RESUMO
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.
Assuntos
Infecções por Papillomavirus , Humanos , Feminino , Infecções por Papillomavirus/diagnóstico , Papillomavirus Humano 16/genética , Anticorpos Antivirais , Imunoglobulina G , Anticorpos NeutralizantesRESUMO
Introdução: o papilomavírus humano (HPV) é reconhecido como o agente causal do câncer de colo uterino. Objetivo: determinar a prevalência de infecção genital por HPV e sua correlação com o resultado do exame citopatológico. Métodos: estudo transversal com 1.021 mulheres de 30 a 45 anos submetidas a rastreamento para câncer de cérvice uterina. As participantes responderam a questionário-padrão e amostras de colo uterino foram encaminhadas para análise citopatológica e para pesquisa de HPV. Resultados: a prevalência de HPV foi de 12,4% sendo de 8,7% nas com citologia negativa e 43,4% nas com citologia alterada, correspondendo a 28,9% nas com ASCUS/AGUS, 60% nas com lesão LSIL, 90% nas com HSIL e 100% nas com carcinoma invasor e com adenocarcinoma in situ. A chance de se detectar HSIL foi cerca de 94 vezes maior nas mulheres infectadas por HPV. Analisando somente as 116 mulheres infectadas e com HPV tipificado, observou-se que a frequência de HPV oncogênico foi de 79,3% (em 71,8% das com citologia negativa e em 91,1% das com citologia com anormalidades), sendo a chance de se detectar anormalidades no exame citopatológico cerca de quatro vezes maior na presença de HPV de alto risco. O HPV 16 foi o tipo mais frequente, detectado em 24,4% das amostras de mulheres com alterações citológicas e em 7,0% das com citologia negativa. Multi-infecção foi detectada em 5,7% das mulheres com anormalidades à citopatologia e em 1,1% das com citologia negativa. Conclusão: o estudo demonstra forte associação entre HPV e anormalidades citológicas.
Assuntos
Papillomavirus Humano 11 , Neoplasias do Colo , Infecções Sexualmente TransmissíveisRESUMO
Introdução: o papilomavírus humano (HPV) é reconhecido como o agente causal do câncer de colo uterino. Objetivo: determinar a prevalência de infecção genital por HPV e sua correlação com o resultado do exame citopatológico. Métodos: estudo transversal com 1.021 mulheres de 30 a 45 anos submetidas a rastreamento para câncer de cérvice uterina. As participantes responderam a questionário-padrão e amostras de colo uterino foram encaminhadas para análise citopatológica e para pesquisa de HPV. Resultados: a prevalência de HPV foi de 12,4% sendo de 8,7% nas com citologia negativa e 43,4% nas com citologia alterada, correspondendo a 28,9% nas com ASCUS/AGUS, 60% nas com lesão LSIL, 90% nas com HSIL e 100% nas com carcinoma invasor e com adenocarcinoma in situ. A chance de se detectar HSIL foi cerca de 94 vezes maior nas mulheres infectadas por HPV. Analisando somente as 116 mulheres infectadas e com HPV tipificado, observou-se que a frequência de HPV oncogênico foi de 79,3% (em 71,8% das com citologia negativa e em 91,1% das com citologia com anormalidades), sendo a chance de se detectar anormalidades no exame citopatológico cerca de quatro vezes maior na presença de HPV de alto risco. O HPV 16 foi o tipo mais frequente, detectado em 24,4% das amostras de mulheres com alterações citológicas e em 7,0%das com citologia negativa. Multi-infecção foi detectada em 5,7% das mulheres com anormalidades à citopatologia e em 1,1% das com citologia negativa.Conclusão: o estudo demonstra forte associação entre HPV e anormalidades citológicas.
Introduction: human papillomavirus (HPV) is the agent of cervical uterine cancer. Objective: determine the prevalence of genital infection due to HPV and their correlation with results in the oncotic cytology. Methods: in a cross-sectional study, 1021 women, age 30 to 45 years were enrolled and submitted to cervical cancer screening. All patients answered a standard protocol. Samples of the uterine cervix were sent to citopathological analysis and to identification of HPV. Results: prevalence of HPV was 12.4%; in women with normal cervical cytology the prevalence of HPV was 8,7% compared to 43,4% in women with altered cervical cytology (28.9% among women with ASCUS/AGUS; 60.0% among women with LSIL; 90.0% among women with HSIL and 100.0%both in women with invasive carcinoma and in situ adenocarcinoma). Chance of detection of HSIL was 94 times higher in women who had HPV in theuterine cervix. A separate analysis including only the 116 HPV infected women revealed that HPV oncogenic types corresponded to 79.3% of the cases(71.8% in women with negative cervical cytology and 91.1% in women with altered cervical cytology). The frequency of oncogenic HPV types in 116 women infected with HPV was 79.3% [71.8% in women with negative citology and 91.1% in women with abnormalities in the citology exam). The odds to detect abnormalities in the citopatology exam was four times greater in the presence of HPV of high risk. HPV 16 was the most frequent type observed(24.4% of women with abnormal cytology and in 7,0% of those with negative cytology). Multiinfection was detected in 5.7% of women with abnormal cytology and in 1.1% with negative cytology. Conclusion: in this study, HPV infection and abnormal cytological findings in the uterine cervix were frequently observed and there was an association between them.
Assuntos
Humanos , Feminino , Adulto , Infecções Sexualmente Transmissíveis , Neoplasias do Colo do Útero/diagnóstico , Prevalência , Infecções por Papillomavirus/diagnóstico , Lesões Intraepiteliais Escamosas Cervicais , Estudos TransversaisAssuntos
Proteínas de Ciclo Celular/metabolismo , Displasia do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Proliferação de Células , Displasia do Colo do Útero/patologia , Colo do Útero/anatomia & histologia , Colo do Útero/metabolismo , Ciclina D1/metabolismo , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Feminino , Humanos , Antígeno Ki-67/metabolismo , Pessoa de Meia-Idade , Biomarcadores Tumorais/metabolismo , Neoplasias do Colo do Útero/patologiaAssuntos
Displasia do Colo do Útero/diagnóstico , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Lesões Pré-Cancerosas/diagnóstico , Biomarcadores Tumorais/análise , Neoplasias do Colo do Útero/diagnóstico , Carcinoma/diagnóstico , Displasia do Colo do Útero/complicações , Feminino , Colo do Útero/metabolismo , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Humanos , Imuno-Histoquímica , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , PrognósticoRESUMO
Genetic variability in the genome of human papillomaviruses (HPV) has been described, particularly in the high-risk types 16 and 18. Based on extensive DNA sequencing analyses of HPV isolates from clinical specimens, a number of variants have been described whose nucleotide sequence does not vary more than 2 percent in coding and 5 percent in noncoding regions of the viral genome. Nucleotide sequence variation has being used as a tool for epidemiological studies of viral transmission and persistence. In the ongoing cohort study being performed in Brazil, we are abalyzing the risk of persistent infection and development of cervical lesions regarding geographical relatedness of variants. Infections with HPV types 16 and 18 were more likely to persist than those with other oncogenic types, with no significant differences between European and non-European variants regarding their tendency to persist. On the other hand, non-European HPV 16 and 18 variants were more strongly associated with risk of cervical neoplasia during follow-up than European variants, as compared with other oncogenic HPVs and low oncogenic risk HPVs. Epitope variability mays also have important implications in the immune response elicited against these viruses as well as in the design of vaccines directed against HPVs. Since these viruses are the etiologic agents of cervical cancer, those studies may provide useful information for the control of these common infections, leading ultimately to a reduction in the morbidity and mortality rates associated with this cancer.
Assuntos
Humanos , Feminino , Variação Genética , Infecções Tumorais por Vírus/genética , Papillomaviridae/genética , Infecções por Papillomavirus/genética , Neoplasias do Colo do Útero/genética , Suscetibilidade a Doenças , Infecções Tumorais por Vírus/epidemiologia , Infecções por Papillomavirus/epidemiologia , Neoplasias do Colo do Útero/epidemiologiaRESUMO
Human Papillomaviruses (HPVs) are etiologically associated to cervical carcinoma. In order to evaluate HPV infection and its relationship with the high frequency of this neoplasia in Quechua women from Jujuy (Argentina), 271 cervical samples from preneoplastic and neoplastic lesions (biopsies) and normal controls (cytologies) were studied. Detection and typing were performed using PCR-RFLP or PCR-hybridization and the HPV-16 variability in L1 and E6 genes (by PCR-hybridization) was analysed. HPV was detected in 52 of controls, 91 of low-grade lesions, 97 of high-grade lesions and 100 of invasive carcinomas, corresponding 55 to HPV-16. HPV-16 European variants were predominant, most of them being non-prototypic strains. The high frequency of high risk infection types and the raised proportion of HPV-16 non-prototypic variants related to a greater oncogenic potential could explain, in part, the high cervical cancer frequency of this native population. These data may contribute to disease control and vaccinal formulation