The role of herpes and human papillomavirus infection in prostate and bladder carcinogenesis

Human papillomavirus (HPV) is a small epithelial, non-enveloped, double-stranded DNA virus that belongs to the Papillomaviridae family. HPV infection is one of the most common sexually transmitted infections, and certain types of HPV are known to be carcinogenic to humans. According to the scientific literature, there is reliable information about the role of highly oncogenic HPV types in the development of cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancer.Currently, a relevant and promising research area is the study of the role of HPV infection in prostate cancer (PC) and bladder cancer (BC), but scientific data on the potential pathogenetic relationship between these phenomena remain contradictory. An in-depth study of the question how herpes and human papillomavirus affect the origin of malignant tumors of the prostate and bladder, as well as the course of these diseases, and the prognosis of their development can become a source of information for development of new approaches to their diagnosis, prevention, and monitoring of morbidity. This literature review analyzes the results of modern studies on the role of oncogenic HPV types in the carcinogenesis of PC and BC.

Incidence of Oncogenic HPV and HPV-Related Dysplasia Five Years After a Negative HPV Test by Self-Sampling in Elderly Women

PURPOSE: Cervical cancer prevention for older women can be challenging since there are no specific guidelines for this group. This study aimed to determine the incidence of oncogenic HPV and HPV-related dysplasia in elderly women 5 years after being HPV negative. METHODS: Invited women participated five years earlier in a study where self-sampling for HPV testing was applied, at this time, they were all HPV negative. The women were now invited to perform self-sampling for HPV testing. Women with a positive result performed a repeat HPV test. Those with a positive repeat HPV test were examined by colposcopy, biopsy and cytology. RESULTS: Of the 804 invited women, 634 (76.9%) agreed to participate in the study and a self-sampling kit was sent to them. Of these, 99.6% (632/634) sent a sample to the HPV laboratory. The participation rate in each age group was 93.3% at age 65, 74.0% at age 70, 80.7% at age 75 and 64.6 % at age 80. Overall 18 women (2.8%, 95% CI 3.2 to 6.0) were HPV positive in the first test and 8 (1.3%, 95% CI 0.6 to 2.6) in the second test. Sampling for the second test was done on average 5.4 months after the first test. Fifty per cent (4/8) of the women with a positive repeat test had dysplasia in histology. CONCLUSION: The incidence of HPV in previously HPV-negative elderly women was low. Among women who were HPV positive in a repeat test, there was a high prevalence of low grade dysplasia.

Muramyl peptides in the complex treatment of cervical intraepithelial neoplasia associated with human papillomavirus

Research objective: the use of an immunomodulator III generation with a wide range of action (muramyl peptide drug Liastenum) to increase the effectiveness of treatment of cervical intraepithelial neoplasia grade I associated with human papilloma virus (HPV) and to reduce the recurrence of cervical pathology.Materials and methods. The study included 60 women with histologically confirmed cervical intraepithelial neoplasia associated with highly oncogenic HPV. The mean age of patients was 25.92 ± 0.61 years. The first group included 30 women who received traditional treatment, the second group included 30 women who additional received Liastenum 0.002 g intramuscularly 1 time per day, 5 injections per course, after that patients took 1 tablets Liastenum twice a day for 20 days.Traditional treatment included antibiotic therapy (doxycycline monohydrate), metronidazole, nystatin in standard dosage. Patients with herpes viruses received valaciclovir 500 mg twice/day for 5 days. Evaluation of treatment efficacy was performed at 6 and 12 months with co-testing, fluid cytology, HPV quantification, and colposcopy.Results. There was a significant decrease in the exposure level of highly oncogenic HPV in the second group compared to the first: after 12 months in the first group HPV was not detected in 2 women (6.67%), and in the second group HPV was no detected in 17 women (56.67%) (p < 0.05). Improvement of the colposcopic picture occurred in 70% of patients in the second group, and in 12 (40.0%) of patients colposcopic conclusion on the Swedish scale was less than 3 points after 12 months of observation. Only 8 (26.67%) women received improvement of the colposcopic picture with a score of 3 points on the Swedish scale in the first group, which was significantly different from the second group (p < 0.05).Conclusions. Advanced therapy with muramyl peptide Liastenum in the treatment of cervix for 12 months can increase the effectiveness of HPV elimination, improves the colposcopic picture by reducing the area of cervical lesions and normalized cytological picture in 70% of patients with cervical intraepithelial neoplasia grade I.

Molecular Signature of Human Papillomavirus in Upper Aerodigestive Tract Cancers in Congo-Brazzaville

Introduction: Carcinomas of the upper aerodigestive tract have a tropism on the epidermoid mucosa. HPV infection remains one of the risk factors for this cancer. This work aimed to study the presence of human papillomavirus (HPV) in carcinomas of the VADS. Materials and Methods: This was a cross-sectional descriptive and analytical study with retrospective data collection over 7 years. The molecular analysis was conducted in Pointe-Noire using Xpert® HPV technology (GeneXpert, Cepheid). The variables studied were anatomopathological and virological. Results: The overall molecular prevalence of oncogenic HPV was 28.1%. HPV-16 and HPV-18/45 were the incriminating genotypes in 88.9% and 11.4% of cases, respectively. A statistically significant association was found between co-infection with HPV-oncogenes in subjects over 40 years of age (P=0.01) and the development of these HPVs in squamous cell carcinomas (p=0.02). Notably, oncogenic HPV was found in the majority of laryngeal carcinomas. Conclusion: In countries with limited resources, the Xpert HPV technology from GéneXpert is a reliable and rapid solution for the virological diagnosis of oncogenic HPV associated with carcinomas of the VADS. HPV-16 remains the most prevalent genotype.

Analysis of the results of combined treatment of cervix precancerous pathology in reproductive aged women

Aim of the study. Comparative analysis of the results of cervical epithelial neoplasia (CIN) I and II levels (p16ink4a-negative) (LSIL in LAST terminology) treatment against the background of highly oncogenic HPV infection using cold plasma ablation and immunomodulatory therapy with Аllokin-alpha.Materials and methods. We examined 60 women who received treatment for CIN I and CIN II (p16ink 4A negative) at the Multidisciplinary Medical Center of Odessa National Medical University. All women were of reproductive age, had mild dysplasia, high-risk HPV infection (HPV 16, 18, 31, 45) and histological confirmation of CIN I and CIN II (p16ink 4A negative). The patients were divided into 2 groups: 1 (main) group consisted of 30 women who received cold plasma ablation of cervical dysplasia in combination with immunomodulatory therapy with Аllokin-alpha (1 mg subcutaneously every other day, 3 injections before surgery and 3 injections after ablation), Group 2 (control) consisted of 30 patients who received standard cold plasma ablative treatment without prescribing immunomodulators. All women underwent cytomorphological examination of the cervical epithelium, HPV testing by RealTime PCR and colposcopy with mandatory targeted biopsy at the preoperative stage.Results. The use of combined cold plasma ablative treatment of CIN I and CIN II (p16ink 4A negative) in combination with the administration of the immunomodulator Аllokin-alpha significantly reduced the duration of discharge after ablation to 5.44 ± 1.03 days (95% CI: 4.96–6.05), the timing of epithelialization is up to 29.31 ± 1.12 days (95% CI: 26.81–32.32), and to exclude cases of recurrence of genital warts and cervical keratosis. Chances of HPV elimination 6 months after treatment (OR – 5.48; 95% CI: 1.56–29.03; p = 0.0075) and 12 months after treatment (OR – 15.48; 95% CI : 2.05–136.45; p = 0.0094), significantly higher with the combined with immunomodulation method of treatment, in contrast to only cold plasma ablation.Conclusion. Combined, with the use of cold plasma ablation and immunomodulation by perioperative management of Аllokin-alpha, LSIL treatment against the background of highly oncogenic HPV infection in women of reproductive age is accompanied by better functional results, compared with the use of cold plasma ablation alone: reduction in the duration of discharge, acceleration of epithelialization, normalization of the colposcopic and cytologic picture, decrease in the frequency of relapses, a significant increase in the frequency of HPV elimination.

Genotype-specific prevalence of human papillomavirus infection in asymptomatic Peruvian women: a community-based study

Objective To determine the general and genotype-specific prevalence of HPV and to identify potential risk factors for the infection in a population-based screening of Peruvian women. Results A total of 524 samples were analyzed by PCR and a total of 100 HPV positive samples were found, of which 89 were high-risk, 19 were probably oncogenic, 9 were low-risk and 27 other HPV types. The 26–35 and 36–45 age groups showed the highest proportion of HPV positive samples with a total of 37% (37/100) and 30% (30/100), respectively. Moreover, high-risk HPV was found in 33.7% of both groups and probably oncogenic HPV in 52.6% and 31.6%, respectively. High-risk HPV were the most frequent types identified in the population studied, being HPV-52, HPV-31 and HPV-16 the most commonly detected with 17.6%, 15.7% y 12.9%, respectively. Demographic characteristics and habits were assessed in the studied population. A total of 62% high-risk HPV were detected in married/cohabiting women. Women with two children showed the highest proportion (33.8%) of high-risk HPV, followed by women with only one child (26.9%). Those women without history of abortion had a higher frequency of high-risk HPV (71.9%), followed by those with one abortion (25.8%).

Antioxidants Associated with Oncogenic HPV Infection in women

Background Human papillomavirus (HPV) infection is a major cause of cervical cancer. Studies showed the onset of HPV carcinogenesis may be induced by oxidative stress affecting the host immune system. The association between antioxidants and oncogenic HPV remains unclear. In this study, we aim to identify antioxidants associated with vaginal HPV infection in women. Methods The associations between the 15 antioxidants and vaginal HPV infection status (no, low-risk, and high-risk HPV [LR- and HR-HPV]) were evaluated using 11,070 women who participated in the 2003-2016 National Health and Nutrition Examination Survey (NHANES). Results We identified serum albumin and four dietary antioxidants (vitamin-A, -B2, -E, and folate) inversely associated with HR-HPV infection. Women with a low level of albumin (≤39 g/L) have a significantly higher risk of HR-HPV (OR=1.4, p=0.009 vs. &gt;44 g/L). A nutritional antioxidant score (NAS) was developed based on these four dietary antioxidants. The women with the lowest quartile NAS had a higher chance of HR-HPV (OR=1.3, p=0.030) and LR-HPV (OR=1.4, p=0.002) compared with the women with the highest quartile NAS. Conclusions We identified five antioxidants negatively associated with vaginal HR-HPV infection in women. Our findings provide valuable insights into understanding antioxidants’ impact on HPV carcinogenesis.

ORGAN-PRESERVING MANAGEMENT TACTICS FOR A PATIENT WITH CERVICAL INTRAEPITHELIAL NEOPLASIA ASSOCIATED WITH THE ONCOGENIC HPV TYPE

The aim of this work was to study a clinical case of organ-preserving management tactics in a patient with cervical intraepithelial neoplasia associated with HPV infection type 16. The object of the study was the data from the outpatient card of patient N, born in 1994 with cervical intraepithelial neoplasia of the third degree associated with HPV infection type 16. The patient underwent surgical circular excision of the cervix against the background of effective antiviral treatment. When taking a control smear for oncocytology from the cervix and cervical canal after the procedure, no pathology was detected after 6 weeks, which confirmed the correct choice of management tactics.

HPV Positivity and Risk of Cervical Cancer according to HIV-Infection: A Comparative Assessment in the Population of Cameroonian Women

Background Cervical cancer, caused by the human papillomavirus (HPV), remains a global health challenge. In HIV highly-burdened settings, it would be relevant to understand the severity of cervical cancer in case of co-infection with HPV. We therefore sought to determine the effect of HPV on the occurrence of cervical lesions among women with versus without HIV-infection. Methods A cross-sectional analytical study was conducted throughout 2012 among 257 women living in Yaoundé, Cameroon. HIV serology, genotyping of high-risk oncogenic HPV and cervical vaginal smear (CVS) were performed for all participants; among those reported to be HIV seropositive, HIV plasma viral load and CD4 count were measured. Results of the CVS were interpreted following the Bethesda 2001 guidelines. Statistical analyses were performed using Graph Pad version 6.0; p < 0.05 was considered statistically significant. Results The mean age of our study participants was 37 ± 6.5 years. According to HIV serology, 184 (71.59%) were HIV-positive vs. 73 (28.40%) HIV-negative women, with a similar age distribution respectively (36 ± 2.80 years versus 42 ± 8.48 years). Among HIV-positive women, median CD4 was 438 [IQR: 317–597] cells/mm3 and median viremia < 40 [IQR: <40 − 2318] copies/mL. Following successful genotyping, the prevalence of high-risk oncogenic HPV was 36.32% (73/201), with a significantly higher proportion among those with HIV-infection (41.98% [55/131] vs. 25.71% [18/70]; p = 0.02; OR = 2.1). CVS revealed 31.74% (97) normal cervix; 38.91% (100) inflammation; 16.34% (42) low-grade squamous intra-epithelial lesion; 6.34% (18) high-grade squamous intra-epithelial lesion. Overall rate of cervical lesions was 23.34% (60/257), with a non-significantly higher proportion in HIV-infected participants (25.00% [46/184] versus 19.17% [14/73]; p = 0.31). Of relevance, the presence of high-risk oncogenic HPV was significantly associated with cervical lesions (p < 0.0001; OR = 5.07), with a higher risk of cervical lesion among HIV-positive (p < 0.0001 and OR = 5.67) versus HIV-negative (p = 0.03 and OR = 3.83). Conclusion Though oncogenic HPV appears as an independent factor of the occurrence of cervical lesions, the risk of cervical lesion is substantially higher among HIV/HPV co-infection compared to HPV-infection alone. Thus, prevention of cervical cancer should be prioritised for women living with HIV-infection in HPV-endemic settings.