE, Google Scholar, and Scopus databases for case-control studies reporting on cervical cancer genetic polymorphisms among Africans. We found that seven African countries conducted cervical cancer molecular epidemiology studies in one of Casp8, p53, CCR2, FASL, HLA, IL10, TGF-beta, and TNF-alpha genes. This analysis reveals a remarkable gap in cervical cancer molecular epidemiology among Africans, whereas cervical cancer continues to disproportionately have an impact on African populations. Genome-wide association, whole exome-and whole-genome sequencing studies confirmed the contribution of candidate genes in cervical cancer. With such advances and omics technologies, the role of genetic susceptibility biomarkers can be exploited to develop novel interventions to improve current screening, diagnostic and prognostic methods worldwide. Exploring these genetic variations is crucial because African populations are genetically diverse and some variants or their combined effects are yet to be discovered and translated into tangible clinical applications. Thus, translational medicine and flourishing system sciences in Africa warrant further emphasis in the coming decade.

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Persistence or Clearance of Human Papillomavirus Infections in Women in Ouro Preto, Brazil

Cited by 40 publications

References 30 publications

Factors associated with type‐specific persistence of high‐risk human papillomavirus infection: A population‐based study

Factors associated with type‐specific persistence of high‐risk human papillomavirus infection: A population‐based study

Causative relations between human papilloma virus infection and cervical intraepithelial neoplasia

Genetic Susceptibility for Cervical Cancer in African Populations: What Are the Host Genetic Drivers?

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