Persistence of human papillomavirus as a predictor for treatment failure after loop electrosurgical excision procedure

2007 ◽  
Vol 17 (6) ◽  
pp. 1271-1277 ◽  
Author(s):  
J. H. Bae ◽  
C. J. Kim ◽  
T. C. Park ◽  
S. E. Namkoong ◽  
J. S. Park
Keyword(s):  
Human Papillomavirus ◽  
Treatment Failure ◽  
Significant Risk ◽  
Hpv Infection ◽  
Dna Chip ◽  
Hpv Dna ◽  
Hpv Test ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure

We aimed to investigate whether postconization human papillomavirus (HPV) DNA testing can predict treatment failure and improve the accuracy of conventional follow-up in women with high-grade cervical intraepithelial neoplasia (CIN). Between March 2001 and October 2005, 120 patients with confirmed CIN 2 or 3 were treated with loop electrosurgical excision procedure (LEEP) and were enrolled. Six patients were lost to the follow-up. Postconization follow-up was performed at every 3–6 months during the first year and then annually. Specimens were tested for the presence of HPV, using the Hybrid Capture 2 (Digene Co, Gaithersburg, MD) and HPV DNA chip (Mygene Co, Seoul, Korea) test. Persistent HPV infection was defined as persistently (two times or more) positive HPV tests with the same HPV subtype(s) at initial diagnosis. Twenty-two (19.3%) patients showed treatment failure after conization. The only significant risk factor for redevelopment of CIN after conization was persistence of the same HPV subtype (P< 0.0001). And women with recurrent or residual CIN had higher HPV load during the 6-month follow-up postconization. In conclusion, the persistence of the same HPV subtype after LEEP conization was an important predictor of treatment failure. The follow-up protocol after conization of CIN should include both cervical cytology and HPV test, and HPV DNA chip test is needed to detect a persistent HPV infection.

scholarly journals Prevalence and genotype distribution of human papillomavirus in Czech non-vaccinated heterosexual couples

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hana Jaworek ◽  
Vladimira Koudelakova ◽  
Ivana Oborna ◽  
Blazena Zborilova ◽  
Jana Brezinova ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Hpv Infection ◽  
Sexual Partners ◽  
Fisher Exact Test ◽  
Genotype Distribution ◽  
Heterosexual Couples ◽  
Anatomic Site ◽  
Hpv Dna ◽  
Hpv Test ◽  
Penile Swabs

Abstract Background Data about the genotype-specific human papillomavirus (HPV) prevalence in the Czech Republic is limited. We aimed to evaluate the prevalence and concordance of genotype-specific HPV infection detected in semen samples, penile swabs and cervical swabs from non-vaccinated heterosexual couples without HPV-associated disease. Methods Semen samples and penile swabs were collected from male partners and cervical swabs were collected from female partners of heterosexual couples treated for infertility (n = 195). Presence of HPV DNA in semen samples and cervical swabs was analyzed using the cobas® HPV Test and PapilloCheck®. Only the PapilloCheck® test was used to detect HPV in penile swabs. The genotype-specific prevalence and concordance of HPV infection not targeted by vaccine were evaluated using Fisher exact test. Results Both partners were infected with any HPV type in 13.8% (27/195) of couples and, of these couples, 55.6% (15/27) harbored at least one mutual genotype. High-risk HPV (hrHPV) genotypes were detected in 12.3% (24/195) of semen samples, 31.3% (61/195) of penile swabs, and 19.5% (38/195) of cervical swabs (P < 0.001). The most prevalent hrHPV genotype were HPV53 (2.56%; 5/195) in semen samples, HPV16 (6.67%, 13/195) in penile swabs and HPV39 (3.59%, 7/195) in cervical swabs. Low-risk (lrHPV) genotypes were detected in 5.13% (10/195) of semen samples, 15.9% (31/195) of penile swabs, and 4.10% (8/195) of cervical swabs (P < 0.001). Male sexual partners of HPV-positive women were more likely to be infected with at least one of the same HPV types than female sexual partners of HPV-positive men (34.9% vs. 17.9%, P = 0.055). Conclusions This study showed that the detection of HPV infection differ by anatomic site and gender. Regardless the anatomic site, high prevalence of HPV genital infection was found in both Czech men and women.

scholarly journals Distribution and Prevalence of High-Risk Human Papillomavirus Genotypes in Cervical Specimens

2020 ◽  
Vol 25 (3) ◽  
pp. 325-331
Author(s):  
Erkan Özmen ◽  
Ülkü Altoparlak ◽  
Muhammet Hamidullah Uyanık ◽  
Abdulkadir Gülen
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Age Groups ◽  
Hpv Infection ◽  
High Rate ◽  
Genotype Distribution ◽  
Hpv Dna ◽  
Hpv Test ◽  
Significant Difference ◽  
Hpv Types

Introduction: Human papillomavirus (HPV) is frequently a sexually transmitted virus and can cause cervical cancer in women. Cervical cancer is the second most common type of cancer among the developing countries. In this study, cervical HPV DNA positivity and genotype distributions were investigated in female patients living in our region and the results were compared with different studies. Materials and Methods: Between 1 July, 2017 and 1 March, 2019, 433 cervical swabs were sent to Ataturk University, Medical Faculty Hospital, Medical Microbiology Laboratory due to suspicion of HPV. Swab samples were evaluated for HPV virus using molecular (Polymerase Chain Reaction-PCR) methods. For this purpose, Xpert HPV Test (Cepheid, Inc, Sunnyvale, CA) was used to identify HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 t in a single sample. Results: Mean age of the patients ranged from 20 to 69 years, with a mean of 39.8 years (± 10.0). Positivity was detected in 62 of the 433 patients. Mean age of the positive patients was 40.2 years (± 11.3). When the positive patients were examined in terms of HPV types, the presence of HPV 16 was observed with a rate of 25.6%, while the HPV 18/45 types were found to be 9.0% in total. When patients were evaluated according to age groups, HPV DNA positivity was highest in the 25-34 age group with 38.7%. In our statistical study, there was no significant difference in HPV DNA positivity rate between the ages of 35 and under 35 years. Conclusion: This study demonstrates the prevalence and viral genotype distribution of HPV infection in women in Erzurum region. HPV type 16 is seen with a high rate in our region.

scholarly journals The Prevalence of Human Papillomavirus between the Neonates and Their Mothers

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Mariusz Skoczyński ◽  
Anna Goździcka-Józefiak ◽  
Anna Kwaśniewska
Keyword(s):  
Human Papillomavirus ◽  
Pregnant Women ◽  
Significant Risk ◽  
Hpv Infection ◽  
Hormonal Status ◽  
Chain Reaction ◽  
Hpv Dna ◽  
Polymerase Chain ◽  
Medical University ◽  
The Impact

The impact of human papillomavirus (HPV) infection on pregnancy is a major problem of medicine. The transmission of the virus from mother to fetus is a process yet unresolved. The immune response and changed hormonal status of pregnant women might facilitate infection. A research on the prevalence of HPV infection was conducted at the Clinic of Obstetrics, Medical University of Lublin (Poland). The studied group included 152 randomly selected women. The material was tested for the presence of HPV DNA by means of polymerase chain reaction (PCR). The aim of the research was to assess the relation between HPV infections detected in the buccal smears of the neonates and the incidence of such infections in the cervical/buccal smears of their mothers. In the group of 152 infants HPV was found in 16 (10.53%). Among the cervical/buccal smears, HPV was isolated, respectively, in 24 (15.79%) and in 19 (12.5%) pregnant women. Statistically significant differences in the prevalence of HPV swabs from the newborns and the cervical/buccal smears of their mothers were found (p< 0.001). The identification of mothers in whose buccal smears HPV was detected can help develop a group of children who run a relatively significant risk of being infected.

Human papillomavirus genotyping and vaginal microbial metabolites in 276 patients with atypical cervical squamous cells and the clinical effect of nano-silver after loop electrosurgical excision procedure

2021 ◽  
Vol 11 (6) ◽  
pp. 904-911
Author(s):  
Zhaoxi Lu ◽  
Bing Sun ◽  
Dan Zhang
Keyword(s):  
Human Papillomavirus ◽  
Precancerous Lesion ◽  
Hpv Infection ◽  
Postoperative Treatment ◽  
Special Treatment ◽  
Clinical Effects ◽  
Microbial Metabolites ◽  
Nano Silver ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure

Cervical intraepithelial neoplasia (CIN) is a precancerous lesion of cervical malignant tumors. CIN is closely related to persistent human papillomavirus (HPV) infection, sexual behavior, and number of childbirths. The effect of vaginal microbial metabolites (VMM) on CIN is unclear; hence, we studied the effects of VMM and high-risk HPV (HR-HPV) infection on CIN and the clinical effects of nano-silver after loop electrosurgical excision procedure (LEEP). We selected the patients who went to the obstetrics and gynecology department of our hospital from January 2019 to November 2020, and we conducted vaginal microbiology, HPV typing, and histopathological examination on 282 patients. Among them, six patients had cervical cancer, 136 patients with CIN were regarded as the CIN group, and 140 patients with normal pathological tissue were regarded as the normal group. The results showed that H2O2 and HR-HPV infection were significantly correlated with the risk of CIN (P < 0.05). LEEP was performed on CIN patients, and the treatment with nano-silver gynecological antibacterial suppository was postoperatively compared with patients without special treatment. The results show that postoperative treatment with nano-silver can shorten the bleeding and exudation time of the wound and promote wound healing. It can simultaneously reduce wound infection and promote HPV to become negative, which can effectively reduce postoperative complications and recurrence.

scholarly journals HPV testing compared with routine cytology in cervical screening: long-term follow-up of ARTISTIC RCT

2019 ◽  
Vol 23 (28) ◽  
pp. 1-44 ◽  
Author(s):  
Clare Gilham ◽  
Alexandra Sargent ◽  
Henry C Kitchener ◽  
Julian Peto
Keyword(s):  
Human Papillomavirus ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Cancer Registration ◽  
Hpv Testing ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Normal Cytology ◽  
Hpv Test ◽  
Hpv Screening

Background The National Screening Committee (NSC) based its recommendation that human papillomavirus (HPV) testing should replace cytology in primary cervical screening largely on the 2009 follow-up results of the ARTISTIC trial (A Randomised Trial In Screening To Improve Cytology). The NSC must now decide on screening intervals and triage policy. Options include extending the screening interval up to 10 years for human papillomavirus-negative (HPV–) women, delaying recall for human papillomavirus-positive (HPV+) women with normal cytology (as their infections are usually transient), and basing triage on full HPV typing. Methods In ARTISTIC, 24,510 women were recruited who were attending routine cervical cytology in Greater Manchester in 2001–3. The women were randomly allocated between revealing and concealing their HPV test results and were recalled every 3 years. After 2009, the women returned to routine cytological screening with recall every 3 years for those aged < 50 years, and every 5 years for those aged 50–64 years. We have followed the cohort to 2015 through national cancer registration for CIN3 (cervical intraepithelial neoplasia grade 3) and cancer, and through linkage to the cervical screening call–recall system to obtain lifetime cytology records. Results The analysis comprised 24,496 women at round 1 and 13,591 women at round 2 (which was 30–48 months later). Follow-up via local histology laboratories and national cancer registration identified 505 cases of cervical intraepithelial neoplasia grade 3 or cervical cancer (CIN3+) (including 22 invasive cervical cancers). The cumulative CIN3+ risk 10 years after a negative HPV test [0.31%, 95% confidence interval (CI) 0.18% to 0.49%, in the revealed arm] was similar to that 3 years after negative cytology (0.30%, 95% CI 0.23% to 0.41%, in the concealed arm) and fell sharply with age, from 1.1% (95% CI 0.7% to 1.8%) in those women aged < 25 years to 0.08% (95% CI 0.03% to 0.20%) in those women aged > 50 years. The 10-year cumulative CIN3+ risk following a new HPV infection at round 2 was 3.4% (95% CI 2.1% to 5.4%). The highest risks were associated with type-specific persistent infections that, overall, resulted in a 10-year cumulative CIN3+ risk of 20.4% (95% CI 15.6% to 26.4%). Conclusions We found a similar level of protection 10 years after a negative HPV test and 3 years after negative cytology. These data support a considerably longer screening interval after a negative HPV test than after a negative cytology test. About three-quarters of women with HPV infection and normal cytology clear their infections within about 3 years. Their risk of CIN3+ within this time frame is low (1.5%), suggesting that the current policy of annual repeat testing and referral after 2 years may be unnecessarily cautious. Approximately 40% of women who remained HPV+ had cleared their initial infection and acquired a new HPV type. The cumulative CIN3+ risks in women with type-specific persistent infections are about six times higher than in women with new infections. Triage strategies based on HPV persistence would, therefore, reduce unnecessary referral of women with new (and largely transient) infections. HPV assays that identify HPV types 31, 33, 45, 52 and 58 in addition to 16 and 18 could be useful in triage as well as in primary HPV testing. Similar results in recent routine HPV screening suggest that our results are generalisable despite changes in cytology and HPV assay methods. We are continuing to follow the ARTISTIC cohort into the new era of primary HPV screening. Future work will focus on the implications of more sensitive HPV testing for primary HPV screening policy and triage of HPV-positive women. Our results suggest that a more sensitive test is needed to detect occult CIN3 at high risk of progression to cancer, but this would substantially increase the overall HPV detection rate. Tests such as DNA (deoxyribonucleic acid) methylation for distinguishing HPV infection from neoplasia will be evaluated on stored samples and on further samples now being collected from women in the cohort who are still being screened. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 28. See the NIHR Journals Library website for further project information.

scholarly journals Evaluation of Two Commercially Available DNA Tests for Detection of Human Papillomavirus

1995 ◽  
Vol 2 (6) ◽  
pp. 255-262
Author(s):  
Diane C. Halstead ◽  
Sharon L. H. Pfleger ◽  
William Dupree
Keyword(s):  
Human Papillomavirus ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Hpv Infection ◽  
Ease Of Use ◽  
Dot Blot ◽  
Predictive Values ◽  
Hpv Dna ◽  
Acceptable Method ◽  
Sensitivity Specificity

Objective: This study was designed to compare the sensitivity, specificity, efficiency, positive and negative predictive values, and ease of use for 2 commercially available hybridization kits for detecting human papillomavirus (HPV) DNA: Oncor Southern blot (SB) (Oncor, Inc., Gaithersburg, MD) and Digene ViraType dot blot (DB) (Digene Diagnostics, Inc., Silver Spring, MD).Methods: A total of 179 specimens (172 cervical and 7 penile biopsies) were assessed for acceptability based on the presence of epithelial cells and tested for HPV by DB and SB. The results were evaluated based on Papanicolaou-stained cervical specimens and selected risk factors.Results: One hundred six (97.2%) of 109 results were concordant, i.e., 93 negative (85.3%) and 13 positive (11.9%). Using SB as the gold standard, we found the sensitivity, specificity, efficiency, and positive and negative predictive values for the ViraType DB to be 100%, 96.9%, 97.3%, 81.3%, and 100%, respectively. Comparing the Papanicolaou smear to SB and DB, we found the sensitivity, specificity, efficiency, and positive and negative predictive values to be 33.3% (SB) vs. 44.4% (DB), 89.5% vs. 87.6%, 87.3% vs. 84.2%, 11.8% vs. 23.5%, and 97.0% vs. 94.9%, respectively. The only significant risk factor for predicting an HPV infection was the number of sexual partners.Conclusions: Although SB has been considered the standard model, DB is an acceptable method for detecting and identifying HPV infections.

Human papillomavirus in cervical screening and vaccination

2006 ◽  
Vol 110 (5) ◽  
pp. 543-552 ◽  
Author(s):  
Emma J. Crosbie ◽  
Henry C. Kitchener
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Residual Disease ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Hpv Testing ◽  
Hpv Dna ◽  
Hpv Test ◽  
High Risk Hpv

Recent decades have witnessed a reduction in the incidence of cervical cancer in countries where screening programmes have achieved broad coverage. The recognized importance of high-risk HPV (human papillomavirus) infection in the aetiology of cervical cancer may introduce a role for HPV DNA testing in cervical screening programmes. Positive HPV DNA tests indicate women at risk of cervical cancer with greater sensitivity, but reduced specificity, compared with exfoliative cytology. Combining HPV testing with cytology may be useful in the triage of minor cytological abnormalities into those requiring referral to colposcopy (HPV positive) compared with those who can be safely managed by cytological surveillance (HPV negative). With its high sensitivity and high-negative-predictive value, HPV testing may also be useful for predicting treatment failure, since residual disease is very unlikely in the event of a negative HPV test. Ultimately, prevention is better than cure, and the advent of HPV prophylactic vaccines may obviate the need for population-based cervical screening programmes in the future. A multivalent vaccine administered to adolescents prior to the onset of sexual activity and boosted at regular intervals throughout their sexually active life may provide protection against type-specific HPV infection, malignant precursors and invasive cervical disease. Several large randomized placebo-controlled trials have been conducted with promising results. For those generations of women already exposed to high-risk HPV infection, therapeutic vaccines may offer advantages over conventional treatment, although much work still needs to be done.

scholarly journals High Risk Human Papillomavirus genital infections in asymptomatic population: effectiveness of Micro-Immunotherapy

2021 ◽  
Vol 11 (40) ◽  
pp. 134-135
Author(s):  
Sandra Mazzoli ◽  
Tommaso Cai ◽  
Francesca Meacci ◽  
Patrizia Addonisio ◽  
Pierre Dorfman
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Viral Infections ◽  
Interleukin 1 ◽  
Interleukin 2 ◽  
Hpv Infection ◽  
Exact Test ◽  
Hpv Dna ◽  
Asymptomatic Patients

Background: persistent infection with high-risk human papillomavirus (HR-HPV) is the primary cause for the development of various anogenital cancers in females and males. Most infections are either latent or subclinical and the majority occur as asymptomatic. HPV infections are not currently treatable by antiviral compounds. Micro-immunotherapy (MI) medications using high dilutions of cytokines and specific nucleotide sequences have been developed to treat targeted viral infections and are currently prescribed in medical practice as immune regulators: 2L®PAPI (Labo’Life) is indicated for HPV infection and may represent a new therapeutic approach. Aims: this exploratory study was to assess the effectiveness of 2L®PAPI on HPV infection eradication in HR-HPV infected asymptomatic patients attending an STD Centre in a long-term microbiological follow-up population survey. Methodology: adult patients of both genders, diagnosed with HR-HPV infection, with no evidence of symptomatic HPV or anogenital cancer, were followed during a 2 year-period (2009-2010). Selected patients had not previously been vaccinated for HPV or treated with medications having an impact on the immune system. HPV testing was performed on biological samples using PCR detection (Innogenetics, Italy). In addition, detection of E6/E7 mRNA of five carcinogenic HPV types was performed by EasyQ HPV (BioMerieux, Italy). HPV-positives were requested by their urology specialist to take 2L®PAPI (composition in table 1) during 4 months (1 caps/day by sublingual route). Globally 46 patients were followed: 23 treated with MI medication, and 23 not treated. Results: one third of selected patients were lost at the control visit (15/46). At the end of the study period, HR-HPV negativity was observed in 50% (8/16) of patients under MI medication in comparison with only 7% (1/15) of the non treated patients who were HPV-DNA negative at the follow-up visit (p=0.01071, Mid-P exact test). This result is in accordance with our previous results which showed long lasting persistence of HR-HPV infection in a male cohort. Conclusions: the relevant percentage of lost patients at follow-up reflects the scarce information and awareness of this infection within asymptomatic people in Italy. 2L®PAPI was efficient in eradicating 50% of HR-HPV infections in treated patients, including 60% of HPV-16. These promising data emphasize the importance of redirecting immune responses in viral infections. Table 1: 2L®PAPI composition Compounds Dilutions Interleukin-1 (IL-1): 17-10 CH* Interleukin-2 (IL-2): 17-10 CH Interferon-α (IFN-α): 17-10 CH SNA-HLA II: 16-10 CH Ciclosporin A (CsA): 7-10-17 CH Ribonucleic acid (RNA): 18-10 CH SNA-PAPI: 16-10 CH * CH: Centesimal Hahnemannian (1/100)

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