scholarly journals Advances in Targeting HPV Infection as Potential Alternative Prophylactic Means

2021 ◽  
Vol 22 (4) ◽  
pp. 2201
Author(s):  
Sinead Carse ◽  
Martina Bergant ◽  
Georgia Schäfer
Keyword(s):  
Cervical Cancer ◽  
Current Knowledge ◽  
Disease Onset ◽  
Target Population ◽  
Hpv Infection ◽  
Cold Chain ◽  
Cultural Issues ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cervical Cancer Risk

Infection by oncogenic human papillomavirus (HPV) is the primary cause of cervical cancer and other anogenital cancers. The majority of cervical cancer cases occur in low- and middle- income countries (LMIC). Concurrent infection with Human Immunodeficiency Virus (HIV) further increases the risk of HPV infection and exacerbates disease onset and progression. Highly effective prophylactic vaccines do exist to combat HPV infection with the most common oncogenic types, but the accessibility to these in LMIC is severely limited due to cost, difficulties in accessing the target population, cultural issues, and maintenance of a cold chain. Alternative preventive measures against HPV infection that are more accessible and affordable are therefore also needed to control cervical cancer risk. There are several efforts in identifying such alternative prophylactics which target key molecules involved in early HPV infection events. This review summarizes the current knowledge of the initial steps in HPV infection, from host cell-surface engagement to cellular trafficking of the viral genome before arrival in the nucleus. The key molecules that can be potentially targeted are highlighted, and a discussion on their applicability as alternative preventive means against HPV infection, with a focus on LMIC, is presented.

scholarly journals Microbiome and Cervical Cancer

Pathobiology ◽  
2020 ◽  
pp. 1-11
Author(s):  
Cristina Paula Castanheira ◽  
Mayara Luciana Sallas ◽  
Rafaella Almeida Lima Nunes ◽  
Noely Paula Cristina Lorenzi ◽  
Lara Termini
Keyword(s):  
Cervical Cancer ◽  
Genital Tract ◽  
Current Knowledge ◽  
Disease Onset ◽  
Female Genital Tract ◽  
Hpv Infection ◽  
Vaginal Microbiome ◽  
Associated Lesions ◽  
Cervical Disease ◽  
Female Genital

Persistent infection with some types of mucosal human papillomavirus (HPV) is the etiological factor for the development of cervical cancer and its precursor lesions. Besides, several cofactors are known to play a role in cervical disease onset and progression either by favoring or by preventing HPV infection and persistence. The microbiome of a healthy female genital tract is characterized by the presence of 1 or few varieties of lactobacilli. However, high-throughput studies addressing the bacterial diversity and abundance in the female genital tract have shown that several factors, including hormonal levels, hygiene habits, and sexually transmitted diseases may disrupt the natural balance, favoring the outgrowth of some groups of bacteria, which in turn may favor some pathological states. Recently, the vaginal microbiome has emerged as a new variable that could greatly influence the natural history of HPV infections and their clinical impact. In this context, changes in the vaginal microbiome have been detected in women infected with HPV and women with HPV-associated lesions and cancer. However, the role of specific bacteria groups in the development/progression or prevention/regression of HPV-associated pathologies is not well understood. In this review we summarize the current knowledge concerning changes in vaginal microbiome and cervical disease. We discuss the potential functional interplay between specific bacterial groups and HPV infection outcomes.

scholarly journals Ordinal losses for classification of cervical cancer risk

2021 ◽  
Vol 7 ◽  
pp. e457
Author(s):  
Tomé Albuquerque ◽  
Ricardo Cruz ◽  
Jaime S. Cardoso
Keyword(s):  
Cervical Cancer ◽  
Cancer Risk ◽  
Pap Smear ◽  
Screening Tests ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cervical Cancer Risk ◽  
Normal Current ◽  
Non Parametric

Cervical cancer is the fourth leading cause of cancer-related deaths in women, especially in low to middle-income countries. Despite the outburst of recent scientific advances, there is no totally effective treatment, especially when diagnosed in an advanced stage. Screening tests, such as cytology or colposcopy, have been responsible for a substantial decrease in cervical cancer deaths. Cervical cancer automatic screening via Pap smear is a highly valuable cell imaging-based detection tool, where cells must be classified as being within one of a multitude of ordinal classes, ranging from abnormal to normal. Current approaches to ordinal inference for neural networks are found to not sufficiently take advantage of the ordinal problem or to be too uncompromising. A non-parametric ordinal loss for neuronal networks is proposed that promotes the output probabilities to follow a unimodal distribution. This is done by imposing a set of different constraints over all pairs of consecutive labels which allows for a more flexible decision boundary relative to approaches from the literature. Our proposed loss is contrasted against other methods from the literature by using a plethora of deep architectures. A first conclusion is the benefit of using non-parametric ordinal losses against parametric losses in cervical cancer risk prediction. Additionally, the proposed loss is found to be the top-performer in several cases. The best performing model scores an accuracy of 75.6% for seven classes and 81.3% for four classes.

Human Papillomavirus Selected Properties and Related Cervical Cancer Prevention Issues

2020 ◽  
Vol 26 (18) ◽  
pp. 2073-2086
Author(s):  
Saule Balmagambetova ◽  
Andrea Tinelli ◽  
Ospan A. Mynbaev ◽  
Arip Koyshybaev ◽  
Olzhas Urazayev ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Screening Program ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Point Of View ◽  
Prevention Strategies ◽  
Middle Income ◽  
Screening Programs

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

scholarly journals Can thermostable vaccines help address cold-chain challenges? Results from stakeholder interviews in six low- and middle-income countries

Vaccine ◽  
2016 ◽  
Vol 34 (7) ◽  
pp. 899-904 ◽  
Author(s):  
Debra D. Kristensen ◽  
Tina Lorenson ◽  
Kate Bartholomew ◽  
Shirley Villadiego
Keyword(s):  
Cold Chain ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

'Have a Pap smear!' – doctors, their clients, and opportunistic cervical cancer screening

2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Cervical Screening ◽  
Pap Test ◽  
Community Members ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Incidence

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.

scholarly journals Development of HPV 16/18 E6 oncoprotein paper-based nanokit for enhanced detection of HPV 16/18 E6 oncoprotein in cervical cancer screening

2020 ◽  
Author(s):  
Lucy Muthoni Mwai ◽  
Mutinda C. Kyama ◽  
Caroline W. Ngugi ◽  
Edwin Walong
Keyword(s):  
Cervical Cancer ◽  
Gold Nanoparticles ◽  
Cancer Screening ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Intraepithelial Neoplasia ◽  
Hpv 16 ◽  
Middle Income ◽  
Middle Income Countries ◽  
E6 Oncoprotein

AbstractCervical cancer caused mainly by high risk human papillomavirus (HPV) 16 and 18 strains is the second most prevalent cancer of women in Kenya. It is often diagnosed late when treatment is difficult due to very low percentage of women attending screening thus, mortalities remain high. The most available tests in low-and-middle-income countries (LMICs) have relatively low specificity, low sensitivity, require a laboratory setting and huge technical and financial support not readily available. HPV 16/18 E6 oncoprotein has been identified as a potential biomarker in a more specific early diagnosis of cervical cancer. This retrospective cross-sectional study developed a paper-based nanokit with enhanced detection of HPV 16/18 E6 oncoprotein for cervical cancer screening. The HRP labelled antibodies HPV 16 E6/18 E6-HRP (CP15) passively conjugated to citrate stabilized 20nm gold nanoparticles were evaluated for immune sensing mechanism using a recombinant viral HPV E6 protein. The diagnostic accuracy was evaluated using 50 tissue lysates from formalin fixed paraffin embedded cervical biopsy, including control (n=10), Mild Dysplasia (n=10), Cervical intraepithelial neoplasia 3 (CIN3) (n=10), Cervical intraepithelial neoplasia 4 (CIN4) (n=10) and invasive carcinoma (n=10). The molecular technique used was dot blot molecular assay. A positive result was generated by catalytic oxidation of peroxidase enzyme on 3,3’,5,5’-Tetramethylbenzidine (TMB) substrate. The gold nanoparticles were used to enhance the signal produced by peroxidase activity of horseradish peroxidase (HRP) enzyme giving a more sensitive assay as compared to use of non-conjugated antibody. This study provides a significantly high and reliable diagnostic accuracy for precancerous and cancerous lesions with a sensitivity of 90%, a specificity of 90%, a likelihood ratio for positive and negative tests as 9:1 and 1:9 respectively, a Positive Predictive Value of 97.3% and a Negative Predictive Value of 69.2%. This study avails a sensitive, rapid test using paper-based nanotechnology which can be utilised in community-based screening outreaches particularly in low- and middle-income countries.

scholarly journals HPV vaccine knowledge and coverage among female students in a medical college, Kerala

2018 ◽  
Vol 5 (12) ◽  
pp. 5133
Author(s):  
Niveditha Das E. ◽  
Paul T. Francis
Keyword(s):  
Cervical Cancer ◽  
Medical Students ◽  
Hpv Vaccine ◽  
General Public ◽  
Preventive Intervention ◽  
Target Population ◽  
Hpv Infection ◽  
Multiple Sexual Partners ◽  
Medical College ◽  
School Of Medicine

Background: Cervical cancer is the second most common cancer among women in developing countries including India. Human papilloma virus (HPV) infection of the cervix is the most common risk factor for cervical cancer. HPV infection is widespread and occurs soon after becoming sexually active. Lack of hygiene and multiple sexual partners increases the risk of chronic HPV infection. HPV vaccine offers protection against cervical cancer. However the knowledge about HPV and vaccine is very limited among the general public. Knowledge among doctors is essential to provide timely advice to the target population.  This study aims to measure the awareness among female medical students in a medical college in Kerala.Methods: 1st to 4th year female medical students of Amrita School of Medicine were administered an anonymous, validated self-administered pretested questionnaire. Only students who had volunteered and given consent were included in the study. 165 students participated in the study.Results: The overall knowledge about cervical cancer its causation and prevention was good only in about 40%. However 83% had a positive attitude towards HPV vaccine and were willing to take the vaccine.  Only 6% had been vaccinated against HPV.Conclusions: There is a need to emphasize the aetiology and preventive measures of cervical cancer in the curriculum of MBBS students. In-depth knowledge among future doctors is essential for dissemination of knowledge to general public and timely preventive intervention.

Human Papillomavirus (HPV)

2021 ◽  
Author(s):  
Anne Schuind
Keyword(s):  
Cervical Cancer ◽  
Neutralizing Antibodies ◽  
Invasive Cervical Cancer ◽  
Cancer Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
Common Cancer ◽  
Associated Lesions ◽  
Hpv Types ◽  
E6 And E7

HPV is extremely common worldwide and mainly transmitted through sexual contact; most people are infected with HPV shortly after onset of sexual activity. There are >200 types of HPV, of which at least 12 are cancer-causing (oncogenic or high-risk types). HPV is a causal factor for several anogenital and a subset of oropharyngeal cancers with 2 HPV types (16 and 18) causing 72% of all HPV-associated cancers. Cervical cancer is the fourth most common cancer among women globally with nearly 90% of the deaths occurring in low- and middle-income countries. Comprehensive cervical cancer control includes primary prevention (vaccination against HPV), secondary prevention (screening and treatment of pre-cancerous lesions) as well as treatment of invasive cervical cancer. The currently licensed vaccines are L1 VLP-based and prophylactic; they have been shown to be safe and highly effective in preventing HPV infections and HPV-associated lesions, precancer and cancer. Neutralizing antibodies are the mechanism of protection for prophylactic HPV VLP-based vaccines. Therapeutic HPV vaccines targeting the oncoproteins E6 and E7 are in clinical development.

Mental health in intellectual disability

2018 ◽  
pp. 265-272
Author(s):  
Sabyasachi Bhaumik ◽  
Dasari Mohan Michael ◽  
Reza Kiani ◽  
Avinash Hiremath ◽  
Shweta Gangavati ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Problems ◽  
Current Knowledge ◽  
Premature Mortality ◽  
Health Problems ◽  
Physical And Mental Health ◽  
Middle Income ◽  
Middle Income Countries

This chapter focuses on the current knowledge in public health for people with intellectual disability and recognizes the extent of health inequalities these individuals experience. The prevalence of intellectual disability worldwide is discussed with special emphasis on the prevalence of mental health problems. Also highlighted are the population health characteristics, including physical and mental health problems. The issue of barriers to accessibility and the possible reasons are discussed. There is a section on premature mortality of people with intellectual disability and measures to improve the health status for this marginalized population. Recent initiatives, including prevention strategies and health promotional aspects, are discussed and solutions suggested, including those for low-and-middle income countries (LAMICs)emphasized. Training aspects to improve quality of health care in LAMICs is highlighted with the recognition of limitations in creating a sustainable transformation of services unless they are backed by authorities.

Human papillomavirus (HPV) vaccination: from clinical studies to immunization programs

2019 ◽  
Vol 29 (8) ◽  
pp. 1317-1326 ◽  
Author(s):  
Raúl Murillo ◽  
Camila Ordóñez- Reyes
Keyword(s):  
Cervical Cancer ◽  
Clinical Trials ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Population Based ◽  
Immunization Programs ◽  
Hpv Vaccines ◽  
Middle Income ◽  
Middle Income Countries

Cervical cancer incidence and mortality have decreased in high-income countries, but low- and middle-income countries continue to bear a significant burden from the disease. Human papillomavirus (HPV) vaccines are a promising alternative for disease control; however, their introduction is slow in settings with greater need. We conducted a review of HPV vaccine efficacy and effectiveness reported in clinical trials and population-based studies. Efficacy of HPV vaccines is close to 100% when using a three-dose schedule in HPV-negative young women (<25 years old) for protection against persistent infection and HPV vaccine-type associated pre-cancerous lesions. Furthermore, sustained protection for up to 12 years of follow-up has been demonstrated; cross-protection against non-vaccine types is particularly observed for the bivalent vaccine, and preliminary data regarding impact on invasive cancer have emerged. Given its lower efficacy, catch-up vaccination beyond 19 years of age and proposals for vaccinating adult women deserve careful evaluation in accurately designed studies and economic analyses. Despite positive results regarding immunogenicity and post-hoc analysis for cervical intra-epithelial neoplasia in clinical trials, population-based data for prime and booster two-dose schedules are not available. Evaluation of vaccine safety from surveillance systems in immunization programs that have already distributed more than 270 million doses found no association of HPV vaccination with serious side effects. The introduction of HPV vaccination in national immunization programs remains the main challenge in tackling the burden of cervical cancer (up to 2018, only 89 countries have introduced vaccination worldwide, and most of these are high-income countries). Access models and technical capacity require further development to help low- and middle-income countries to increase the pace of vaccine delivery. Alternative approaches such as one-dose schedules and vaccination at younger ages may help reduce the programmatic and economic challenges to adolescent vaccination.

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