Epstein-Barr Virus, High-Risk Human Papillomavirus and Abnormal Cervical Cytology in a Prospective Cohort of African Female Sex Workers

Background High-oncogenic-risk human papillomavirus (hrHPV) is necessary, although insufficient, to promote cervical cancer. Like HPV, Epstein-Barr virus (EBV) is a common pathogen with the capacity to promote epithelial neoplasms. We examined the association between cervical EBV, hrHPV, and cytology in female sex workers in Nairobi, Kenya. Methods Women (n = 332) with known cervical cytology and hrHPV mRNA results were evaluated for cervical EBV DNA by conventional polymerase chain reaction. Prevalence ratios (PRs) were calculated to assess the relationships between EBV, hrHPV, and cervical cytology. Prospective analyses used risk ratios and time-to-event analyses to determine the association of EBV with hrHPV clearance and with abnormal cytology outcomes. Results Baseline prevalence of hrHPV and EBV was 29% and 19%, respectively. Higher EBV prevalence was found among women with older age, HIV, hrHPV, abnormal cytology, Mycoplasma genitalium infection, smoking habits, younger age at sexual debut, and less frequent condom use. At baseline, women with EBV had a higher prevalence of hrHPV infection than did EBV-negative women (52% vs. 24%; HIV-adjusted PR [95% confidence interval], 1.8 [1.3-2.6]). Epstein-Barr virus-positive women had a higher prevalence than did EBV-negative women of high-grade precancer (15% vs. 2%) and abnormal cytology (37% vs. 15%), although HIV- and hrHPV-adjusted associations were not significant (high-grade precancer: PR, 2.0 [0.7-5.9]; abnormal cytology: PR, 1.4 [0.9-2.2]). In prospective analyses, a marginal association was observed between baseline EBV detection and delayed hrHPV clearance. Conclusions Our data support a possible role for EBV as a high-risk marker or cofactor for HPV-mediated cervical cancer development

The role of vaccines in the control of STDs: HPV vaccines.

Prophylactic vaccines for genital human papillomavirus (HPV) infection have been shown to be feasible in animal models, and suitable vaccine material based on virus-like particles can be produced in bulk at reasonable cost. Initiation of phase III clinical trials will follow definition of trial outcome measures through further epidemiological studies, and development of assays of host protective immunity. Vaccines could in principle eliminate HPV-related disease, as the human race is the only natural host for the relevant papillomaviruses (PVs). Therapeutic vaccines for genital HPV infection are also possible, but have not yet been demonstrated as feasible in practice because the choice of vaccine antigens is difficult, the method of their optimal delivery is uncertain, and the nature of the relevant antiviral immunity is unknown. PV species specificity will require trials to be conducted in man, which will slow definition of an ideal vaccine

Prevalence of human papillomavirus infection in rural villages of the Bolivian Amazon Prevalência da infecção pelo papilomavirus humano nas aldeias rurais do Amazonas Boliviano

Cervical cancer constitutes a major health problem in developing countries like Bolivia. The roles of certain genotypes of human papillomaviruses (HPVs) in the pathogenesis of cervical cancer is well established. The prevalence of HPV infection among sexually active women varies greatly. Information regarding HPV infection in Bolivia is very much scarce, specially in regions like the Amazonian lowland. We studied 135 healthy women living in four rural localities of the Bolivian Amazon. Presence of HPV in DNA extracted from cervical swabs was analyzed using a reverse line hybridization assay. The estimated overall HPV infection prevalence among the studied rural localities was 5.9% (ranging from 0-16.6%). These values were unexpectedly low considering Bolivia has a high incidence of cervical cancer. The fact that Amazonian people seem to be less exposed to HPV, makes it likely that some other risk factors including host lifestyle behaviors and genetic background may be involved in the development of cervical cancer in this population.<br>O câncer cervical constitui problema de saúde da maior importância nos países em desenvolvimento tais como a Bolívia. O papel de certos genótipos de papilomavirus humano (HPVs) na patologia do câncer cervical está bem estabelecido. A prevalência da infecção pelo HPV nas mulheres sexualmente ativas varia amplamente. Contudo, as informações existentes acerca da infecção pelo HPV na Bolivia são muito escassas, especialmente nas zonas rurais, nomeadamente na região amazônica do país. Foram estudadas 135 mulheres saudáveis, residentes em quatro localidades do Amazonas Boliviano. Foi detectada a presença de HPV no DNA extraído de esfregaços cervicais, utilizando o método de hibridização em linha reversa. A prevalência da infecção por HVP, encontrada nas localidades rurais, foi de 5,9% (variação entre 0-16,6%). Estes valores foram inesperadamente baixos, uma vez que a Bolívia é um país com alta incidência de câncer cervical. O fato da população do Amazonas parecer estar menos exposta ao HPV leva-nos a pensar que outros fatores de risco, inclusive estilos de vida e fatores genéticos, poderiam ter alguma relevância no desenvolvimento do câncer cervical nesta população