Incidence and clearance of anal high-risk Human Papillomavirus infection and their risk factors in men who have sex with men living with HIV

HIV-infected men who have sex with men (MSM) display the highest prevalence of anal infection by high-risk Human Papillomaviruses (hrHPVs) and incidence of anal carcinoma. Anal specimens were genotyped by the Linear Array. Incidence and clearance of anal infection by hrHPVs, hrHPVs other than HPV16, low-risk HPVs, and four individual types (6,11,16,18) were estimated using a two-state Markov model. Determinants for incidence and clearance were assessed by logistic regression. Overall, 204 individuals were included (median age 42 years, IQR = 34–49). For hrHPVs, incidence and clearance rates were 36.1 × 1000 person-months (p-m) (95% CI 23.3–56.5) and 15.6 × 1000 p-m (95% CI 10.7–23.3), respectively. HPV16 showed a higher incidence than HPV18 (10.2 vs. 7.2 × 1000 p-m). Its clearance was more than twofold lower than that of HPV18 (30.1 vs. 78.2 × 1000 p-m). MSM receiving cART displayed a 68% to 88% decrease in risk of acquiring hrHPVs, hrHPVs other than HPV16, HPV16, and HPV18 (adjusted Hazard Ratio [aHR] 0.13, 95% CI 0.02–0.67; aHR 0.22, 95% CI 0.06–0.78; aHR 0.32, 95% CI 0.12–0.90; aHR 0.12, 95% CI 0.04–0.31, respectively) than patients not treated. A nadir CD4 + count < 200 cells/mm3 significantly reduced the clearance of hrHPVs other than HPV16 (aHR 0.39, 95% CI 0.17–0.90). cART use reduces the risk of acquiring anal infection by hrHPVs.

Phototheranostics of Cervical Neoplasms with Chlorin e6 Photosensitizer

(1) Purpose: Improving the treatment effectiveness of intraepithelial neoplasia of the cervix associated with human papillomavirus infection, based on the application of the method of photodynamic therapy with simultaneous laser excitation of fluorescence to clarify the boundaries of cervical neoplasms. (2) Methods: Examination and treatment of 52 patients aged 22 to 53 years with morphologically and cytologically confirmed mild to severe intraepithelial cervix neoplasia, preinvasive, micro-invasive, and squamous cell cervix carcinoma. All patients were carriers of human papillomavirus infection. The patients underwent photodynamic therapy with simultaneous laser excitation of fluorescence. The combined use of video and spectral fluorescence diagnostics for cervical neoplasms made it possible to control the photodynamic therapy process at all stages of the procedure. Evaluation of the photodynamic therapy of intraepithelial cervical neoplasms was carried out with colposcopic examination, cytological conclusion, and morphological verification of the biopsy material after the photodynamic therapy course. The success of human papillomavirus therapy was assessed based on the results of the polymerase chain reaction. (3) Results. The possibility of simultaneous spectral fluorescence diagnostics and photodynamic therapy using a laser source with a wavelength of 660 nm has been established, making it possible to assess the fluorescence index in real-time and control the photobleaching of photosensitizers in the irradiated area. The treatment of all 52 patients was successful after the first photodynamic therapy procedure. According to the PCR test of the discharge from the cervical canal, the previously identified HPV types were not observed in 48 patients. Previously identified HPV types were absent after repeated PDT in four patients (CIN III (n = 2), CIS (n = 2)). In 80.8% of patients, regression of the lesion was noted. (4) Conclusions. The high efficiency of photodynamic therapy with intravenous photosensitizer administration of chlorin e6 has been demonstrated both in relation to eradication therapy of human papillomavirus and in relation to the treatment of intraepithelial lesions of the cervix.

Balanoposthitis: issues of classification, diagnosis and approaches to therapy

Objective. To present a variant of the modern classification of the processes occurring with lesions of the genitals, to draw specialists’ attention to the peculiarities and variety of causes leading to inflammation of the glans and foreskin, as well as to discuss topical issues of external therapy of balanopostitis.Material and methods. Data from modern studies and clinical guidelines were used in the preparation of the publication.Results. The variety of variants of lesions of the glans and foreskin can be due to a number of reasons and can be either an independent local process or a fragment of dermatosis, where it is possible to be affected in the form of balanoposthitis. Also, when examining and selecting therapy options, it is important to consider the possible role of microorganisms, whose spectrum as a cause of balanoposthitis varies from aerobic and anaerobic, to viral and fungal microflora. Treatment approaches are determined by the etiological factors.Conclusions. Balanoposthitis is a heterogeneous group of nosologies. The choice of treatment is based on the identified cause or empirically when possible. External therapy and hygiene constitute an essential part of treatment. When choosing drugs for topical glucocorticosteroids, preferenceshould be given to drugs with a high therapeutic index and low atrophogenic potential. Dysplastic processes of the penis are associated with human papillomavirus infection, the treatment of which can be both conservative and destructive.

Identification of Pathways and Genes Associated with Chemoradiotherapy in Locally Advanced Cervical Cancer

The standard treatment approach for locally advanced cervical cancer (LACC) is concurrent chemoradiotherapy (CCRT). However, resistance to radiotherapy and chemotherapy often leads to failure of LACC therapy. Thus, the key pathways and genes associated with CCRT in LACC should be identified urgently. The Weighted Gene Co-Expression Network Analysis (WGCNA) was used for the identification of highly correlated gene modules. A protein-protein interaction (PPI) network was constructed using STRING and hub genes were selected. Furthermore, single-cell transcriptome sequencing was used to elucidate the cell type composition of the cervix sample and analyze the expression levels of key genes in cells. We identified 580 differentially expressed genes (DEGs) in LACCk, which were mainly invovled in Human papillomavirus infection, focal adhesion, and ECM-receptor interaction signaling pathways. Ten hub genes (COL1A1, COL6A1, COL6A2, LAMA4, COL6A3, LAMC1, HSPG2, ITGA9, CTGF, PDGFRB) were screened for further study. We showed that COL1A1, COL6A1, COL6A2 were highly expressed after radiotherapy or chemoradiotherapy. By analyzing the single-cell sequence, we found that the main cell types in cervical tissue include Fibroblasts, Smooth muscle cells, Tissue stem cells, Endothelial cells, Progenitor cells, Epithelial cells, T cells, Basal cells, Macrophages, and Mast cells. COL1A1, COL6A1, COL6A2, COL6A3, CTGF, and PDGFRB were highly expressed in Progenitor cells. Human papillomavirus infection, focal adhesion, and ECM-receptor interaction signaling pathway are related to the failure of CCRT for LACC, which warrants further research to improve CCRT sensitivity in LACC targeting on these candidate genes or pathways.

Treatment of Recalcitrant Plantar Wart Unresponsive to Cryotherapy with Acupuncture and Moxibustion: A Case Report

Objectives: Plantar wart is a common viral skin disease caused by human papillomavirus infection and poses a therapeutic challenge in the paediatric patient population. Acupuncture and moxibustion are effective treatments for a wide range of skin conditions.Case report: This study presents the case of a 9-year-old girl for whom complete resolution of recalcitrant warts was achieved with acupuncture and moxibustion treatment.Results: After 20-week treatment, the wart lesions and pain were completely resolved. At the 6-month follow-up, the lesions remained fully resolved.Conclusion: This result suggests that acupuncture and moxibustion could be effective therapeutic strategies for plantar warts.