HPV Virus

Hoyme UB. Department of Obstetrics and Gynaecology, University of Essen, Germany.

Most of the publications reviewed focus on human papillomavirus (HPV), and a small proportion on herpes simplex virus (HSV), Chlamydia trachomatis, as well as the syndromes of pelvic inflammatory disease and bacterial vaginosis. The present hypothesis associates cervical intraepithelial neoplasia (CIN)-1 with high oncogenic risk HPV types in less than 30% of cases; whereby CIN-2 and CIN-3 are associated with a 90% risk. However, on the basis of HPV types, four categories ['low risk' (HPV 6/11, 42, 43, 44); 'intermediate risk' (HPV 31, 33, 35, 51, 52, 58); 'high risk/HPV 16'; and 'high risk/HPV 18'] for the associated risk for a high-grade lesion or an invasive cancer can also be defined. In practice it appears efficient to re-evaluate patients with oncogenic types in association with low-grade cytology, as well as women with high-grade cytology or suspicious colposcopy in narrow intervals. Several reports have suggested that HPV genital infections are multifocal; however, HPV DNA was also found in the lymph nodes and in the granulocytes of women with cervical cancer, in ovarian and endometrial tissue, in tumours of the urinary bladder, and in mammary ductal carcinoma.

Publication Types:
• Review

J Low Genit Tract Dis. 2004 Jan;8(1):21-4.

Fungal species changes in the female genital tract.

Martens MG, Hoffman P, El-Zaatari M. Department of Obstetrics and Gynaecology, The University of Oklahoma, College of Medicine, Tulsa, OK 74104-4070, USA.

BACKGROUND: Candidal vaginitis has traditionally been associated with Candida albicans. OBJECTIVE: Two changes occurred over the past decade: first, the dispensing of over-the-counter (OTC) topical antifungals, and second, the approval of oral fluconazole 5 years later. Both have excellent activity versus C. albicans, but less activity versus nonalbicans species. MATERIALS AND METHODS: To determine if there has been a shift in species causing vaginitis, swabs were obtained from 156 symptomatic patients during the period after the release of OTC antifungals, but before fluconazole's approval. Specimens were inoculated onto nonselective mycotic agar, with growth transferred to selective media. RESULTS: One hundred eleven patients had a diagnosis of vulvovaginal candidiasis confirmed with yeast isolated. Ninety (81.1%) were identified as C. albicans. Of the 21 nonalbicans species, 15 (71.4%) were Candida glabrata. CONCLUSIONS: Therefore, it appears that after decades of the predominance of Candida albicans, a change may be occurring resulting in an increase in nonalbicans species.

Am J Obstet Gynecol. 2003 Mar;188(3):677-84.

Clinical findings among young women with genital human papillomavirus infection.

Mao C, Hughes JP, Kiviat N, Kuypers J, Lee SK, Adam DE, Koutsky LA. Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.

OBJECTIVE: The purpose of this study was to identify clinical signs and symptoms associated with detection of human papillomavirus (HPV) DNA in the female genital tract. STUDY DESIGN: A total of 516 university students (18 to 24 years old) enrolled in a cohort study that included the collection of genital specimens for HPV DNA testing every 4 months for up to 4 years. Reported symptoms and objective clinical findings of women with and without HPV DNA were compared by multivariate analysis. RESULTS: Acute and persisting HPV infections were not associated with discharge, itching, burning, soreness, or fissures. Clinical evidence of genital warts was statistically associated only with HPV types 6 and 11. Detection of any HPV DNA was associated with bacterial vaginosis (BV). Furthermore, a time lag analysis suggests that HPV infection usually precedes detection of BV. CONCLUSION: Most women who acquire genital HPV infection are asymptomatic; some, however, are at increased risk for BV.

Gynecol Obstet Invest. 2004;58(4):189-93. Epub 2004 Jul 14.

Increased frequency of bacterial vaginosis and Chlamydia trachomatis in pregnant women with human papillomavirus infection.

da Silva CS, Adad SJ, Hazarabedian de Souza MA, Macedo Barcelos AC, Sarreta Terra AP, Murta EF. Discipline of Gynecology and Obstetrics, Faculdade de Medicina do Triangulo Mineiro, Av. Getulio Guarita s/n, Bairro Abadia, 38025-440 Uberaba, Minas Gerais, Brazil.

The aim of this study was to verify the presence of bacterial vaginosis (BV), Candida sp, Chlamydia trachomatis, Neisseria gonorrhoeae, to determine the prevalence of tobacco use and measure vaginal pH (VpH) in pregnant women with (n = 26) and without (n = 26) human papillomavirus (HPV) infection, and make comparisons between these 2 groups. HPV, C. trachomatis and N. gonorrhoeae were diagnosed using hybrid capture, BV using clinical criteria, and Candida sp via cultures. A digital pH meter was used to measure VpH. The frequencies of Candida sp were 19.2 and 23.1% (p = 1), and VpH was 4.4 +/- 0.4 and 4.3 +/- 0.4 (p = 0.23), in the HPV-positive and HPV-negative groups, respectively. Compared to the group of pregnant women without HPV infection, those with HPV infection had a significantly higher prevalence of tobacco use (50 vs. 11.5%; p = 0.006), BV (53.8 vs. 15.4%; p = 0.007), and C. trachomatis (34.6 vs. 7.7%; p = 0.039). No case of N. gonorrhoeae was diagnosed. All cases of C. trachomatis and BV had high-grade HPV infection. Copyright (c) 2004 S. Karger AG, Basel.

Zhonghua Yi Xue Za Zhi. 2004 Mar 17;84(6):469-73.

Detection of HPV16 E6 gene in cervical tissues by quantitative polymerase chain reaction

HPV Virus - Article in Chinese

OBJECTIVE: To establish a method for detection of Human Papillomavirus (HPV) type16 E6 gene in Cervical carcinomas Specimens. To study the relationship between the quantities of HPV16 E6 (Human papillomavirus type16 E6 gene) in cervical tissues and the course of cervical disease in Xinjiang. METHODS: HPV16E6 gene and beta-actin was detected in parallel by FQ-PCR (fluorescence quantitative PCR). The number of copies of HPV16 E6 gene and beta-actin was detected in parallel by FQ-PCR (fluorescence quantitative PCR) in tissues of 69 cervical cancer, 65 cervical intraepithelial neoplasia (CIN), 33chronic cervicitis and samples of 96 cervical smear samples of vaginitis and cervicitis. The variation in HPV copies per genomic DNA equivalent can be estimated by dividing the HPV copy number by the beta-actin copy number. RESULTS: The positive rate of HPV16 E6 gene was 83.0%, 75.7%, 93.3% and 3.3% in tissues of cervical cancer, cervical intraepithelial neoplasia (CIN), chronic cervicitis and samples of cervical smear respectively. The amount of HPV16 E6 gene was gradually higher by the developing of the course of cervical disease. They have positive rank correlation, r = 0.83, P < 0.01. CONCLUSION: The study underscores the importance of the relationship between the HPV16 E6 gene and the course of cervical disease in Xinjiang. It also suggests that the quantification of HPV16 E6 gene may be useful as a prognostic tool to identify women who are at increased risk of developing cervical cancer. This method may be applied to studies of a number of issues related to the natural history of cervical cancer, such as the amounts of HPV in high- and low-grade lesions.

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