"PREVENÇÃO CONTRA AO HPV E SUAS COMORBIDADES" REVISÃO DE LITERATURA

The HPV virus is directly linked to the development of genital cancer, genital warts and skin lesions. Knowing that HPV infection is a crucial factor in cervical cancer, HPV vaccination plays a fundamental role in reducing the incidence of cervical diseases and precancerous lesions. Study objectives: To analyze HPV vaccination coverage and its relationship with precursor lesions in the cervix, as well as other indicators of the disease. Methodology: A retrospective descriptive study was carried out in the southern region of Brazil, between 2014 and 2019, focusing on the female population that was the target of the vaccination campaign, excluding 9-year-old girls. Age groups from 10 to 19 years old and the general population were evaluated. Data were collected through the DATASUS Health Information System. Results found: In 2014, there was a higher percentage of girls vaccinated with the first and second dose, with 56.5% and 35.8%, respectively. From 2016 onwards, there was a reduction in vaccination coverage, especially in relation to the first dose. Even with vaccination starting in 2014, there was a 134% increase in cases of Cervical Intraepithelial Neoplasia (CIN) in the region until 2019. The age group from 14 to 19 years old was the most affected, with a predominance of cases of CIN 1. The number of cases of cervical cancer increased, both carcinoma (+63.6%) and adenocarcinoma. Discussion of results: The southern region of Brazil did not reach the target of 80% vaccination coverage established by the Ministry of Health. Final considerations: The need to reevaluate existing vaccination programs is evident, aiming to control diseases associated with HPV that could be prevented through immunization.O vírus HPV está diretamente ligado ao desenvolvimento de câncer genital, verrugas genitais e lesões de pele. Sabendo que a infecção por HPV é um fator crucial para o câncer do colo do útero, a vacinação contra o HPV tem um papel fundamental na redução da incidência de doenças cervicais e lesões pré-cancerígenas. Objetivos do estudo: Analisar a cobertura vacinal contra o HPV e sua relação com lesões precursoras no colo do útero, bem como outros indicadores da doença. Metodologia: Realizou-se um estudo descritivo retrospectivo na região sul do Brasil, no período entre 2014 e 2019, com foco na população feminina que era alvo da campanha de vacinação, excluindo as meninas de 9 anos. Foram avaliadas as faixas etárias de 10 a 19 anos e a população em geral. Os dados foram coletados através do Sistema de Informação em Saúde do DATASUS. Resultados encontrados: Em 2014, houve um maior percentual de meninas vacinadas com a primeira e segunda dose, com 56,5% e 35,8%, respectivamente. A partir de 2016, houve uma redução na cobertura vacinal, especialmente em relação à primeira dose. Mesmo com a vacinação iniciada em 2014, houve um aumento de 134% nos casos de Neoplasia Intraepitelial Cervical (NIC) na região até 2019. A faixa etária de 14 a 19 anos foi a mais afetada, com predominância de casos de NIC 1. O número de casos de câncer de colo do útero aumentou, tanto de carcinoma (+63,6%) quanto de adenocarcinoma. Discussão dos resultados: A região sul do Brasil não atingiu a meta de 80% de cobertura vacinal estabelecida pelo Ministério da Saúde. Considerações finais: Fica evidente a necessidade de reavaliar os programas de vacinação existentes, visando o controle de doenças associadas ao HPV que poderiam ser prevenidas através da imunização

Common, low-frequency, rare, and ultra-rare coding variants contribute to COVID-19 severity

The combined impact of common and rare exonic variants in COVID-19 host genetics is currently insufficiently understood. Here, common and rare variants from whole-exome sequencing data of about 4000 SARS-CoV-2-positive individuals were used to define an interpretable machine-learning model for predicting COVID-19 severity. First, variants were converted into separate sets of Boolean features, depending on the absence or the presence of variants in each gene. An ensemble of LASSO logistic regression models was used to identify the most informative Boolean features with respect to the genetic bases of severity. The Boolean features selected by these logistic models were combined into an Integrated PolyGenic Score that offers a synthetic and interpretable index for describing the contribution of host genetics in COVID-19 severity, as demonstrated through testing in several independent cohorts. Selected features belong to ultra-rare, rare, low-frequency, and common variants, including those in linkage disequilibrium with known GWAS loci. Noteworthily, around one quarter of the selected genes are sex-specific. Pathway analysis of the selected genes associated with COVID-19 severity reflected the multi-organ nature of the disease. The proposed model might provide useful information for developing diagnostics and therapeutics, while also being able to guide bedside disease management. © 2021, The Author(s)