RESUMEN
Little is known about the protection conferred by antibodies from natural human papillomavirus (HPV) infection. Our objective was to evaluate the association between HPV16 seroreactivity and HPV16 redetection, newly detected HPV infections, and loss of HPV DNA detection during follow-up. We analyzed data from 2462 unvaccinated Brazilian women. HPV16 IgG and neutralizing antibodies at baseline were assessed by enzyme-linked immunosorbent assay (n = 1975) and by the pseudovirus-based papillomavirus neutralization assay (n = 487). HPV detection, genotyping, and viral load were assessed by PCR-based methods. The associations were analyzed by Cox proportional hazards models. We observed a positive association between HPV16 IgG seroreactivity and redetection of HPV16 infections. Age-adjusted hazard ratios (HR) with 95% confidence intervals (CI) ranged from 2.45 (1.04-5.74) to 5.10 (1.37-19.00). Positive associations were also observed between HPV16 IgG antibodies and (1) newly detected HPV infections by genotypes unrelated to HPV16 (age-adjusted HR [95% CI] = 1.32 [1.08-1.2]) and (2) loss of detection of HPV infections by genotypes unrelated to HPV16 (age-adjusted HR [95% CI] = 1.24 [1.03-1.50]). Naturally developed HPV16 antibodies do not prevent recurrent HPV infections. Overall HPV16 IgG and neutralizing antibodies seem to be serological markers for latent or past infections.
Asunto(s)
Infecciones por Papillomavirus , Humanos , Femenino , Infecciones por Papillomavirus/diagnóstico , Papillomavirus Humano 16/genética , Anticuerpos Antivirales , Inmunoglobulina G , Anticuerpos NeutralizantesRESUMEN
Aiming at the problems of target model drift or loss of target tracking caused by serious deformation, occlusion, fast motion, and out of view of the target in long-term moving target tracking in complex scenes, this paper presents a robust multi-feature single-target tracking algorithm based on a particle filter. The algorithm is based on the correlation filtering framework. First, to extract more accurate target appearance features, in addition to the manual features histogram of oriented gradient features and color histogram features, the depth features from the conv3-4, conv4-4 and conv5-4 convolutional layer outputs in VGGNet-19 are also fused. Secondly, this paper designs a re-detection module of a fusion particle filter for the problem of how to return to accurate tracking after the target tracking fails, so that the algorithm in this paper can maintain high robustness during long-term tracking. Finally, in the adaptive model update stage, the adaptive learning rate update and adaptive filter update are performed to improve the accuracy of target tracking. Extensive experiments are conducted on dataset OTB-2015, dataset OTB-2013, and dataset UAV123. The experimental results show that the proposed multi-feature single-target robust tracking algorithm with fused particle filtering can effectively solve the long-time target tracking problem in complex scenes, while showing more stable and accurate tracking performance.
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Although correlation filter-based trackers (CFTs) have made great achievements on both robustness and accuracy, the performance of trackers can still be improved, because most of the existing trackers use either a sole filter template or fixed features fusion weight to represent a target. Herein, a real-time dual-template CFT for various challenge scenarios is proposed in this work. First, the color histograms, histogram of oriented gradient (HOG), and color naming (CN) features are extracted from the target image patch. Then, the dual-template is utilized based on the target response confidence. Meanwhile, in order to solve the various appearance variations in complicated challenge scenarios, the schemes of discriminative appearance model, multi-peaks target re-detection, and scale adaptive are integrated into the proposed tracker. Furthermore, the problem that the filter model may drift or even corrupt is solved by using high confidence template updating technique. In the experiment, 27 existing competitors, including 16 handcrafted features-based trackers (HFTs) and 11 deep features-based trackers (DFTs), are introduced for the comprehensive contrastive analysis on four benchmark databases. The experimental results demonstrate that the proposed tracker performs favorably against state-of-the-art HFTs and is comparable with the DFTs.
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OBJECTIVE: Direct comparison of the clinical outcomes between nucleos(t)ide analogue (NA) discontinuation versus NA continuation has not been performed in patients with chronic hepatitis B who achieved HBsAg-seroclearance. Whether NA discontinuation was as safe as NA continuation after NA-induced surface antigen of HBV (HBsAg) seroclearance was investigated in the present study. DESIGNS: This multicentre study included 276 patients from 16 hospitals in Korea who achieved NA-induced HBsAg seroclearance: 131 (47.5%) discontinued NA treatment within 6 months after HBsAg seroclearance (NA discontinuation group) and 145 (52.5%) continued NA treatment (NA continuation group). Primary endpoint was HBsAg reversion and secondary endpoints included serum HBV DNA redetection and development of hepatocellular carcinoma (HCC). RESULTS: During follow-up (median=26.9 months, IQR=12.2-49.2 months), 10 patients (3.6%) experienced HBsAg reversion, 6 (2.2%) showed HBV DNA redetection and 8 (2.9%) developed HCC. Compared with NA continuation, NA discontinuation was not associated with HBsAg reversion in both univariable (HR=0.45, 95% CI=0.12 to 1.76, log-rank p=0.24) and multivariable analyses (adjusted HR=0.65, 95% CI=0.16 to 2.59, p=0.54). The cumulative probabilities of HBsAg reversion at 1, 3 and 5 years were 0.8%, 2.3% and 5.0% in the NA discontinuation group, and 1.5%, 6.3% and 8.4% in the NA continuation group, respectively. NA discontinuation was not associated with higher risk of either HBV redetection (HR=0.83, 95% CI=0.16 to 4.16, log-rank p=0.82) or HCC development (HR=0.53, 95% CI=0.12 to 2.23, log-rank p=0.38). CONCLUSION: The discontinuation of NA was not associated with a higher risk of either HBsAg reversion, serum HBV DNA redetection or HCC development compared with NA continuation among patients who achieved HBsAg seroclearance with NA.
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Antivirales/administración & dosificación , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis B Crónica/tratamiento farmacológico , Respuesta Virológica Sostenida , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/prevención & control , Carcinoma Hepatocelular/virología , ADN Viral/sangre , Femenino , Estudios de Seguimiento , Guanina/administración & dosificación , Guanina/análogos & derivados , Virus de la Hepatitis B/genética , Humanos , Lamivudine/administración & dosificación , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/prevención & control , Neoplasias Hepáticas/virología , Masculino , Persona de Mediana Edad , Tenofovir/administración & dosificaciónRESUMEN
BACKGROUND: Infections with human papillomavirus (HPV) types 16 and 18 account for ~70% of invasive cervical cancers but the degree of protection from naturally acquired anti-HPV antibodies is uncertain. We examined the risk of HPV infections as defined by HPV DNA detection and cervical abnormalities among women >25 years in the Human Papilloma VIrus Vaccine Immunogenicity ANd Efficacy trial's (VIVIANE, NCT00294047) control arm. METHODS: Serum anti-HPV-16/18 antibodies were determined at baseline and every 12 months in baseline DNA-negative women (N = 2687 for HPV-16 and 2705 for HPV-18) by enzyme-linked immunosorbent assay (ELISA) from blood samples. HPV infections were identified by polymerase chain reaction (PCR) every 6-months, and cervical abnormalities were confirmed by cytology every 12 months. Data were collected over a 7-year period. The association between the risk of type-specific infection and cervical abnormalities and serostatus was assessed using Cox proportional hazard models. RESULTS: Risk of newly detected HPV-16-associated 6-month persistent infections (PI) (hazard ratio [HR] = 0.56 [95%CI:0.32; 0.99]) and atypical squamous cells of undetermined significance (ASC-US+) (HR = 0.28 [0.12; 0.67]) were significantly lower in baseline seropositive vs baseline seronegative women. HPV-16-associated incident infections (HR = 0.81 [0.56; 1.16]) and 12-month PI (HR = 0.53 [0.24; 1.16]) showed the same trend. A similar trend of lower risk was observed in HPV-18-seropositive vs -seronegative women (HR = 0.95 [0.59; 1.51] for IIs, HR = 0.43 [0.16; 1.13] for 6-month PIs, HR = 0.31 [0.07; 1.36] for 12-month PIs, and HR = 0.61 [0.23; 1.61] for ASC-US+). CONCLUSIONS: Naturally acquired anti-HPV-16 antibodies were associated with a decreased risk of subsequent infection and cervical abnormalities in women >25 years. This possible protection was lower than that previously reported in 15- to 25-year-old women.
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Papillomavirus Humano 16/inmunología , Papillomavirus Humano 18/inmunología , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/inmunología , Adulto , Anticuerpos Antivirales/sangre , Ensayos Clínicos Fase III como Asunto , ADN Viral/genética , Femenino , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Humanos , Infecciones por Papillomavirus/prevención & control , Modelos de Riesgos Proporcionales , Neoplasias del Cuello Uterino/virologíaRESUMEN
PURPOSE: To assess whether HPV 16 originally detected in adolescent women can be redetected in adulthood. METHODS: A convenience sample of 27 adult women with known HPV 16 detection during adolescence was assessed for HPV 16 redetection. A comparison of the long control region (LCR) DNA sequences was performed on some of the original and redetected HPV 16 isolates. RESULTS: Median age at reenrollment was 27.5 years (interquartile range of 26.7-29.6). Reenrollment occurred six years on average after the original HPV 16 detection. Eleven of 27 women had HPV 16 redetected. Some of these HPV 16 infections had apparently cleared during adolescence. LCR sequencing was successful in paired isolates from 6 women; in 5 of 6 cases the redetected HPV 16 isolates were identical to those detected during adolescence, CONCLUSIONS: HPV 16 may be episodically detected in young women, even over long time periods. HPV 16 redetection with identical LCR sequences suggests low-level persistent infection rather than true clearance, although newly acquired infection with an identical HPV 16 isolate cannot be excluded. However, this study suggests that a new HPV 16-positive test in a clinical setting may not indicate a new infection.
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Cuello del Útero/virología , Papillomavirus Humano 16/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Activación Viral , Adolescente , Adulto , Factores de Edad , ADN Viral/genética , Femenino , Papillomavirus Humano 16/fisiología , Humanos , Factores de Riesgo , Análisis de Secuencia de ADN , Conducta Sexual , Latencia del VirusRESUMEN
BACKGROUND: Persistent infection with oncogenic human papillomavirus (HPV) is associated with an increased risk of cervical malignancy. Redetection of type-specific HPV after a period of nondetection may be caused by reactivation of a low-level persistent infection. Little is known about factors associated with type-specific HPV redetection. METHODS: For a longitudinal cohort of adolescent women with frequent behavioral and sexually transmitted infection (STI) information (every 3 months), Cox proportional hazard models were used to assess the influence of sexual behaviors and STIs on the redetection of oncogenic or high-risk HPV infections. RESULTS: A total of 210 type-specific high-risk HPV detection episode periods were identified in this longitudinal cohort; 71 (33.8%) were characterized by a period of nondetection followed by redetection. Chlamydia trachomatis (hazard ratio [HR], 3.14; 95% confidence interval [CI], 1.44-6.86) was associated with redetection; redetection was >2 times more likely with each additional self-reported sex partner in the past 3 months (HR, 2.26; 95% CI, 1.35-3.78). CONCLUSIONS: This study demonstrates the role of C. trachomatis and number of recent sexual partners in type-specific HPV redetection. Given that persistent oncogenic HPV infections are associated with cancer-related outcomes, understanding the potential role of such factors in the pathogenesis of HPV-related outcomes is important.
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Infecciones por Chlamydia/complicaciones , Chlamydia trachomatis , Coinfección/diagnóstico , Infecciones por Papillomavirus/diagnóstico , Adolescente , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Coinfección/epidemiología , Coinfección/microbiología , Coinfección/prevención & control , Femenino , Humanos , Estimación de Kaplan-Meier , Estudios Longitudinales , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/microbiología , Infecciones por Papillomavirus/prevención & control , Recurrencia , Conducta Sexual , Parejas SexualesRESUMEN
BACKGROUND: The purpose of this study was to examine the rate of and risks for cervical human papillomavirus type 16 (HPV16) redetection in women with documented or suspected HPV16 infection. METHODS: A convenience sample of women aged 13-21 years were seen at 4-month intervals for HPV DNA testing and cytology. Serum samples were obtained at baseline and annually. RESULTS: A total of 1543 women entered the study. Of the 295 women with detection of HPV16 DNA and subsequent clearance, 18.1% had HPV16 redetected by 8.5 years (88% cleared this second detection by 3 years). Of the 247 women who had antibodies to HPV16 and were HPV16 DNA negative at baseline, 15.3% had HPV16 redetected by year 5. Risks for redetection included douching, current use of medroxyprogesterone, reporting >1 sex partner or having a new sex partner, and having a sexually transmitted infection. Development of cervical intraepithelial neoplasia 2/3 was rare in women with redetection, except for those with prevalent HPV16 infection. CONCLUSIONS: Reappearance of HPV16 DNA was observed in 18% of women. Most are associated with sexual exposure and appear benign. Interpretation of the studies is more complex in women with prevalent infections as it appears that this small subset reflects women with persistence already present at entry.