The Distribution of Human Papillomavirus Type 30 (HPV30) Lineages Among Women With Normal Cervical Cytology in China

Background: Human papillomavirus type 30 (HPV30) is involved in cervical diseases. In human immunodeficiency virus (HIV) positive women, the prevalence HPV30 is almost the same as HPV16. However, HPV30 has seldom been investigated. In order to better understand the prevalence and intratype lineage distribution of HPV30 in China, HPV30 infection among women with normal cytology was investigated.Methods: Prevalence of HPV30 was investigated by the screening of type specific polymerase chain reaction (PCR); intratype lineage distribution was performed by the phylogenetic analysis of the L2 DNA sequences of HPV30 isolates; the diversity of genetic variants of HPV30 isolates was also evaluated. Results: (1) The infection rate of HPV30 was 0.56% (9/1600). (2) All the nine HPV30 isolates belonged to lineage A, none belonged to lineage B. (3) Compared with the HPV30 prototype reference, 87 variations including 79 substitutions, four insertions and four deletions were observed in this study. (4) Sample 4 contained a C base deletion of the E2 gene resulting in an amino acid sequence shift. (5) Sample had a truncated L2 protein.Conclusions: The infection rate of HPV30 is 0.56% in this study. All of the HPV30 isolates belongs to lineage A. Natural L2 and E2 defective isolates of HPV30 were found.

A Systematic Review of Human Papillomavirus Genotypes in Women With Normal Cervical Cytology: The Brazilian Paradigm

Background: Human papillomavirus (HPV) family of viruses is the leading cause of cervical cancer in women worldwide. More than 67 types of HPV are known to infect humans, and their distribution varies from region to region. HPV prevalence studies in Brazil have focused on cervical cancer; however, a detailed understanding of HPV type prevalence in women with normal cervix is absent in the literature. Our primary aim is to systematically review the literature and summarize the prevalence and distribution of HPV types in Brazilian women with HPV positive but normal cervical cytology and lack observed abnormal cells on their cervix's surface upon cytology analysis. Methods: This protocol was designed following the PRISMA-P guidelines. We conducted this systematic review with an active search in PubMed, Web of Science, and CINAHL databases and supplemented by a secondary screening of all included articles' reference lists. The search terms "Brazil", "HPV", "Human Papillomavirus", "prevalence", "distribution", "Human Papillomavirus types", and "normal cervical cytology" were used for screening the databases. Of 1048 articles retrieved and subjected to duplicates assessment, title and abstract assessment, and full-text assessment of eligibility, 11 articles were included in the review. We excluded articles from the male population, known cervical cancer cases, and studies with a sample size of <15. Qualitative assembly of the data and analysis was performed using GraphPad Prism 5.0 Results: The articles included in the study reported the prevalence of HPV types in women with normal cytology and HPV positive from ten Brazilian states. The total sample size ranged from 80 to 432, and the sample size for the HPV positive and normal cervical cytology group ranged from 28 to 209. HPV prevalence ranged from 0 to 89.4%, and a total of 43 HPV types were identified in the study population. There was variation between studies on the distribution of HPV types because of the detection and genotyping technique used and geographical location. HPV66 was the only HPV type detected in every study reviewed, regardless of geographical region and methods. Conclusions: Due to variation in genotyping techniques used in these studies, HPV type prevalence and geographical distribution may be misestimated or underestimated. But results of these studies give a clear view of the total prevalence of HPV types in Brazil. It is also essential to consider the HPV types present in women with normal cervical cytology before the HPV-mediated progression to abnormal cervical lesions.Systematic Review Registration: Prospective Register for Systematic Reviews (PROSPERO) registration CRD42020151655

HIV and Development of Epithelial Cell Abnormalities in women with prior normal cervical cytology in Nigeria

Background HIV-associated cellular immune dysfunction has been linked to higher risk of cervical dysplasia and cancer in HIV infected women. We sought to understand the relationship between HIV and development of epithelial cell abnormalities (ECA) at follow-up in women with prior normal cervical cytology (NCC).Methods Retrospective cohort analysis of women who received a Pap test at the Operation Stop Cervical Cancer Unit in Jos, Nigeria over a 10-year period (2006-2016). We analyzed the data of women with NCC at first Pap who had at least one follow-up cytology result for time-to-detection of ECA. We determined follow-up time in years from date of first NCC to date of first ECA report or date of last NCC follow up report with censoring at last follow-up date or December 31st, 2016 whichever came first. The primary outcome was development of any ECA as defined by the Bethesda 2001 reporting system. We identified demographic and clinical factors associated with incident ECA using multivariable Cox regression. Results A total of 1,599 women were eligible for this analysis. Overall, 3.7% (57/1,556) of women reported being HIV infected. The median age at first Pap was 39 years (IQR; 33-45). The HIV infected women were younger (36.3 ± 8.1) compared to those uninfected (39.3 ± 6.6), p=0.005. After an accrued follow-up time of 3,809 person-years (PYs), 243 women (15%) had an ECA with an event rate of 6.38 per 100 PYs. Women ≥35 years at first Pap were more likely to have an ECA compared to those <35 years (7.5 per 100 PYs vs 3.8 per 100 PYs, HR=1.96; 95% CI: 1.4, 2.8). HIV status was not significantly associated with developing ECA in either unadjusted (7.4 per 100 PYs vs 6.4 per 100 PYs, HR=1.17; 95% CI: 0.53, 2.3) or adjusted analyses (aHR=1.78; 95% CI: 0.87, 3.65).Conclusion Women living with HIV and on successful antiretroviral treatment may not have a differential hazard in the development of ECA during follow up after a prior normal Pap. Offering a repeat CCS to women who are 35 years or older irrespective of HIV status is likely an effective strategy in resource limited settings.

HIV and Development of Epithelial Cell Abnormalities in Women with Prior Normal Cervical Cytology in Nigeria

Background HIV-associated cellular immune dysfunction has been linked to higher risk of cervical dysplasia and cancer in HIV infected women. We sought to understand the relationship between HIV and development of epithelial cell abnormalities (ECA) at follow-up in women with prior normal cervical cytology (NCC).Methods Retrospective cohort analysis of women who received a Pap test at the Operation Stop Cervical Cancer Unit in Jos, Nigeria over a 10-year period (2006–2016). We analyzed the data of women with NCC at first Pap who had at least one follow-up cytology result for time-to-detection of ECA. We determined follow-up time in years from date of first NCC to date of first ECA report or date of last NCC follow up report with censoring at last follow-up date or December 31st, 2016 whichever came first. The primary outcome was development of any ECA as defined by the Bethesda 2001 reporting system. We identified demographic and clinical factors associated with incident ECA using multivariable Cox regression.Results A total of 1,599 women were eligible for this analysis. Overall, 3.7% (57/1,556) of women reported being HIV infected. The median age at first Pap was 39 years (IQR; 33–45). The HIV infected women were younger (36.3 ± 8.1) compared to those uninfected (39.3 ± 6.6), p = 0.005. After an accrued follow-up time of 3,809 person-years, 243 women (15%) had an ECA with an event rate of 6.38 per 100 person-years (PYs). Women ≥ 35 years at first Pap were more likely to have an ECA compared to those < 35 years (7.5 per 100 PYs vs 3.8 per 100 PYs, HR = 1.96; 95% CI: 1.4, 2.8). HIV was not significantly associated with developing ECA in either unadjusted (7.4 per 100 PYs vs 6.4 per 100 PYs, HR = 1.17; 95% CI: 0.53, 2.3) or adjusted analyses (aHR = 1.78; 95% CI: 0.87, 3.65).Conclusion Women with HIV on successful antiretroviral treatment may not have a differential hazard in the development of ECA during follow up after a prior normal Pap. Offering a repeat CCS to women who are 35 years or older irrespective of HIV status is likely an effective strategy in resource limited settings.

Systematic review and meta-analysis of human papillomavirus prevalence and types among women with normal cervical cytology in the Eastern Mediterranean Region

Aim: To predict the impact of human papillomavirus (HPV) vaccines in the Eastern Mediterranean Region (EMRO), knowing the prevalence and type distribution of HPV are mandatory. Methods: This study investigated 26,536 women with normal cervical cytology based on the data available from 13 countries of EMRO. Results: The HPV prevalence estimated to be 9.3% (CI = 7.1–12.0). The five most frequent HPV types were HPV 16 (2.3%), 18 (0.7%), 6 (0.7%), 11 (0.6%) and 31 (0.5%). The prevalence of multiple infections of HPV was observed in 1.6% of all cases. Conclusion: The present meta-analysis provides a comprehensive summary of HPV type distribution in normal cervical cytology in EMRO region to estimate and predict the impact of HPV vaccines.