Genotype Distribution Change After Human Papillomavirus Vaccination in Two Autonomous Communities in Spain.

Context: It has been more than 10 years since the human papillomavirus (HPV) vaccination program was initiated in most advanced countries. Thus, it seems necessary to change the uterine cervical cancer screening strategy. Molecular-based tests are considered essential in this scenario. Objective: We aimed to review the distribution of the HPV genotypes after the introduction of the vaccination program with Cervarix® and Gardasil 4® in two autonomous communities in Spain, looking for possible changes in distribution and the occurrence of a herd effect. Design: A cross-sectional study was performed in 45,362 samples that were processed in the Cantabria and Aragon communities during the period from 2002 to 2016. We compared the genotype distribution before and after the vaccination program was initiated. Results: Genotypes HPV6 and HPV11 have decreased significantly after the introduction of the vaccine. HPV16 has had a decrease, but not a significant one in the statistical analysis. However, HPV31, HPV52, and HPV45 have increased in percentage. A replacement phenomenon with other genotypes not included in the vaccine has been observed in our population. Conclusions: Continued surveillance is needed to provide further indication of any changes over time in the genotypes in circulation. This will be facilitated by monitoring the genotyping results from the new model of cervical screening using primary HPV DNA testing.

Clinical Outcome in Human T-Lymphotropic Virus Type 2 Carriers Following Organ Transplantation.

BACKGROUND: Frequent and rapid development of myelopathy has been reported in individuals with human T-lymphotropic virus type 1 (HTLV-1) infection following solid organ transplantation. There is no information regarding HTLV-2, a closely related virus that often infects injection drug users. METHODS: This study includes a retrospective analysis of all consecutive organ transplants performed during the last 2 decades at a large reference transplantation unit in Spain. All participants were tested for anti-HTLV antibodies. RESULTS: A total of 2019 individuals were tested for HTLV during the study period, including 663 potential donors and 1356 recipient candidates. Twelve (0.59%) were reactive on initial HTLV serologic screening, but only 6 (all recipients) were confirmed as positive, all for HTLV-2. Two recipients underwent liver transplantation and have remained asymptomatic despite being on tacrolimus for 4 and 8 years, respectively. Likewise, the remaining 4 HTLV-2 carriers have not developed clinical complications potentially associated with HTLV-2. CONCLUSIONS: Unlike HTLV-1 infection, HTLV-2 infection in the transplantation setting does not seem to be associated with rapid development of neurologic complications, Given the cross-seroreactivity between HTLV-1 and HTLV-2, discriminatory rapid tests are urgently needed and would reduce unnecessary organ discharge.

Human papillomavirus (HPV) infection and intraepithelial neoplasia and invasive cancer of the uterine cervix: a case-control study in Zaragoza, Spain.

INTRODUCTION: The raw incidence of cancer of the uterine cervix is Spain is 7,8 per 100.000 inhabitants (adjusted incidence is 5.6). The incidence of this tumor is still low, but a steady increase has been seen, probably related to increasing risk factors. AIM: To determine the frequency of infection by different types of human papillomavirus (HPV) in Papanicolau smears from women with and without cancer of the uterine cervix in Spain. PATIENTS AND METHODS: A case-control study was performed in women with and without cervical cancer from Zaragoza, Spain. Pap smears from 600 cases (540 women with cervical intraepithelial neoplasms (CIN) and 60 with invasive cancer) and 1200 controls (women without those lesions) were tested by polymerase chain reaction (PCR) and typed by oligonucleotide microarray-based detection. RESULTS: HPV was detected in 93.3% of all samples with invasive cancer versus 17.5% of controls. OR for invasive cancer was 55 (95% CI 21.5-140,5). Statistically significant associations were also found for different grades of cervical dysplasia. CONCLUSION: The strong association found between HPV infection, specifically types 16 and 18 and cancer of the uterine cervix in Zaragoza, Spain, stresses the importance of ongoing efforts to institute a vaccine program with recently approved HPV vaccines in order to prevent cervical cancer in this population.

Case of keratitis caused by an uncommon Fusarium species.

Fusarium polyphialidicum caused a corneal ulcer in a Spanish man. Diagnosis was established by a histopathological study and repeated cultures. The isolate was clearly resistant in vitro to the antifungal agents tested. This is the first case of human or animal mycosis by this rare fungus.

Pre- and postsurgical detection of IgG, IgM, and IgA specific to hydatidosis by ELISA with purified antigen enriched with the 5/B antigen complex.

An enzyme-linked immunoassay (ELISA) using purified 5/B Echinococcus enriched antigen was used to follow IgG, IgM, and IgA antibody levels pre- and posttreatment or surgical removal of hydatid cysts. The sensitivity was 97%, 37.5%, and 54.5%, respectively, and the specificity was 95.7%, 100%, and 98.9%, respectively. All isotypes could be detected 3 years after surgical removal of cysts in patients showing no remaining cyst evidence. This was especially true for IgG, which persisted in 85.2% of the patients. The data indicate that antigen purification improves specificity without affecting sensitivity, although this new antigen offers no advantages in the postsurgical monitoring of the patients.