A Prospective Study of Human Papillomavirus (HPV) Type 16 DNA Detection by Polymerase Chain Reaction and Its Association with Acquisition and Persistence of Other HPV Types

Liaw, Kai Li; Hildesheim, Allan; Burk, Robert D.; Gravitt, Patti E.; Wacholder, Sholom; Manos, M. Michele; Scott, David; Sherman, Mark E.; Kurman, Robert J.; Glass, Andrew G.; Anderson, Steven M.; Schiffman, Mark

doi:10.1086/317638

Cited by 247 publications

(204 citation statements)

References 15 publications

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“…2); but its impact with regard to the percentage of cases theoretically prevented would be higher in Asia (73.5%) and A vaccine that included the 7 most common HPV types shown in Figure 2 (16, 18, 45, 31, 33, 52 and 58) would prevent 87.4% of cervical cancers worldwide: 90.6% in northern Africa, 88.8% in south Asia, 86.5% in sub-Saharan Africa, 85.8% in Europe/North America and 84.9% in Central/South America (data not shown). These estimates assume that the prevention of HPV-16 and HPV-18 infections is unlikely to increase the risk of persistent infection by other HPV types, as has been suggested by Liaw et al 27 Another approach would be to consider that the vaccine is effective for cervical cancer cases linked to multiple types when all the types are included in the vaccine. Under this assumption, the global percent prevention would decrease from 71% to 68.3% for an HPV-16/-18 vaccine and from 87.4% to 85.8% if the 7 most common HPV types were included.…”

Section: Discussionmentioning

confidence: 99%

Against which human papillomavirus types shall we vaccinate and screen? the international perspective

Muñóz

Bosch

Castellsagué

et al. 2004

Intl Journal of Cancer

968

669

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At least 15 types of HPV have been associated with cervical cancer, but current HPV vaccines confer only type-specific immunity. To determine geographic variations in the HPV type distribution in cervical cancer, we carried out a pooled analysis of data from an international survey of HPV types in cervical cancer and from a multicenter case-control study, both co-coordinated by the IARC. Study cases were 3,607 women with incident, histologically confirmed cervical cancer recruited in 25 countries. HPV DNA detection and typing in cervical cells or biopsies were centrally done using PCR assays. Estimates of the potential number of cases prevented by HPV type-specific vaccines and changes in the validity of different HPV screening cocktails were calculated. HPV DNA was detected in 96% of specimens, and 30 different types were detected. Key words: cervical cancer; human papillomavirus; human papillomavirus geographic distributionCervical cancer is the second most common cancer in women worldwide but the first in most developing countries, where 80% of cases occur. 1 Molecular epidemiologic evidence accumulated over the past 20 years clearly indicates that certain HPV types are the central and probably necessary cause of cervical cancer. [2][3][4] Over 100 HPV types have been identified, and about 40 are known to infect the genital tract. 5 To assess the geographic distribution of HPV types in invasive cervical cancer and the risk linked to the various HPV types, the IARC carried out an international survey of cervical cancer specimens in 22 countries 4,6 and a multicenter case-control study in 11 countries around the world. [7][8][9][10][11][12][13][14][15] These studies were carried out using the same protocol and sensitive PCR assays for the detection of HPV DNA in a central laboratory.HPV prophylactic vaccines for the most common types (HPVs 16 and 18) are now being tested in various populations with promising results as they have been shown to be safe and to induce high titers of neutralizing antibodies that prevent HPV infection and cervical intraepithelial neoplasia (CIN). 16 -18 Although there is some evidence of cross-reactivity among certain HPV types, 19 this appears to account for Ͻ1% of antibody reactivity, indicating that protection to infection is type-specific. Effective HPV vaccines should then be polyvalent and should contain the HPV types responsible for most cervical cancers. It is thus of great importance to assess if there are significant differences in the geographic distribution of HPV types causing cervical cancer. If this is the case, their description would provide the rationale for considering tailoring vaccine products to the HPV types prevalent in a given geographic area vs. producing a common vaccine suitable to the worldwide distribution of HPV types. Previous studies have revealed some geographic differences in HPV type distribution, but the size of individual studies and the validity of the PCR testing systems used precluded delineation of clear patterns. 4,6 -15,20 HPV screening...

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Section: Discussionmentioning

confidence: 99%

Against which human papillomavirus types shall we vaccinate and screen? the international perspective

Muñóz

Bosch

Castellsagué

et al. 2004

Intl Journal of Cancer

968

669

View full text Add to dashboard Cite

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“…Recently, Liaw et al 44 observed a reduced risk for subsequent acquisition of a new infection within the same phylogenetic clade A9 in initially cytological normal women, which implies a potential protective cross reactivity within clade A9. The immunologic situation, however, is probably different in cancer patients and cross-reactivity was possibly lost in our group of patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of multiple HPV infection on response to treatment and survival in patients receiving radical radiotherapy for cervical cancer

Bachtiary

Obermair

Dreier

et al. 2002

Intl Journal of Cancer

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To obtain information on the incidence and the clinical significance of infection with various types of the human papillomavirus (HPV) in cancer of the uterine cervix, we retrospectively examined the HPV status of 106 patients who had received radical radiotherapy for cervical cancer stages IB to IIIB. DNA was extracted from formalin-fixed, paraffinembedded biopsies and PCR was carried out to identify HPV types 16, 18, 31, 35, 33 and 45. To detect additional HPV types, consensus PCR products were cloned and sequenced. A catalyzed signal-amplified colorimetric in situ hybridization was carried out in 84 of 106 specimens as a positive control. Response to therapy, progression-free survival (PFS) and cervical cancer-specific survival (CCSS) were the statistical endpoints. Survival analysis was carried out using univariate and multivariate analysis (Cox regression). Ninety-six patients (90.6%) were HPV-positive and 42/96 (43.7%) were positive for multiple HPV types. Eight patients had persistent disease after radiotherapy. From these 8 patients, 7 were infected with multiple HPV types and only 1 patient had an infection with a single HPV type. After a median follow up period of 50 months, patients with multiple HPV infection had a significantly shorter PFS and CCSS compared to those with single HPV infection (24.8% and 34.9% vs. 64% and 60.8%, Log rank, p < 0.01 and 0.04). In multivariate analysis, the presence of multiple HPV types (RR 1.9), node status (RR 2.3), tumor size (RR 3.2) and histologic type (RR 4.8) were independent prognostic factors of CCSS. Our results demonstrate that the presence of multiple HPV types is associated with poor response and with reduced survival in cervical cancer patients who receive radiotherapy as the primary treatment.

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“…Low-level cell-mediated cross-reactivity between genetically related HPV types may occur because of the different (not so conformation dependent) nature of the epitopes [57]. Cross-reactive cell-mediated immunity could potentially keep the oncogenic non-vaccine types under control due to naturally occurring boosting by the benign non-vaccine included types [26].…”

Section: Effectiveness Of Vaccination In Prevention Of Cervical Cancementioning

confidence: 99%

Vaccines for cervical cancer

Lowndes¹

2006

Epidemiol. Infect.

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SUMMARYThis review focuses on current and future prevention of invasive cervical cancer (ICC), the second most common cancer among women worldwide. Implementation of population-based cytological screening programmes, using the 'Pap ' smear to detect pre-cancerous lesions in the cervix, has resulted in substantial declines in mortality and morbidity from ICC in North America and some European countries. However, cases of, and deaths from, ICC continue to occur. Primary prevention of infection with high-risk human papillomavirus (HPV) types, the central causal factor of ICC, could further reduce incidence of and mortality from ICC. This is particularly the case in developing countries, which bear 80% of the burden of ICC, and where effective Pap screening programmes are extremely difficult to implement. Very promising results from several trials of synthetic HPV type-specific monovalent (HPV 16) and bivalent (HPV 16 and 18) vaccines have recently been published, showing high efficacy against type-specific persistent HPV infection and development of type-specific pre-cancerous lesions. Large-scale phase III trials of a number of such vaccine candidates are currently underway, and there is real hope that an effective vaccine capable of protecting against infection with HPV types 16 and 18 (which together account for y70% of cervical cancer cases worldwide), and thereby of preventing development of a very significant proportion of cases of ICC, could be available within the next 2 years.

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A Prospective Study of Human Papillomavirus (HPV) Type 16 DNA Detection by Polymerase Chain Reaction and Its Association with Acquisition and Persistence of Other HPV Types

Cited by 247 publications

References 15 publications

Against which human papillomavirus types shall we vaccinate and screen? the international perspective

Against which human papillomavirus types shall we vaccinate and screen? the international perspective

Impact of multiple HPV infection on response to treatment and survival in patients receiving radical radiotherapy for cervical cancer

Vaccines for cervical cancer

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