Human papillomaviruses (HPVs) are well known for being linked to the development of cervical cancers, most of them being caused by the high-risk (HR) oncogenic genotypes, mainly 16 and 18. The efficacy of 2LPAPI<su...Human papillomaviruses (HPVs) are well known for being linked to the development of cervical cancers, most of them being caused by the high-risk (HR) oncogenic genotypes, mainly 16 and 18. The efficacy of 2LPAPI<sup><sup>®</sup> </sup>(Labo’Life), a micro-immunotherapy homeopathic drug, has been evaluated in HR-HPV infected women (n = 18), in a private gynecology practice, by comparing them to an untreated control group (n = 18). Patients were 20 to 45 years old and had cytology with Atypical Squamous Cells of Undetermined Significance (ASCUS) or Low grade Superficial Intra Lesions/ Cervical Intraepithelial Neoplasia Grade I (LSIL/CINI). Patients freely chose to be treated with the drug or not. Those deciding not to take the drug remained untreated and were followed as a control group. The drug was taken at the regimen of one capsule per day during 6 months. HR-HPV and cytology were evaluated at 6 and 12 months. After 12 months, HR-HPV was cleared in 78% of the patients taking the drug versus 44% in those not taking it (p = 0.086). In patients over 25 years, HR-HPV clearance in the treated group was significantly higher (81.3%) than in the control group (20%) (p = 0.004). The difference in the regression of the lesion grades almost reached statistical significance (p = 0.053). This follow-up confirms that the micro-immunotherapy drug 2LPAPI<sup><sup>®</sup></sup> is a safe and effective therapeutic approach to treat HR-HPV cervical lesions in women over 25 years.展开更多
Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus ...Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus (HPV) infection is the main underlying cause of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN). Objective: The aim of the study was to identify the subtypes of high-risk HPV infection among women with the colposcopic diagnosis of cervical intraepithelial neoplasia in Bangladesh. Methods: This cross-sectional observational study was conducted in the colposcopy clinic of Dhaka Medical College Hospital over a six-month period. A total of 100 participants were enrolled. Married women, between 30 - 60 years of age with colposcopically diagnosed cervical intra epithelial neoplasia were enrolled. Women with chronic illness, pregnancy, and women unable to consent were excluded from this study. After counselling, colposcopically directed punch biopsies were taken from each CIN case concurrently with high-risk HPV testing by polymerase chain reaction (PCR). Results: The mean age of the patients was 38.69 (SD ±7.76) years. CIN 1 was diagnosed in 57% of participants, while 24% had CIN II and 19% had CIN III lesions. High-risk HPV was present in 52 patients. HPV 16 was the most common identified in 28 (53.84%) and HPV 18 was the second most common with 20 (38.46%) either singly or in combination with other high-risk subtypes. The other HPV strains, HPV 31, 33, 35, 52, 56 and 58, were also detected either as mono or co-infections. Out of the 52 HPV positive cases, 29 (55.8%) had mono infection and 23 (44.2%) had co-infection with several subtypes. The highest incidence (50%) of oncogenic HPV infections was present among women aged 35 - 45 years. Risk factors associated with HPV positive cases were high parity (P 0.05), early age at marriage (P = 0.754) and early age of first child. Conclusion: This study identified a high prevalence of HPV 16 and 18 genotypes. HPV vaccination with the current 9-valent HPV vaccine, which contains HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Will be an effective public health measure to eradicate cervical cancer in Bangladesh.展开更多
Introduction:HIV epidemics in hard-to-reach high-risk subpopulations are often discovered years after epidemic emergence in settings with poor surveillance infrastructure.Using hypothesis-generation modeling,we aimed ...Introduction:HIV epidemics in hard-to-reach high-risk subpopulations are often discovered years after epidemic emergence in settings with poor surveillance infrastructure.Using hypothesis-generation modeling,we aimed to investigate and demonstrate the concept of using routine HIV testing data to identify and characterize hidden epidemics in high-risk subpopulations.We also compared this approach to surveillance based on AIDS case notifications.Methods:A deterministic mathematical model was developed to simulate an emerging HIV epidemic in a high-risk subpopulation.A stochastic Monte Carlo simulation was implemented on the total population to simulate the sampling process of generating routine HIV testing data.Epidemiological measures were estimated on the simulated epidemic and on the generated testing sample.Sensitivity analyses were conducted on the results.Results:In the simulated epidemic,HIV prevalence saturated at 32%in the high-risk subpopulation and at 0.33%in the total population.The epidemic started its emergingepidemic phase 28 years after infection introduction,and saturated 67 years after infection introduction.In the simulated HIV testing sample,a significant time trend in prevalence was identified,and the generated metrics of epidemic emergence and saturation were similar to those of the simulated epidemic.The epidemic was identified 4.0(95%CI 3.4e4.6)years after epidemic emergence using routine HIV testing,but 29.7(95%CI 15.8 e52.1)years after emergence using AIDS case notifications.In the sensitivity analyses,none of the sampling biases affected the conclusion of an emerging epidemic,but some affected the estimated epidemic growth rate.Conclusions:Routine HIV testing data provides a tool to identify and characterize hidden and emerging epidemics in high-risk subpopulations.This approach can be specially useful in resource-limited settings,and can be applied alone,or along with other complementary data,to provide a meaningful characterization of emerging but hidden epidemics.展开更多
文摘Human papillomaviruses (HPVs) are well known for being linked to the development of cervical cancers, most of them being caused by the high-risk (HR) oncogenic genotypes, mainly 16 and 18. The efficacy of 2LPAPI<sup><sup>®</sup> </sup>(Labo’Life), a micro-immunotherapy homeopathic drug, has been evaluated in HR-HPV infected women (n = 18), in a private gynecology practice, by comparing them to an untreated control group (n = 18). Patients were 20 to 45 years old and had cytology with Atypical Squamous Cells of Undetermined Significance (ASCUS) or Low grade Superficial Intra Lesions/ Cervical Intraepithelial Neoplasia Grade I (LSIL/CINI). Patients freely chose to be treated with the drug or not. Those deciding not to take the drug remained untreated and were followed as a control group. The drug was taken at the regimen of one capsule per day during 6 months. HR-HPV and cytology were evaluated at 6 and 12 months. After 12 months, HR-HPV was cleared in 78% of the patients taking the drug versus 44% in those not taking it (p = 0.086). In patients over 25 years, HR-HPV clearance in the treated group was significantly higher (81.3%) than in the control group (20%) (p = 0.004). The difference in the regression of the lesion grades almost reached statistical significance (p = 0.053). This follow-up confirms that the micro-immunotherapy drug 2LPAPI<sup><sup>®</sup></sup> is a safe and effective therapeutic approach to treat HR-HPV cervical lesions in women over 25 years.
文摘Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus (HPV) infection is the main underlying cause of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN). Objective: The aim of the study was to identify the subtypes of high-risk HPV infection among women with the colposcopic diagnosis of cervical intraepithelial neoplasia in Bangladesh. Methods: This cross-sectional observational study was conducted in the colposcopy clinic of Dhaka Medical College Hospital over a six-month period. A total of 100 participants were enrolled. Married women, between 30 - 60 years of age with colposcopically diagnosed cervical intra epithelial neoplasia were enrolled. Women with chronic illness, pregnancy, and women unable to consent were excluded from this study. After counselling, colposcopically directed punch biopsies were taken from each CIN case concurrently with high-risk HPV testing by polymerase chain reaction (PCR). Results: The mean age of the patients was 38.69 (SD ±7.76) years. CIN 1 was diagnosed in 57% of participants, while 24% had CIN II and 19% had CIN III lesions. High-risk HPV was present in 52 patients. HPV 16 was the most common identified in 28 (53.84%) and HPV 18 was the second most common with 20 (38.46%) either singly or in combination with other high-risk subtypes. The other HPV strains, HPV 31, 33, 35, 52, 56 and 58, were also detected either as mono or co-infections. Out of the 52 HPV positive cases, 29 (55.8%) had mono infection and 23 (44.2%) had co-infection with several subtypes. The highest incidence (50%) of oncogenic HPV infections was present among women aged 35 - 45 years. Risk factors associated with HPV positive cases were high parity (P 0.05), early age at marriage (P = 0.754) and early age of first child. Conclusion: This study identified a high prevalence of HPV 16 and 18 genotypes. HPV vaccination with the current 9-valent HPV vaccine, which contains HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Will be an effective public health measure to eradicate cervical cancer in Bangladesh.
基金The Qatar National Research Fund(NPRP 9-040-3-008).
文摘Introduction:HIV epidemics in hard-to-reach high-risk subpopulations are often discovered years after epidemic emergence in settings with poor surveillance infrastructure.Using hypothesis-generation modeling,we aimed to investigate and demonstrate the concept of using routine HIV testing data to identify and characterize hidden epidemics in high-risk subpopulations.We also compared this approach to surveillance based on AIDS case notifications.Methods:A deterministic mathematical model was developed to simulate an emerging HIV epidemic in a high-risk subpopulation.A stochastic Monte Carlo simulation was implemented on the total population to simulate the sampling process of generating routine HIV testing data.Epidemiological measures were estimated on the simulated epidemic and on the generated testing sample.Sensitivity analyses were conducted on the results.Results:In the simulated epidemic,HIV prevalence saturated at 32%in the high-risk subpopulation and at 0.33%in the total population.The epidemic started its emergingepidemic phase 28 years after infection introduction,and saturated 67 years after infection introduction.In the simulated HIV testing sample,a significant time trend in prevalence was identified,and the generated metrics of epidemic emergence and saturation were similar to those of the simulated epidemic.The epidemic was identified 4.0(95%CI 3.4e4.6)years after epidemic emergence using routine HIV testing,but 29.7(95%CI 15.8 e52.1)years after emergence using AIDS case notifications.In the sensitivity analyses,none of the sampling biases affected the conclusion of an emerging epidemic,but some affected the estimated epidemic growth rate.Conclusions:Routine HIV testing data provides a tool to identify and characterize hidden and emerging epidemics in high-risk subpopulations.This approach can be specially useful in resource-limited settings,and can be applied alone,or along with other complementary data,to provide a meaningful characterization of emerging but hidden epidemics.
