HPV prevalence and HPV-related dysplasia in elderly women

Hermansson, Ruth S.; Olovsson, Matts; Hoxell, Emelie; Lindström, Annika

doi:10.1371/journal.pone.0189300

Cited by 45 publications

(76 citation statements)

References 26 publications

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“…In a gynecology outpatient clinic in Sweden in 2013-2015, clinician-collected samples from 1051 women were tested with a multiplex real-time PCR-assay. Mean age was 68 years, and 4.1% (95% CI 3.0-5.5) were HPV-positive [10]. These results are in line with the Danish data.…”

Section: Other Studiessupporting

confidence: 87%

HPV-prevalence in elderly women in Denmark

Andersen

Christensen

et al. 2019

Gynecologic Oncology

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Aim. In countries like Denmark, cervical cancer incidence is at present relatively high in elderly women, while routine screening stops at age 65 years. On this background, all women aged 69 and above were invited to human papillomavirus (HPV)-screening in Denmark in 2017.Methods. Women were identified from the Central Population Register and personally invited by digital or ordinary mail to have a screening sample taken by their general practitioner. In four regions, samples were tested for high risk (HPV) with the cobas 4800® HPV-assay, and in the last region with the BD Onclarity® HPV-assay. Participation rate, prevalence of high risk HPV, and proportion of positive samples with HPV16, HPV18, and other high risk HPV-types were tabulated by 5-year age-groups.Results. 455,612 women were invited, and 30.2% (95 confidence interval (CI) 30.0-30.3) participated. Average age of participants was 74.6 years. Overall, 4.3% (95% CI 4.1-4.4) of participants were HPV-positive, of whom 24% had HPV 16/18. HPV-prevalence decreased slightly from 4.5% in women aged 69-73 years to 3.1% in women aged 84-88 years, but was 5.2% in the very small group of participants aged 89+ years.Conclusion. Invitation to HPV-screening was well received by elderly women. The HPV-prevalence decreased slightly with increasing age. No rebound of HPV-prevalence after menopause was found when our data were combined with previously published Danish data from younger women. The presently relatively high cervical cancer incidence in elderly women was not reflected in the HPV-prevalence.

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Section: Other Studiessupporting

confidence: 87%

HPV-prevalence in elderly women in Denmark

Andersen

Christensen

et al. 2019

Gynecologic Oncology

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“…However, a significantly higher HPV prevalence was detected in CSOM patients aged ≥ 65 yrs than in CSOM patients aged ≤ 65 yrs, suggesting that HPV infection and old age may be co-factors in the etiopathogenesis of CSOM. One explanation is that HPV infection may persist longer in the middle ear mucosa of older compared to younger individuals, as shown for HPV infection in uterine cervix [30]. Considering the already known promoting role of high-risk HPV infection in inflammation, our results suggest that high-risk HPV infection may play a role in triggering inflammation of the middle ear mucosa in the elderly, ultimately leading to the development of CSOM.…”

Section: Discussionsupporting

confidence: 62%

“…The role of HPV infection in middle ear disease onset remains to be elucidated. In this context, it should be remembered that some HPV-infected subjects, due to their genetic or immunological characteristics, are more prone/susceptible to viral activity resulting in disease, as reported for HPV-positive uterine cervix tissues [30]. It is possible that older patients, due to immune senescence, do not react in the normal way to HPV infection in the middle ear mucosa, with the result that the higher HPV DNA load favors the inflammation process and disease onset/progression.…”

Section: Discussionmentioning

confidence: 96%

High Human Papillomavirus DNA loads in Inflammatory Middle Ear Diseases

et al. 2020

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Background. Previous studies reported human papillomaviruses (HPVs) in middle ear tumors, whereas these viruses have been poorly investigated in chronic inflammatory middle ear diseases. We investigated HPVs in non-tumor middle ear diseases, including chronic otitis media (COM). Methods. COM specimens (n = 52), including chronic suppurative otitis media (CSOM) (n =38) and cholesteatoma (COMC) (n = 14), as well as normal middle ear (NME) specimens (n = 56) were analyzed. HPV sequences and DNA loads were analyzed by quantitative-PCR. HPV genotyping was performed by direct sequencing. Results. HPV DNA was detected in 23% (12/52) of COM and in 30.4% (17/56) of NME (p > 0.05). Specifically, HPV DNA sequences were found in 26.3% (10/38) of CSOM and in 14.3% (2/14) of COMC (p > 0.05). Interestingly, the HPV DNA load was higher in COMC (mean 7.47 copy/cell) than in CSOM (mean 1.02 copy/cell) and NME (mean 1.18 copy/cell) (P = 0.03 and P = 0.017 versus CSOM and NME, respectively). HPV16 and HPV18 were the main genotypes detected in COMC, CSOM and NME. Conclusions. These data suggest that HPV may infect the middle ear mucosa, whereas HPV-positive COMCs are associated with higher viral DNA loads as compared to NME.Pathogens 2020, 9, 224 2 of 10 mucosa sampled from CSOM patients [11]. However, the etiology of CSOM remains to be determined. The relationship between HPV infection and inflammation has been previously reported [12]. It has been shown that persistent infection with high-risk HPVs leads to an increase in pro-inflammatory cytokines, including IL-6, TNF-α and MIP-1α [13]. In addition, high-risk HPV type 16 (HPV16) is able to increase the expression of cyclooxygenase-2 (COX-2), a key enzyme in the synthesis of prostaglandins, which are important mediators of inflammation [14,15]. Until now, only a single study has reported HPV DNA sequences in CSOM, whereby different HPV genotypes, including HPV16, HPV18 and HPV6, have been detected in 30.7% of CSOM [4].COMC is a form of expanding growth consisting of keratinizing squamous cell epithelium [16]. There is great interest in the etiopathogenesis of HPV-associated cholesteatoma because HPV commonly infects the stratified epithelium [17,18]. However, conflicting data have been reported for HPV in COMC [10,[19][20][21]. HPV sequences have been detected in COMC with different prevalence, ranging from 3% to 70% [10,[19][20][21]. Moreover, no specific HPV genotypes have been associated with COMC, as high-and low-risk HPVs, such as HPV16, HPV18 and HPV6 and HPV11, have been detected [10,[19][20][21].There is emerging evidence that HPV infection can occur in different anatomical sites. Since HPV infects epithelia [22], all anatomical sites covered with epithelial tissue are potentially exposed to HPV infection. Apart from pluristratified tissues of the cervix [23], vulva [24] and oral pharynx [25], HPV sequences have been detected in simple epithelia from several anatomical sites such as lung [26], upper respiratory tract [27], larynx [28] and nose [29]. Since the middle ear muc...

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“…HPV testing was performed using the real-time PCR-based assay hpVIR. 26,27 The test detects and quantifies the following HPV types: 16,18,31,33,35,39,45,51,52,56, 58 and 59. The limit of detection (LOD) of HPV is ten HPV copies per PCR.…”

Section: Hpv Testing Systemmentioning

confidence: 99%

Randomised study of HPV prevalence and detection of CIN2+ in vaginal self‐sampling compared to cervical specimens collected by medical personnel

Gustavsson

Aarnio

Berggrund

et al. 2018

Intl Journal of Cancer

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We conducted a randomised study to compare vaginal self-sampling with assisted sampling by medical personnel on the cervix for HPV testing in primary screening. The first aim was to determine if the HPV prevalence is independent of sampling location (vagina versus cervix) and the person performing the sampling. The second aim was to evaluate if the two sampling strategies differed in the detection rate of CIN2+. In total, 19,523 women were randomised into two groups, with 9926 invited to perform self-sampling (SS arm) using the Rover VIBA-brush and 9597 offered assisted sampling using the cytobrush (AS arm). All samples were applied to the indicating FTA elute card and analysed for high-risk HPV using the hpVIR real-time PCR assay. The outcome for the first aim was HPV prevalence and for the second aim the number of CIN2+ based on histology. In the SS arm, 52.7% of invited women participated in the study, as compared to 34.2% in the AS arm. All samples contained sufficient amount of nuclear DNA for a valid HPV result, with vaginal samples having a higher DNA amount than cervical samples (p < 4.62 × 10 ). HPV prevalence was 4.6% in the SS arm and 4.1% in the AS arm (p = 5.5 × 10 ), and the distribution of HPV types similar between arms. There was no difference in the prevalence of CIN2+ per 1000 women screened between arms (p = 0.86). The results show that vaginal self-sampling is an equivalent alternative to sampling by medical personnel for HPV typing and identification of CIN2+.

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HPV prevalence and HPV-related dysplasia in elderly women

Cited by 45 publications

References 26 publications

HPV-prevalence in elderly women in Denmark

HPV-prevalence in elderly women in Denmark

High Human Papillomavirus DNA loads in Inflammatory Middle Ear Diseases

Randomised study of HPV prevalence and detection of CIN2+ in vaginal self‐sampling compared to cervical specimens collected by medical personnel

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