Human papillomavirus positivity at three anatomical sites among transgender women in Central Brazil

Abstract

Background: Transgender women (TGW) are susceptible to the acquisition of sexually transmitted infections (STIs), including human papillomavirus (HPV). Nonetheless, the exact data for this population are scarce. We estimated HPV positivity at the anal, genital, and oral sites among TGW and also identified the related characteristics and behaviors that could be risk factors for HPV infection in a sample of TGW in Brazil. Furthermore, we characterized the site-specific HPV genotypes among those who were positive for HPV at these 3 sites. Methods:A cross-sectional study was conducted on TGW in Goiânia City (Central-Midwest region), Brazil, between April 2018 and August 2019. Respondent-driven sampling was applied for recruitment. Next, self-collected anal, genital, and oral samples were examined for HPV DNA using polymerase chain reaction (SPF-10 primer). Human papillomavirus genotypes were identified in 12 TGW. Results:In the TGW included in the study, the anal, genital, and oral HPV positivity values were 77.2% (95% confidence interval [CI], 67.3%-84.6%), 33.5% (95% CI, 26.1%-48.9%), and 10.9% (95% CI, 5.8%-17.0%), respectively. In addition, the majority of 12 participants who tested for HPV had multiple genotypes. HPV-52 was the most prevalent genotype identified at the anal (66.6%) and genital (40.0%) sites, whereas HPV-62 and HPV-66 were the most common at the oral site (25.0%).Conclusions: A high HPV positivity was observed among TGW. Therefore, additional epidemiological studies on HPV genotypes should generate health intervention information, including the prevention, diagnosis, and treatment of sexually transmitted infections.H uman papillomavirus (HPV) is the most prevalent sexually transmitted pathogen globally. High-risk HPV genotypes are responsible for almost all cases of cervical cancer and several other anogenital, head, and neck cancers. 1,2 Annually, HPV accounts for 60,000 and 570,000 cases of cancers (including anal, penile, cervical, vaginal, vulvar, and oropharyngeal cancers) in men and women worldwide, respectively. Despite the availability of vaccines against HPV since 2006, cancers related to this virus continue to be a significant cause of morbidity and mortality in several regions worldwide, particularly in less developed countries. 1,3 It is interesting that an estimated 0.69% of the adult population in Brazil identifies as transgender, which represents approximately 1,090,200 Brazilians. 4 Transgender women (TGW) are vulnerable to the acquisition of sexually transmitted infections (STIs), including HPV; nonetheless, the precise data for this population are scarce. [5][6][7] Previous studies reported that the prevalence of HPV infection in TGW ranged from 77.9% to 97.4% for the anal area, 88.3% for anogenital HPV, and 9.1% for the oral cavity. [6][7][8] Only one study had previously reported a prevalence of 77.9% for anal HPVamong TGW in Brazil and identified HPV-16 as the most frequent genotype. 6 Nonetheless, no studies in Brazil have investigated HPV at 3 sites (anal, genital, and oral...

Rationale and design of the Self-TI Study protocol: a cross-sectional human papillomavirus self-testing pilot study among transgender adults in England

“… 27 A Brazilian study of 268 transgender women reported a study prevalence to be 77% in anal, 34% in genital and 11% oral specimens. 28 Studies from both The Netherlands and Thailand estimate a 20% prevalence of neovaginal high-risk HPV, though these two studies had a high proportion of invalid HPV results, suggesting the true prevalence may be higher. 29 30 The oncogenic potential of persistent high-risk HPV infection in the vagina of TWNB is poorly understood and current guidelines do not recommend screening for this population.…”

Screening for High-Risk Human Papillomavirus Reveals HPV52 and HPV58 among Pediatric and Adult Patient Saliva Samples

“…In fact, new evidence has suggested that HPV52 and 58 may be of particular concern to oral health professionals and oral epidemiologists [ 22 , 23 , 24 ]. Although most of the research into these high-risk strains has focused on cervical infections, there is evidence that these strains may be involved in the oncogenesis and transformation of oral infections and may mediate or modulate oral carcinogenesis [ 25 , 26 , 27 ]. Although previous studies at this institution have explored the high-risk oral prevalence of HPV strains 16 and 18 among children and adults, only one study to date has assessed additional high-risk strains, such as HPV31, 33, and 35, and no study to date has evaluated the presence of HPV52 and HPV58 among this patient population [ 28 , 29 ].…”