La relación profesor–alumno en la Maestría de Enfermedades Infecciosas y Zoonóticas

Revista Portal de la Ciencia, No. 7, diciembre 2014; 13-18Revista Portal de la Ciencia, No. 7, diciembre 2014; 13-1

Cáncer de laringe y Virus del papiloma humano en adultos del Hospital Escuela Universitario, Honduras

Introduction: laryngeal cancer is the most frequent in head and neck, recently HPV is involved in its carcinogenesis. Objective: To identify the presence of human papillomavirus (HPV) in patients with larynx carcinoma at HEU from March 2012 until March 2015.Methods: A retrospective study was performed. Under authorization of the Pathology Department, the histopathological studies from patients already diagnosed having laryngeal carcinoma during the period from March 2012- March 2015 were reviewed. A universe of 91 patients with larynx carcinoma was obtained. In the selected 30 patients whose specimens were preserved in paraffin blocks, HPV DNA identification by polymerase chain reaction (PCR) followed by molecular genotyping using hybridization probes by reverse LIPA (INMO - LIPA HPV Genotyping Extra) were accomplished.Results: Gender distribution: 26/30 (86.6 %) men and 4/30 (13.3 %) women with a mean age of 62.7 yearsin HVP positive patients was 54.8 years .Coming largely from the rural areas19/30(63.3 %). The risk co-factors identified weresmoking22/30(73.3 %) and alcoholism 20/30(66.6 %).The most affected anatomic site: the glottis 16/30 (53.3 %). Histologically prevailed in 21/30 (70 %) of patients moderately differentiated squamous cell carcinoma. Most patients were in stage III12/30(40 %) at the diagnosis time, (p=0.09).HPV prevalence was 13/30(43.3%), IC95% (25.5-62.6), p<0.001. High risk genotypes (16, 31, 33, 51, 52, 53, 56, 58), as well as low risk (6, 11, 71 and 74) were identified. Non-oncogenic HPV 11 (23%) was the most frequent type encountered and the oncogenic HPV 16 (15.4%). Co-infection was noted with two or more genotypes.Conclusions: Prevalence HPV was 43.3%. HPV 11 and 16 were the most frequent. Due to a reduce sample and results variability among international studies, it is not possible to establish a clear association between HPV and laryngeal cancer. Further studies with more representative sample are required and recommended.Revista Portal de la Ciencia, No.11, diciembre 2016, 40-53El cáncer de laringe es el más frecuente en cabeza y cuello; recientemente se plantea la infección por virus del papiloma humano (VPH) en la carcinogénesis. El objetivo del estudio fue establecer la presencia del VPH en pacientes con carcinoma de laringe en el Hospital Escuela Universitario (HEU) desde marzo de 2012 a marzo de 2015.Se hizo un estudio retrospectivo. Previa autorización del Departamento de Patología se revisaron los diagnósticos histopatológicos de pacientes con carcinoma de laringe en HEU. El universo fue de 91 pacientes con carcinoma de laringe; la muestra fue de 30 pacientes.Se identificó el ADN del VPH mediante la reacción en cadena de la polimerasa (PCR) y genotipificación molecular utilizando sondas marcadas mediante hibridación reversa LIPA (INNO-LIPA HPV Genotyping Extra). Se realizó tabulación y análisis en EPIINFO 3.5.4; se obtuvo frecuencias, porcentajes, medidas de tendencia central y de significancia estadística.Los resultados indican distribución por género, masculino 26/30 (86.6 %) y femenino 4/30 (13.3 %); edad media para VPH negativos (62.7 años) y para VPH positivos (54.8 años). Procedentes del área rural 19/30(63.3 %). Cofactores predominantes: el tabaquismo en 22/30 (73.3 %) y alcoholismo 20/30 (66.6 %). El sitio anatómico más afectado fue la glotis 16/30(53.3 %). Histológicamente predominó el carcinoma epidermoide moderadamente diferenciado 21/30 (70 %). Al momento del diagnóstico12/ 30(40 %) se encontraban en estadio III.El porcentaje de VPH fue del 43.3 % (13/30), IC 95%(25.5-62.6), p< 0.001. Se identificaron genotipos de alto riesgo (16, 31, 33, 51, 52, 53, 56, 58) y bajo riesgo (6, 11, 71 y 74), predominando VPH 11 (23 %) no oncogénico, seguido del VPH 16 (15.4 %) oncogénico. Hubo coinfección de dos o más genotipos.La conclusión es que el porcentaje de VPH fue del 43.3 % con predominio de VPH 11 y 16. Debido a la muestra reducida y a la variabilidad de los resultados en estudios internacionales, se recomiendan estudios futuros con casuística más grande.Revista Portal de la Ciencia, No.11, diciembre 2016, p.40-5

Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study

Q1Q1Pacientes con Virus del Papiloma Humano (VPH)VIA is recommended for triage of HPV-positive women attending cervical screening. In the multicentric ESTAMPA study, VIA performance for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among HPV-positive women was evaluated. Women aged 30-64 years were screened with HPV testing and cytology and referred to colposcopy if either test was positive. At colposcopy visit, study-trained midwives/nurses/GPs performed VIA ahead of colposcopy. VIA was considered positive if acetowhite lesions were observed in or close to the transformation zone. Ablative treatment eligibility was assessed for VIA positives. Performance indicators were estimated. Three thousand one hundred and forty-two HPV-positive women were included. Sensitivity for CIN3+ was 85.9% (95% CI 81.2-89.5) among women <50 years and, although not significant, slightly lower in women 50+ (78.0%, 95% CI 65.9-86.6). Overall specificity was 58.6% (95% CI 56.7-60.5) and was significantly higher among women 50+ (70.3%, 95% CI 66.8-73.5) compared to women <50 (54.3%, 95% CI 52.1-56.5). VIA positivity was lower among women 50+ (35.2%, 95% CI 31.9-38.6) compared to women <50 (53.2, 95% CI 51.1-55.2). Overall eligibility for ablative treatment was 74.5% and did not differ by age. VIA sensitivity, specificity, and positivity, and ablative treatment eligibility varied highly by provider (ranges: 25%-95.4%, 44.9%-94.4%, 8.2%-65.3%, 0%-98.7%, respectively). VIA sensitivity for cervical precancer detection among HPV-positive women performed by trained providers was high with an important reduction in referral rates. However, scaling-up HPV screening triaged by VIA will be challenging due to the high variability of VIA performance and providers' need for training and supervision.https://orcid.org/0000-0001-7187-9946Revista Internacional - IndexadaA1N

Identification of Human Papillomavirus Type 58 Lineages and the Distribution Worldwide

Background. Human papillomavirus type 58 (HPV-58) accounts for a much higher proportion of cervical cancers in East Asia than other types. A classification system of HPV-58, which is essential for molecular epidemiological study, is lacking. Methods and results. This study analyzed the sequences of 401 isolates collected from 15 countries and cities. The 268 unique concatenated E6-E7-E2-E5-L1-LCR sequences that comprised 57% of the whole HPV-58 genome showed 4 distinct clusters. L1 and LCR produced tree topologies that best resembled the concatenated sequences and thus are the most appropriate surrogate regions for lineage classification. Moreover, short fragments from L1 (nucleotides 6014–6539) and LCR (nucleotides 7257–7429 and 7540–52) were found to contain sequence signatures informative for lineage identification. Lineage A was the most prevalent lineage across all regions. Lineage C was more frequent in Africa than elsewhere, whereas lineage D was more prevalent in Africa than in Asia. Among lineage A variants, sublineage A2 dominated in Africa, the Americas, and Europe, but not in Asia. Sublineage A1, which represents the prototype that originated from a patient with cancer, was rare worldwide except in Asia. Conclusions. HPV-58 can be classified into 4 lineages that show some degree of ethnogeographic predilection in distribution. The evolutionary, epidemiological, and pathological characteristics of these lineages warrant further study

Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America : the ESTAMPA screening study protocol

Q1Q1Introduction Human papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC. Methods and analysis Women aged 30–64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre. Ethics and dissemination The study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant safety, advice on scientific conduct and analysis and suggest protocol improvements. Study findings will be published in peer-reviewed journals and presented at scientific meetings. Trial registration number NCT01881659Revista Internacional - Indexad

Rotavirus Genotypes in Costa Rica, Nicaragua, Honduras and the Dominican Republic

In this study, 574 stool samples from children with gastroen- teritis were obtained from different hospitals in Costa Rica, Honduras, Nicaragua and the Dominican Republic during 2005–2006. Diarrhea stool samples were analyzed for rotavi- rus by ELISA and typed by the RT-PCR-based method. Un- usual strains were detected: G1P6, G2P8, G3P6, G9P4 and mixed infections. Recent studies have indicated that unusu- al human rotavirus strains are emerging as global strains, which has important implications for effective vaccine de- velopment. In this context, the next generation of rotavirus vaccines will need to provide adequate protection against diseases caused not only by mixed infections, but also by unusual G/P combinations.En este estudio, 574 muestras de heces de niños con gastroen- teritis se obtuvieron de diferentes hospitales de Costa Rica Honduras, Nicaragua y la República Dominicana durante 2005-2006. Las muestras de heces con diarrea se analizaron para detectar rotavi- rus por ELISA y se tipificaron por el método basado en RT-PCR. No se detectaron las cepas habituales: Se detectaron cepas no habituales: G1P6, G2P8, G3P6, G9P4 y infecciones mixtas. Estudios recientes han indicado que las cepas inusuales de rotavirus humano de los rotavirus humanos están emergiendo como cepas globales, lo que tiene importantes implicaciones para el desarrollo de vacunas eficaces. de vacunas. En este contexto, la próxima generación de vacunas contra el rotavirus de vacunas contra el rotavirus tendrá que ofrecer una protección adecuada contra contra las enfermedades causadas no sólo por infecciones mixtas, sino también por combinaciones inusuales de G/P.Universidad Nacional, Costa RicaEscuela de Medicina Veterinari

Assessment of HPV infection among female university students in Honduras via Roche linear array

Contains fulltext : 96652.pdf (publisher's version ) (Closed access)OBJECTIVE: To determine the prevalence of specific types of human papillomavirus (HPV), and the association with possible risk factors, among female university students at university in Honduras. METHODS: In a cross-sectional study, cervical samples from 400 women aged 18-35years were tested using a Roche HPV linear array to differentiate 37 genotypes of HPV. Associations with risk factors were assessed. RESULTS: Of the 400 participants, 393 completed the study. HPV DNA was detected in 45% of these women, of whom 73% were infected with high-risk types of HPV and 46% had multiple infections. Overall, 36 HPV genotypes were identified, of which HPV types 16, 51, 84, 66, and 39 were the most common. There was a marked decrease in the prevalence of multiple and high-risk infections with age. The factors that were independently associated with risk of being infected were related to sexual behavior and smoking habits. CONCLUSION: The study showed that genital HPV infection is common among sexually active women at university in Honduras. In addition, the Roche linear array was shown to be a valuable tool for HPV genotyping, which will be useful for monitoring the future effectiveness of an HPV vaccine in the population