Papilomavírus Humano (HPV) e sua associação entre lesões cervical e anal em mulheres<br>Human papillomavirus (HPV) and its association between cervical and anal injuries in women<br>doi:10.12662/2317-3076jhbs.v4i3.860.p174-180.2016

Abstract

Introdução: Entre as doenças virais sexualmente transmissíveis, a infecção pelo Papilomavírus Humano (HPV) configura-se como a mais comum, e sua incidência vem aumentando acentuadamente nos últimos trinta anos. A infecção anal por subtipos específicos do HPV predispõe o indivíduo à neoplasia intraepitelial anal, que pode evoluir para o câncer de forma similar ao colo uterino. Portanto, o objetivo deste estudo foi avaliar a associação tipo-específica entre infecções anais e cervicais, assim como os aspectos citopatológicos das lesões anais pelo vírus HPV em mulheres de São Luís, Maranhão. Métodos: Estudo analítico transversal com 27 mulheres atendidas no Centro de Pesquisa Clínica da UFMA, entre agosto de 2012 e julho de 2015, mediante entrevista e realização de exames complementares. Resultados: As mulheres tinham, em média, 32 anos. Em relação ao resultado do PCR, 77,7% das pacientes apresentaram resultado positivo para HPV anal, sendo o subtipo 16 o mais frequente (47,6%). Na região cervical, 88,8% apresentaram PCR positivo, sendo o mais comum o subtipo 16 (47,8%). A coinfecção anal e cervical pelo HPV foi observada em 74% das mulheres. 93,3% dos resultados de citologia anal não apresentaram alteração, assim como 72,2% das anuscopias realizadas. Conclusões: A infecção cervical por HPV é um fator sugestivo de risco para o desenvolvimento da infecção na região anal.

Prevalence and Genotype Diversity of Anal HPV Infection Among Hiv-Infected Women in Belem, Para, North of Brazil

“…The present study reported for the first time the prevalence and diversity of HPV in anal specimens in HIV-infected women assisted in Belém, Pará, Brazil. Interestingly, we found a low prevalence of anal HPV infection (26.8%) in the examined women, which proved to be much lower than previously reports of anal specimens evaluated in other cities of Brazil, such as Santos [14], Manaus [15], and São Luiz do Maranhão [16], which showed a prevalence of 63%, 79% and 77.7%, respectively. The research of HPV in anal specimen of women infected with HIV-1 is of great importance as the HIV / HPV co-infection may be considered a risk factor for the development of pre-neoplastic lesions in both uterine cervix [17] and the anus [18].…”

“…We noticed that most of the participants co-infected with HIV and HPV have had sexual initiation between 10 and 15 years of age (55.2%), similar to that observed in Pernambuco [19]. However, the prevalence of HPV infection was lower than that observed in cervical samples in other cities of Brazil, such as 73.2% [20] and 78.8% [21] in Minas Gerais and 77.7% in Maranhão [16]. We expected a greater prevalence of HIV and HPV co-infection, similar to that found in the city of Manaus (79%), Amazonas' capital, another State of the northern region of Brazil [7].…”

“…We could address possibly some reasons, one of them could be the methodology employed in the present study, the second is the fact that the majority of the women enrolled in the study related a non risk behavior since they reported a low number of sexual partners during their life. Even though, many others studies have described a high prevalence of coinfection HPV/HIV in women with low numbers of partners [8,16], which highlights the fact that the risk of HPV infection may be independent of the number of sexual partners, i.e., the chance of acquiring the infection does not seem to increase in a directly proportional ratio to the number of partners during their lifetime. In this study, we identified 12 species of HPV and this number may be a reflection of the low prevalence of infection in the population studied and not the sample size, bearing in mind that other studies in Brazil have reported a wide variety of types of HPV in a sample similar to ours, such as in Rio de Janeiro [22], the Espírito Santo [23] and Maranhão [16].…”

“…Even though, many others studies have described a high prevalence of coinfection HPV/HIV in women with low numbers of partners [8,16], which highlights the fact that the risk of HPV infection may be independent of the number of sexual partners, i.e., the chance of acquiring the infection does not seem to increase in a directly proportional ratio to the number of partners during their lifetime. In this study, we identified 12 species of HPV and this number may be a reflection of the low prevalence of infection in the population studied and not the sample size, bearing in mind that other studies in Brazil have reported a wide variety of types of HPV in a sample similar to ours, such as in Rio de Janeiro [22], the Espírito Santo [23] and Maranhão [16]. An interesting finding in our study was the low prevalence of HPV of high oncogenic risk (27.6%), and the majority of infections found were caused by low risk HPV (72.4%).…”

“…HPV infection was detected in 29 (26,8%). Twelve different type s were found (HPV- 16,58,59,6,11,53,61,62,66,70,71,102) and low risk types were present in 72.4% of samples. HPV infection was positively correlated wit h CD4 + T lymphocytes counts.…”