Surveillance of Human Papilloma Virus Infection and Cervical Cancer in Kidney Transplant Recipients: Preliminary Data

Veroux, Massimiliano; Corona, Daniela; Scalia, Guido; Garozzo, V.; Gagliano, M.; Giuffrida, G; Costanzo, Carmela Maria; Giaquinta, Alessia; Palermo, I.; Zappalà, Dario; Tallarita, Tiziano; Zerbo, D.; Russo, R; Cappellani, Alessandro; Franchina, Concetta; Scriffignano, V.; Veroux, Pierfrancesco

doi:10.1016/j.transproceed.2009.03.015

Cited by 41 publications

(34 citation statements)

References 8 publications

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“…The incidence of HR-HPV infection as well as abnormal Pap smear results is reported to be quite high in recipients, reaching 59% according to some studies [14-16]). However, other data suggest a low prevalence of HPV infections in kidney graft recipients, similar to that of the general population [17].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of high-risk human papillomavirus cervical infection in female kidney graft recipients: an observational study

Pietrzak

Mazanowska

Ekiel

et al. 2012

Virol J

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BackgroundImmunosuppressive therapy protects the transplanted organ but predisposes the recipient to chronic infections and malignancies. Transplant patients are at risk of cervical intraepithelial neoplasia (CIN) and cervical cancer resulting from an impaired immune response in the case of primary infection or of reactivation of a latent infection with human papillomavirus of high oncogenic potential (HR-HPV).MethodsThe aim of this study was to assess the prevalence of HR-HPV cervical infections and CIN in 60 female kidney graft recipients of reproductive age in comparison to that in healthy controls. Cervical swabs were analyzed for the presence of HR-HPV DNA. HR-HPV-positive women remained under strict observation and were re-examined after 24 months for the presence of transforming HR-HPV infection by testing for HR-HPV E6/E7 mRNA. All the HR-HPV-positive patients were scheduled for further diagnostic tests including exfoliative cytology, colposcopy and cervical biopsy.ResultsThe prevalence of HR-HPV did not differ significantly between the study group and the healthy controls (18% vs 25%, p = 0.37). There was no correlation between HR-HPV presence and the immunosuppresive regimen, underlying disease, graft function or time interval from transplantation. A higher prevalence of HR-HPV was observed in females who had had ≥2 sexual partners in the past. Among HR-HPV-positive patients, two cases of CIN2+ were diagnosed in each group. In the course of follow-up, transforming HR-HPV infections were detected in two kidney recipients and in one healthy female. Histologic examination confirmed another two cases of CIN2+ developing in the cervical canal.ConclusionsFemale kidney graft recipients of reproductive age are as exposed to HR-HPV infection as are healthy individuals. Tests detecting the presence of HR-HPV E6/E7 mRNA offer a novel diagnostic opportunity in those patients, especially in those cases where lesions have developed in the cervical canal.

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Section: Discussionmentioning

confidence: 99%

Prevalence of high-risk human papillomavirus cervical infection in female kidney graft recipients: an observational study

Pietrzak

Mazanowska

Ekiel

et al. 2012

Virol J

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“…The prevalence of HPV disease in immunosuppressed patients is thought to result from the reactivation of latent infections (1–8), and as reviewed by Gravitt, there is growing evidence that HPV latency and the persistence of particular HPV types (even in the absence of apparent disease) constitutes an important risk factor in the development of cervical neoplasia (9, 10). The ability of papillomaviruses to persist long-term in a latent state (i.e., in the absence of disease) has been shown most convincingly in animal models and has led to the suggestion that latency may be a general consequence of immune-mediated regression (11–14).…”

Section: Textmentioning

confidence: 99%

Immunosuppression Facilitates the Reactivation of Latent Papillomavirus Infections

Maglennon

McIntosh²,

Doorbar

2014

J Virol

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At mucosal sites, papillomavirus genomes can persist in the epithelial basal layer following immune-mediated regression. Subsequent T-cell depletion stimulates a 3- to 5-log increase in the viral copy number, to levels associated with productive infection. Reappearance of microlesions was rare within the short time frame of our experiments but was observed in one instance. Our studies provide direct evidence that immunosuppression can trigger the reactivation of latent papillomavirus genomes, as previously proposed in humans.

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“…32 Whether newly acquired or reactivated latent infection, the incidence of mucosal HPV infections can range between 22% and 63%. 32,[59][60][61][62][63][64] RTRs present with a higher rate of multifocal HPV infections than the general population and hrHPV DNA is detected in a high percentage of these infections. Veroux and colleagues 64 detected HPV DNA in the cervicovaginal brushings of 62.8% of RTRs, and 59% of these women were positive for the hrHPV genotype.…”

Section: Cervical Cancer Screening In Other Immunocompromised Women Omentioning

confidence: 99%

Cervical Cancer Screening in Immunocompromised Women

Nguyen

Flowers

2013

Obstetrics and Gynecology Clinics of North America

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Surveillance of Human Papilloma Virus Infection and Cervical Cancer in Kidney Transplant Recipients: Preliminary Data

Cited by 41 publications

References 8 publications

Prevalence of high-risk human papillomavirus cervical infection in female kidney graft recipients: an observational study

Prevalence of high-risk human papillomavirus cervical infection in female kidney graft recipients: an observational study

Immunosuppression Facilitates the Reactivation of Latent Papillomavirus Infections

Cervical Cancer Screening in Immunocompromised Women

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