Association of anal dysplasia and human papillomavirus with immunosuppression and HIV infection among homosexual men

Kiviat, Nancy B.; Critchlow, Cathy W.; Holmes, King K.; Kuypers, Jane; Sayer, James; Dunphy, Carol; Surawicz, Christina M.; Kirby, Phil; Wood, Robert; Daling, Janet R.

doi:10.1097/00002030-199301000-00007

Cited by 141 publications

(46 citation statements)

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“…The precise effector mechanisms leading to lesion destruction in these clinical infections, however, are unknown. Additional evidence for immune control of HPV infections includes the high incidence of active HPV disease in immunosuppressed patients (18,19,32,35,54).Despite the strong evidence of multiple mechanisms of Bcell and T-cell immunity to papillomavirus antigens in hosts with papillomavirus infections (reviewed in references 22 and 39), persistent infections are common. Cervical cancer associated with HPV accounts for over 250,000 deaths of women worldwide (42).…”

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confidence: 99%

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Combination Treatment with Intralesional Cidofovir and Viral-DNA Vaccination Cures Large Cottontail Rabbit Papillomavirus-Induced Papillomas and Reduces Recurrences

Christensen

Han²,

Cladel³

et al. 2001

Antimicrob Agents Chemother

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. However, recurrences at periods from 1 to 8 weeks after treatment cessation were observed at approximately 50% of cured sites. DNA vaccinations with CRPV E1, E2, E6, and E7 were initiated either after or at the time of intralesional treatments, and the recurrence rates were observed. When DNA vaccinations were started after intralesional cures, recurrence rates were similar to those of vector-vaccinated rabbits. A small proportion of recurrent sites subsequently regressed (4 out of 10, or 40%) in the vaccinated group versus no regression of recurrences in the vectorimmunized group (0 out of 19, or 0%), indicating partial effectiveness. In contrast, when DNA vaccinations were conducted during intralesional treatments, a significant reduction of recurrences (from 10 out of 19, or 53%, of sites in vector-immunized rabbits to 3 out of 20, or 15%, of sites in viral-DNA-immunized rabbits) was observed. DNA vaccination without intralesional treatments had a minimal effect on preexisting papillomas. These data indicated that treatment with a combination of antiviral compounds and specific immune stimulation may lead to long-term cures of lesions without the ensuing problem of papilloma recurrence.Treatment of persistent papillomas with intralesional and topical antiviral compounds and immunomodulators often leads to effective cure of treated lesions in clinical trials with human papillomavirus (HPV) disease (4,5,16,56). However, recurrences are common after treatment cessation (5,6,16,20,56). The reasons for clinical recurrences are unclear, but possible mechanisms include (i) reinfection at adjacent sites, (ii) incomplete destruction of the entire area of active clinical disease, (iii) reactivation of subclinical HPV disease in wounded areas within and adjacent to treated sites, (iv) incomplete activation or induced anergy of antigen-specific cell-mediated immunity to HPV-infected papilloma cells, and (v) genetic factors associated with ineffective host immunity together with antigenic differences between variants of the same HPV type (2,3,9,23,31,46,47,58).There is strong evidence that host immunity to papillomavirus antigens can clear the bulk of HPV and animal papillomavirus infections (reviewed in references 22 and 39). Spontaneous regression of papillomas induced by cottontail rabbit papillomavirus (CRPV), rabbit oral papillomavirus, bovine papillomavirus type 4, and canine oral papillomavirus in rabbits, cattle, and beagles have been observed (8,10,12,34,38,41). The regressions are associated with a heavy infiltrate of T cells of both CD4 and CD8 phenotypes (1,33,40), and regressions of all lesions occur systemically. Immunosuppression of animals during the periods of papilloma growth has been shown to prolong lesion persistence (29,37,48). HPV-infected lesion regression with an associated immune infiltrate and in situ detectable cytokines has been reported also (17,57). The precise effector mechanisms leading to lesion destruction in these clinical infections, however, are unknown. Additional evidence for immu...

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confidence: 99%

mentioning

confidence: 99%

Combination Treatment with Intralesional Cidofovir and Viral-DNA Vaccination Cures Large Cottontail Rabbit Papillomavirus-Induced Papillomas and Reduces Recurrences

Christensen

Han²,

Cladel³

et al. 2001

Antimicrob Agents Chemother

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“…HPV are epitheliotropic, and their replication depends on the presence of differentiating squamous epithelium [2,3]. Papillomatous lesions commonly occur on the penis, scrotum, urethral meatus and perianal region in males, and over the introitus, vulva, perineum and perianal regions in females.…”

Section: Discussionmentioning

confidence: 99%

Giant Condyloma Acuminata of the Inguinal Region

2013

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“…In 1993, Kiviat et al [56] quantified the level of HIVspecific immunosuppression in association with AIN and HPV, and examined the mechanisms of the association. In this cross-sectional study of gay men in an HIV-screening clinic, anal HPV DNA was detected by Southern transfer hybridization in 55% of the 285 HIV-positive men compared to 23% of the 204 negative men (RR: 4.0; Cl: 2.7-6.2).…”

Section: Other Anogenital Cancers Related To Hpvmentioning

confidence: 99%

Epidemiology: A Tool for the Study of Human Papillomavirus-Related Carcinogenesis

Fisher

1994

Intervirology

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Association of anal dysplasia and human papillomavirus with immunosuppression and HIV infection among homosexual men

Cited by 141 publications

References 0 publications

Combination Treatment with Intralesional Cidofovir and Viral-DNA Vaccination Cures Large Cottontail Rabbit Papillomavirus-Induced Papillomas and Reduces Recurrences

Combination Treatment with Intralesional Cidofovir and Viral-DNA Vaccination Cures Large Cottontail Rabbit Papillomavirus-Induced Papillomas and Reduces Recurrences

Giant Condyloma Acuminata of the Inguinal Region

Epidemiology: A Tool for the Study of Human Papillomavirus-Related Carcinogenesis

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