Human papillomavirus infection in multiple sites

Abstract

Introduction: Studies concerning human papillomavirus natural history have been focused on cervical infection and disease, but have scarcely described anal infections, especially in clinically health population. Hence, knowledge on HPV natural history is recently being investigated although viral maintenance in hosts is poorly understood. Detection on diverse, extragenital sites may add in the elucidation of infection-dissemination-reinfection cycle reported on the human genital tract. Besides that, it is evident the importance of an adequate screening of the viruses for appropriate diagnosis, mainly in the first steps of the neoplasia in order to provide a better prognosis. Our results pointed out HPV prevalence rates in genital lesions of 87% (80/92) and of 47.8% (44/92) for anal samples. We pointed out that this high prevalence is due to clinically detected lesions, that contributes to the risk of extragenital infections, mainly by host auto-inoculation. Despite the difference in samples size, we did not find statistical relevant differences related with genera (men 85.1% and women 92%; p>0.05), corroborating the idea of no tropism differences by sex. Nevertheless, for anal samples, statistically significant differences were found between men and women (68% of anal HPV infection in women against 40.3% in men (p=0.038). These results reveal that female anal infections are more frequent than in men, suggesting that infection by autoinoculation occurs and can render this site as an HPV reservoir, occasionally becoming clinical lesions. Hormonal profile, sexual behavior and differences among body sites can explain these differences here described. Our study is a preliminary evaluation of HPV infection in human multiple sites. Keywords: papillomavirus infections; polymerase chain reaction; anus. RESUMO Introdução:Muitos estudos sobre a história natural do papilomavírus humano (HPV) têm focado nas infecções cervicais, mas pouco tem se falado sobre infecções anais em pacientes assintomáticos. Assim, a história natural do HPV ainda está em construção e os mecanismos de manutenção dele no organismo hospedeiro são pouco compreendidos. Entendemos que a detecção do vírus em sítios extragenitais poderá ajudar na compreensão da cadeia de infecção-disseminação-reinfecção pelo HPV no trato genital humano. Além disso, é evidente a importância de um rastreio adequado do vírus diante de diagnósticos clínicos, principalmente no período inicial da lesão, provendo, assim, um melhor prognóstico. Nossos resultados apontaram uma prevalência da infecção por HPV em lesões genitais de 87% (80/92) e nas amostras anais tal prevalência foi de 47,8% (44/92). Ressaltamos que nossa prevalência foi alta, mas estudamos indivíduos com lesões genitais clinicamente detectadas, aumentando, assim, o risco de infecção em outros sítios e confirmando a ocorrência da presença do HPV no hospedeiro, provavelmente decorrente de autoinoculação. Apesar da diferença entre o número de indivíduos dos sexos feminino e masculino em nosso estudo, não enco...

Predictors associated with and the prevalence of condylomata acuminata infection among people in Southern Brazil

“…Among the 3,447 patients seen, the prevalence of infection was higher in women (37.5%). Cordeiro et al 35 show that the number of genital cases is similar between both sexes. However, the group of sexually active women is more affected by infection, mainly due to the development of intraepithelial lesions and due to some biological aspects that make them susceptible to the virus, such as cervical immaturity, inadequate mucus production, and increased cervical ectopy 36 .…”

“…To date, approximately 200 genotypes of HPV have been identified; among them, 40 can infect the human anogenital tract 2 .Genotypes are categorized as low and high risk for developing malignant lesions. Fifteen types were classified as high risk (16,18,31,33,35,39,45,51,52,56,58,59, 68, 73, and 82), three were classified as likely to be high risk (26, 53, and 66), and 12 as low risk (6,11,40,42,43,44,54,61,70,72, 81, and CP6108) 3 . These anogenital HPVs are associated with a broad spectrum of diseases, such as cervical, vaginal, vulvar, anal, perianal, and colorectal cancer, as well as benign proliferative lesions such as anogenital warts or condylomata acuminate [4][5][6][7] .…”