Human Papillomavirus genotypes in cervical intraepithelial lesions among women at two referral centers in Brazil

This study aimed to describe Human Papilloma Virus (HPV) genotypes and women with cervical intraepithelial neoplasia (CIN) sociodemographic characteristics at the oncology reference centers. A secondary data of 325 records on women with CIN were analyzed from a cohort study database conducted in two public institutions in the oncological service in the Northeast of Brazil, from July 2014 to February 2016. The HPV genotype analysis was carried out on 142 through viral DNA sequence after amplifying PCR technique and compared the sequences identified in the GenBank databases. The women were predominantly 25 to 39 years old. The 325 biopsies revealed 17.6% low-grade of cervical intraepithelial lesion (CIN1) and 82.4% high-grade of cervical intraepithelial lesion (CIN2 or CIN3). Among the 142 HPV genotypes the most prevalent was HPV-16 (51.7%), followed by HPV-35 (6.9%) and HPV-45 (6.2%). HPV-18 was in only 2.1%. There was an association between HPV-16 and high-grade lesions (CIN2 or CIN3) (p=0.008). Although HPV-16 was the predominant genotype in cervical intraepithelial lesions, especially high-grade lesions (CIN2 or CIN3), HPV-35 was the second most frequent in high-grade lesions in this population. This suggests that other HPVs may be as prevalent as those commonly known in some regions.

Prevalence and factors associated to cervical changes in units from the Single Health System

ABSTRACT Objective: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. Method: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. Results: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. Conclusion: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

Experience of clinical use of diindolylmethane in the treatment of HPV-associated low-grade cervical lesions

Introduction. A genital human papillomavirus infection receives the sword-point attention of both researchers and practitioners, due to its large prevalence in the human population, high contagiousness and, in particular, the ability of some HPV strains to contribute to the development of malignancy. This is particularly so with cervical cancer (CC), one of the most common types of cancer both in the Russian Federation and most countries of the world. It ranked first among the causes of malignant tumour deaths of women aged over 30 years. Objective. To present the experience in using the 3,3’-diindolylmethane-containing drug in the treatment of patients with HPVassociated low-grade cervical intraepithelial lesion. Material and methods. 62 women with HPV-associated low-grade cervical intraepithelial lesion were examined and received treatment with the 3,3’-diindolylmethane-containing drug (Cervicon-DIM). The primary diagnosis and therapeutic outcomes monitoring included the following research methods: colposcopy, histological examination of biopsy cervical specimens, Pap test, RT-PCR of high carcinogenic risk (HCR) HPV. The therapy compliance was evaluated using the clinical psychological test method (Morisky Green scale): compliant patients 4 scores (noncompliant 2 scores or less, insufficiently compliant 3 scores). Results. The therapeutic outcomes using 3,3’-diindolylmethane-containing drug (Cervicon-DIM) in the form of vaginal suppositories (100 mg twice daily for 90 days) showed clinical (recovery of colposcopic status in 83.0% of patients), cytological (confirmed absence of LSIL in 98.3% of women) and microbiological (PCR-negative HCR HPV in 91.5% of women) efficacy with satisfactory tolerance of the drug. Сonclusions. The therapeutic outcomes obtained using 3,3’-diindolylmethane-containing drug in the treatment of patients with HPV-associated low-grade cervical intraepithelial lesion could be considered as satisfactory. The data presented may be of interest to practicing gynecologists and other specialists.