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
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:Persistent human papillomavirus(HPV)infection is the necessary factor for cervical cancer.Human immunodeficiency virus(HIV)-positive women are a high-risk population for cervical cancer,but little is known ...Background:Persistent human papillomavirus(HPV)infection is the necessary factor for cervical cancer.Human immunodeficiency virus(HIV)-positive women are a high-risk population for cervical cancer,but little is known about persistent HPV infection among HIV-positive women in China.We aimed to investigate the persistence and incidence of infection with high-risk HPV(hrHPV)and associated factors among HIV-positive women in China.Method:Using a prospective observational study design,we collected data from 670 HIV-positive women in five counties of three provinces through interviews,medical record reviews,health examination,and laboratory tests at a baseline survey in 2015 and a follow-up survey in 2016.We tested HIVpositive women for hrHPV infection using the Cobas 4800 HPV test,and analyzed factors associated with persistence and new incidence of hrHPV infection using logistic regression.Results:After an average of 15 months at follow-up,the persistence and new incidence rates of hrHPV infection were 38.0%(46/121,95%CI:29.2%-46.8%)and 8.3%(35/420,95%CI:5.7%-11.1%),respectively.HIV-positive women in Yunnan and Guangxi were more likely to have persistent hrHPV infections than those in Xinjiang(aOR=3.18,95%CI:1.00-10.14,p=0.05;aOR=6.38,95%CI:2.29-17.77,p<0.001).Migrant women had a higher rate of new hrHPV incidence than local women(aOR=4.48,95%CI:1.65-12.15,p=0.003).HIV-positive women from Xinjiang were 6.5 times more likely to be newly infected with hrHPV than those from Yunnan(95%CI:2.40-17.60,p<0.001).HIV-positive women with HBV infection had a higher risk of being infected with hrHPV than those without HBV infection(aOR=3.48,95%CI:1.13-10.71,p=0.029).Conclusions:The persistence and new incidence rates of hrHPV infection among HIV-positive women were high and varied significantly between regions.HBV infection and being among the migrant population were associated with new hrHPV infection.展开更多
目的:观察膦甲酸钠联合重组人干扰素α2b治疗宫颈人乳头瘤病毒(HPV)持续感染的临床疗效。方法:选取宫颈HPV持续感染患者65例,按照随机数字表法分为治疗组(n=35)和对照组(n=30)。两组患者均给予重组人干扰素α2b栓10万IU,qod(睡前),治疗...目的:观察膦甲酸钠联合重组人干扰素α2b治疗宫颈人乳头瘤病毒(HPV)持续感染的临床疗效。方法:选取宫颈HPV持续感染患者65例,按照随机数字表法分为治疗组(n=35)和对照组(n=30)。两组患者均给予重组人干扰素α2b栓10万IU,qod(睡前),治疗时间为3个月;治疗组患者在此基础上给予膦甲酸钠氯化钠注射液250 m L,ivgtt,qd,治疗时间为14 d。观察两组患者根据HPV病毒载量判定的疗效、HPV转阴率、宫颈炎评分、根据宫颈炎评分改善率判定的疗效及不良反应发生情况。结果:治疗组患者根据HPV病毒载量判定的总有效率(94.29%)明显高于对照组(76.67%),差异有统计学意义(P<0.05);治疗组患者HPV转阴率(77.14%)明显高于对照组(36.67%),差异有统计学意义(P<0.05)。两组患者宫颈炎评分均较治疗前明显降低,且治疗组[(1.49±0.70)分]明显低于对照组[(1.97±0.89)分],差异均有统计学意义(P<0.05);治疗组患者根据宫颈炎评分改善率判定的总有效率(88.57%)明显高于对照组(73.33%),差异有统计学意义(P<0.05)。两组患者治疗过程中均未见不良反应发生。结论:膦甲酸钠联合重组人干扰素α2b能有效抑制HPV病毒复制、提高HPV转阴率、缓解宫颈炎症状,且安全性较高。展开更多
Human papillomavirus(HPV) genital infection is a very common sexual transmitted disease.Mostly,the infection is transient and asymptomatic.The induction of effective immune responses usually allows the infection to be...Human papillomavirus(HPV) genital infection is a very common sexual transmitted disease.Mostly,the infection is transient and asymptomatic.The induction of effective immune responses usually allows the infection to be spontaneously cured.However,the infection sometimes can be responsible for an intraepithelial lesion,which may progress to be cervical cancer.Cervical cancer is one of the most common neoplastic diseases affecting women.It is clear that carcinogenic HPV infection is the necessary process for the development of cervical cancer.HPV infection is very frequent in young women aged less than 25 years and viral clearance lasts for 8 months in average.This clearance is the consequence of host immunity intervention,which leads to spontaneous regression of infection and the overwhelming majority of low-grade squamous intraepithelial lesions(more than 80% within a period of 2 years).The major factor,which permits the progression to high grade squamous intraepithelial lesions and invasive cervical cancer,is the persistent feature of HPV infection.HPV infection is usually transient,but several factors were identified as host factors(genetic,immunodepression,oral contraception and smoking) and viral factors(genotype,variants,viral load and integration) to increase the persistence.Cervical cancer is clearly the first virus-induced solid tumor discovered in human.Furthermore,it represents a woman death cause that can be avoided.展开更多
目的探讨高危型人乳头瘤（high risk human papillomavirus,HR-HPV）感染后病毒自然清除和持续感染的相关因素。方法将2011-01-2013-10在沧州市中心医院妇科门诊就诊的1 302例不明确意义的不典型鳞状上皮细胞（ASCUS）及其以上级别的妇...目的探讨高危型人乳头瘤（high risk human papillomavirus,HR-HPV）感染后病毒自然清除和持续感染的相关因素。方法将2011-01-2013-10在沧州市中心医院妇科门诊就诊的1 302例不明确意义的不典型鳞状上皮细胞（ASCUS）及其以上级别的妇女,进行阴道镜检查及HPV检测,其中784例高危HPV阳性,完成随访603例,观察高危HPV感染患者病毒自然清除,分析年龄、病毒基因分型、单一及多重感染与病毒自然消除及持续性感染的关系。结果不同高危HPV感染的持续性感染率不同,差异具有统计学意义（χ^2=38.617,P〈0.05）;多重高危HPV感染与单一高危HPV感染相比,持续感染率高,差异有统计学意义（χ^2=36.902,P〈0.05）;持续感染率位于前3位分别是HPV16、HPV18、HPV31。603例HR-HPV感染患者平均病毒清除时间为13.695个月,中位消退时间9个月。不同亚型HPV自然清除时间不同,清除时间最长的前3位分别是HPV16、HPV56、HPV35,清除时间最短的是HPV59、HPV68。多重高危感染者病毒清除时间延长（χ^2=16.600,P〈0.05）。不同年龄组HR-HPV清除的平均时间及中位消退时间比较,差异无统计学意义（P〉0.05）。结论高危HPV感染后病毒自然清除和持续感染受型别、单一或多重感染影响。相比于单一高危HPV感染,多重高危HPV持续感染率高,感染病毒自然清除时间长。展开更多
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.
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:Persistent human papillomavirus(HPV)infection is the necessary factor for cervical cancer.Human immunodeficiency virus(HIV)-positive women are a high-risk population for cervical cancer,but little is known about persistent HPV infection among HIV-positive women in China.We aimed to investigate the persistence and incidence of infection with high-risk HPV(hrHPV)and associated factors among HIV-positive women in China.Method:Using a prospective observational study design,we collected data from 670 HIV-positive women in five counties of three provinces through interviews,medical record reviews,health examination,and laboratory tests at a baseline survey in 2015 and a follow-up survey in 2016.We tested HIVpositive women for hrHPV infection using the Cobas 4800 HPV test,and analyzed factors associated with persistence and new incidence of hrHPV infection using logistic regression.Results:After an average of 15 months at follow-up,the persistence and new incidence rates of hrHPV infection were 38.0%(46/121,95%CI:29.2%-46.8%)and 8.3%(35/420,95%CI:5.7%-11.1%),respectively.HIV-positive women in Yunnan and Guangxi were more likely to have persistent hrHPV infections than those in Xinjiang(aOR=3.18,95%CI:1.00-10.14,p=0.05;aOR=6.38,95%CI:2.29-17.77,p<0.001).Migrant women had a higher rate of new hrHPV incidence than local women(aOR=4.48,95%CI:1.65-12.15,p=0.003).HIV-positive women from Xinjiang were 6.5 times more likely to be newly infected with hrHPV than those from Yunnan(95%CI:2.40-17.60,p<0.001).HIV-positive women with HBV infection had a higher risk of being infected with hrHPV than those without HBV infection(aOR=3.48,95%CI:1.13-10.71,p=0.029).Conclusions:The persistence and new incidence rates of hrHPV infection among HIV-positive women were high and varied significantly between regions.HBV infection and being among the migrant population were associated with new hrHPV infection.
文摘目的:观察膦甲酸钠联合重组人干扰素α2b治疗宫颈人乳头瘤病毒(HPV)持续感染的临床疗效。方法:选取宫颈HPV持续感染患者65例,按照随机数字表法分为治疗组(n=35)和对照组(n=30)。两组患者均给予重组人干扰素α2b栓10万IU,qod(睡前),治疗时间为3个月;治疗组患者在此基础上给予膦甲酸钠氯化钠注射液250 m L,ivgtt,qd,治疗时间为14 d。观察两组患者根据HPV病毒载量判定的疗效、HPV转阴率、宫颈炎评分、根据宫颈炎评分改善率判定的疗效及不良反应发生情况。结果:治疗组患者根据HPV病毒载量判定的总有效率(94.29%)明显高于对照组(76.67%),差异有统计学意义(P<0.05);治疗组患者HPV转阴率(77.14%)明显高于对照组(36.67%),差异有统计学意义(P<0.05)。两组患者宫颈炎评分均较治疗前明显降低,且治疗组[(1.49±0.70)分]明显低于对照组[(1.97±0.89)分],差异均有统计学意义(P<0.05);治疗组患者根据宫颈炎评分改善率判定的总有效率(88.57%)明显高于对照组(73.33%),差异有统计学意义(P<0.05)。两组患者治疗过程中均未见不良反应发生。结论:膦甲酸钠联合重组人干扰素α2b能有效抑制HPV病毒复制、提高HPV转阴率、缓解宫颈炎症状,且安全性较高。
文摘Human papillomavirus(HPV) genital infection is a very common sexual transmitted disease.Mostly,the infection is transient and asymptomatic.The induction of effective immune responses usually allows the infection to be spontaneously cured.However,the infection sometimes can be responsible for an intraepithelial lesion,which may progress to be cervical cancer.Cervical cancer is one of the most common neoplastic diseases affecting women.It is clear that carcinogenic HPV infection is the necessary process for the development of cervical cancer.HPV infection is very frequent in young women aged less than 25 years and viral clearance lasts for 8 months in average.This clearance is the consequence of host immunity intervention,which leads to spontaneous regression of infection and the overwhelming majority of low-grade squamous intraepithelial lesions(more than 80% within a period of 2 years).The major factor,which permits the progression to high grade squamous intraepithelial lesions and invasive cervical cancer,is the persistent feature of HPV infection.HPV infection is usually transient,but several factors were identified as host factors(genetic,immunodepression,oral contraception and smoking) and viral factors(genotype,variants,viral load and integration) to increase the persistence.Cervical cancer is clearly the first virus-induced solid tumor discovered in human.Furthermore,it represents a woman death cause that can be avoided.
文摘目的探讨高危型人乳头瘤（high risk human papillomavirus,HR-HPV）感染后病毒自然清除和持续感染的相关因素。方法将2011-01-2013-10在沧州市中心医院妇科门诊就诊的1 302例不明确意义的不典型鳞状上皮细胞（ASCUS）及其以上级别的妇女,进行阴道镜检查及HPV检测,其中784例高危HPV阳性,完成随访603例,观察高危HPV感染患者病毒自然清除,分析年龄、病毒基因分型、单一及多重感染与病毒自然消除及持续性感染的关系。结果不同高危HPV感染的持续性感染率不同,差异具有统计学意义（χ^2=38.617,P〈0.05）;多重高危HPV感染与单一高危HPV感染相比,持续感染率高,差异有统计学意义（χ^2=36.902,P〈0.05）;持续感染率位于前3位分别是HPV16、HPV18、HPV31。603例HR-HPV感染患者平均病毒清除时间为13.695个月,中位消退时间9个月。不同亚型HPV自然清除时间不同,清除时间最长的前3位分别是HPV16、HPV56、HPV35,清除时间最短的是HPV59、HPV68。多重高危感染者病毒清除时间延长（χ^2=16.600,P〈0.05）。不同年龄组HR-HPV清除的平均时间及中位消退时间比较,差异无统计学意义（P〉0.05）。结论高危HPV感染后病毒自然清除和持续感染受型别、单一或多重感染影响。相比于单一高危HPV感染,多重高危HPV持续感染率高,感染病毒自然清除时间长。
