PAPILOMAVÍRUS HUMANO: UMA ABORDAGEM ATUAL

O desenvolvimento do câncer cervical e sua associação ao papilomavírus humano (HPV) estão fortemente evidenciados em estudos epidemiológicos, sendo o HPV o principal fator para a doença. A associação da infecção pelo HPV a outros co-fatores, como de comportamento sexual e socioeconômicos, mostram a importância de medidas preventivas e diagnóstico precoce dentro da rotina de serviços da saúde feminina. A prevalência da infecção por HPV em pacientes HIVpositivas é maior, permitindo que novas infecções por genótipos múltiplos do vírus agravem ainda mais a situação. Com a implementação da vacina que visa a imunizar mulheres contra a infecção por quatro genótipos de HPV, espera-se que haja uma diminuição significativa na prevalência da infecção por HPV e redução da incidência de lesões precursoras ao câncer cervical. Este estudo objetiva ressaltar que o conhecimento da extensão da infecção pelo HPV na população é fundamental para que estratégias de prevenção e controle adequados à realidade do serviço de saúde sejam propostas. Nesta revisão abordam-se as características microbiológicas e epidemiológicas da infecção pelo HPV, bem como seu potencial oncogênico

Is intrauterine exposure to acetaminophen associated with emotional and hyperactivity problems during childhood? : findings from the 2004 Pelotas birth cohort

Background: Longitudinal studies have consistently reported that prenatal exposure to acetaminophen can to lead to an increased risk of attention deficit-hyperactivity disorder during childhood. This study aimed to investigate the association between intrauterine exposure to acetaminophen and the presence of emotional and behavioral problems at the ages of 6 and 11 years in a low-middle income country. Methods: We performed a prospective longitudinal population-based study using data from the 2004 Pelotas birth cohort. From the 4231 initial cohort participants, 3722 and 3566 children were assessed at 6 and 11 years of age, respectively. The outcomes were assessed using the parent version of Strengths and Difficulties Questionnaire (SDQ). The cut-off points established for the Brazilian population were used to categorize the outcomes. Crude and adjusted odds ratio were obtained through logistic regression. Results: Acetaminophen was used by 27.5% (95% confidence interval [CI]: 26.1–28.9) of the mothers at least once during pregnancy. The prevalence of emotional problems at 6 and 11 years was 13.6 and 19.9%, respectively. For hyperactivity problems, prevalence was 13.9 and 16.1%, respectively. Intrauterine exposure to acetaminophen increased the odds of having emotional (odds ratio [OR] = 1.47; 95% CI: 1.07–2.02) and hyperactivity/inattention (OR = 1.42; 95% CI: 1.06–1.92) problems in 6-year-old boys. At the age of 11, a small decrease in the effect was observed for both outcomes after adjustment: OR = 1.31 (95% CI: 0.99–1.73) for emotional problems and OR = 1.25 (95% CI: 0.95–1.65) for hyperactivity/inattention in boys. No association for any phenotypes at both ages was observed for girls. Conclusion: The effect of intrauterine exposure to acetaminophen in emotional and hyperactivity symptoms was dependent on sex in a Brazilian cohort. While it seemed to be important for boys, mainly at 6 years of age, for girls, no association was observed

Infecção por HPV e polimorfismos nos genes TP53 e MDM2 em mulheres HIV positivas e negativas

Estimates show that approximately 80% of sexually active women will be infected by the Human Papillomavirus (HPV) in some point of their life course, and HPV DNA has been found in 99,7% of cervical cancer (CC) cases. Thus, several factors may contribute to CC development, including co-infections with Human Immunodeficiency Virus (HIV), as well as genetic factors, including TP53 and MDM2 polymorphisms. Some authors have associated CC development risk, among women infected with oncogenic HPV strains, with the Arg72Pro TP53 SNP. The MDM2 protein plays an important role in p53 protein regulation and, thus, a MDM2 SNP referred as SNP309 may also be implicated in CC risk in association with high-risk HPV genotypes. The present work aimed at determining the frequencies of HPV infection and identification of its genotypes, as well as the frequencies of the SNPs Arg72Pro and SNP309 and their associations with CC risk in female HIV-positive and negative populations in the city of Pelotas. It has been observed a prevalence of HPV infection of 30% among HIV-negative women, and 68% in the positive group. The HPV-16 genotype was the most prevalent in the HIV-negative group, and HPV-6 in the positive group. Among HPV-positive women, the TP53 Arg/Arg genotype was the most prevalent in both HIV groups, and the SNP309 TT genotype was the most prevalent in the HIV negative group, and the TG genotype in the positive group. These findings suggest that future investigations in larger populations are necessary and of interest to better understand the potential roles of these SNPs in HPV infected women.Estimativas mostram que cerca de 80% das mulheres sexualmente ativas estarão infectadas pelo Vírus do Papiloma Humano (HPV) em algum momento de suas vidas, o que DNA-HPV tem sido encontrado em 99,7% dos casos de câncer cervical (CC). Assim, vários fatores podem contribuir para o desenvolvimento do CC, incluindo coinfecções como o vírus da Imunodeficiência Humana (HIV), bem como fatores genéticos, incluindo os polimorfismos nas proteínas p53 e MDM2. Alguns autores relacionam um maior risco ao desenvolvimento de CC em mulheres infectadas com genótipos oncogênicos do HPV e que apresentam polimorfismo do gene supressor de tumor TP53 (SNP Arg72Pro). A proteína MDM2 apresenta um papel importante na regulação da p53, e assim como o SNP Arg72Pro da p53, o SNP309 da MDM2 (substituição de T por G) também pode favorecer o desenvolvimento de CC quando associado a genótipos de HPV de alto risco. O presente trabalho objetivou conhecer o grau da extensão de infecção pelo HPV e identificação de seus genótipos, frequência do SNP Arg72Pro e MDM2 SNP309 e associação ao risco de CC, na população feminina HIV positiva e negativa residente em Pelotas. Foi observada uma prevalência de infecção por HPV em 30% no grupo HIV negativo e 68% no grupo HIV positivo. O genótipo de HPV mais prevalente no grupo HIV negativo foi o HPV-16, e HPV-6 no grupo HIV positivo. Nas HPV positivas, o genótipo Arg72Arg foi o mais prevalente em ambos os grupos, e o SNP309 TT para o grupo HIV negativo e TG para HIV positivo. Os resultados encontrados mostram que futuros estudos em populações maiores são necessários para um melhor entendimento destes SNPs em mulheres infectadas por HPV

Uncommon non-oncogenic HPV genotypes, TP53 and MDM2 genes polymorphisms in HIV-infected women in Southern Brazil

Background:It is believed that Human Papillomavirus (HPV) and Human Immunodeficiency Virus coinfection contributes to increase the risk for cervical intraepithelial injuries. Several factors may contribute to cervical cancer (CC) development, including genetic variants such as TP53and MDM2 gene polymorphisms.Materials and methods:A hundred HIV-infected women were examined for HPV detection and its genotypes, as well as the frequencies of the SNPs Arg72Pro and SNP309 and their associations with CC risk factors. Nested Polymerase Chain Reaction (nPCR) was used for HPV detection and PCR-RFLP for TP53 and MDM2 SNP309 genotyping.Results:HPV DNA was detected in 68% of samples. A higher frequency of low-risk HPV genotypes (66.7%) was observed when compared to high-risk genotypes (33.3%). Nine different HPV genotypes were identified, with the highest prevalence of HPV-6, followed by HPV-16 and 31. p53 Arg72Arg and SNP309 TG genotype were the most prevalent. HPV genotyping was performed by sequencing.Conclusion:The data obtained suggest that HIV-infected women are more susceptible to be infected by low-risk HPV (LR-HPV) genotypes than by high-risk (HR-HPV), and Pro72Pro of TP53 gene and TG of MDM2 SNP309 genotypes apparently seem to be protective factors among HIV-infected women for HPV acquisition and HR-HPV infection, respectively, in a sample of Southern Brazilian woman. Future investigations in larger populations are necessary to better understand the potential roles of these SNPs and the behavior of non-oncogenic HPV genotypes in HIV-mediated immunosuppression cases

Human papillomavirus: prevalence and genotypes found among HIV-positive and negative women at a reference center in the far south of Brazil

Submitted by Thainã Moraes ([email protected]) on 2012-09-17T18:22:48Z No. of bitstreams: 1 Papilomavírus humano.pdf: 176678 bytes, checksum: 005c036c83b1a5efef6ffa377b4fc3f1 (MD5)Approved for entry into archive by Gabriela Silva da Rosa([email protected]) on 2012-09-21T13:08:10Z (GMT) No. of bitstreams: 1 Papilomavírus humano.pdf: 176678 bytes, checksum: 005c036c83b1a5efef6ffa377b4fc3f1 (MD5)Made available in DSpace on 2012-09-21T13:08:10Z (GMT). No. of bitstreams: 1 Papilomavírus humano.pdf: 176678 bytes, checksum: 005c036c83b1a5efef6ffa377b4fc3f1 (MD5) Previous issue date: 2010Introdução: O objetivo deste estudo foi detectar a presença do papilomavírus humano e verificar a prevalência e distribuição dos genótipos HPV-6, -11, -16 e -18 em mulheres HIV-1 positivas e negativas. Métodos: Analisou-se amostras de secreção cervical de 98 mulheres por reação em cadeia da polimerase nested para presença do HPV e tipo-específica para detecção dos genótipos, sendo estes confirmados por análise dos fragmentos de restrição. Realizou-se os testes do qui-quadrado e Fisher para a análise estatística. Resultados: O DNA-HPV foi observado em 66,3% das amostras analisadas, 76,4% no grupo HIV positivo e 60% no grupo HIV negativo (p=0,1). Uma prevalência maior de infecção viral por genótipos oncogênicos foi observada no grupo de pacientes HIV positivo (65,2%) quando comparado ao grupo HIV negativo (28,6%), (p=0,006), sendo HPV-16 foi o mais frequente nos dois grupos, seguido pelo HPV-18. Conclusões: Sugere-se que mulheres HIV positivas apresentam maior probabilidade de se infectar por genótipos oncogênicos de HPV, ressaltando a importância de um programa de rastreamento e diagnóstico diferenciado para este grupo.Introduction: The aim of this study was detect the presence of human papillomavirus and investigate the prevalence and distribution of the HPV-6, 11, 16 and 18 genotypes among HIV-1 positive and negative women. Methods: Samples of cervical smears from 98 women were analyzed using the nested polymerase chain reaction for the presence of HPV and using the type-specific technique for genotype detection. Genotypes were confirmed by means of restriction fragment analysis. The chi-square and Fisher tests were performed for the statistical analysis. Results: HPV-DNA was observed in 66.3% of the samples analyzed: 76.4% in the HIV-positive group and 60% in the HIV-negative group (p = 0.1). Higher prevalence of viral infection due to oncogenic genotypes was observed in the HIV-positive group (65.2%) than in the HIV-negative group (28.6%), (p = 0.006), and HPV-16 was the most frequent in the two groups, followed by HPV-18. Conclusions: It is suggested that HIV-positive women present a higher likelihood of infection by oncogenic HPV genotypes, and the importance of a screening and differential diagnosis program for this group is highlighted