Vânia Lúcia Noronha

Papilomavírus humano associado a lesões de cérvice uterina

Estudou-se a prevalencia do papilomavirus humano (HPV) em 228 mulheres portadoras de lesoes em cervice uterina, atendidas no Instituto Ofir Loiola, em Belem, Para, no periodo de marco de 1992 a maio de 1996. As pacientes foram submetidas a biopsia de colo uterino, sendo o material encaminhado para histopatologia e pesquisa de HPV por PCR e hibridizacao por dot-blot. Distribuiram-se as participantes em tres grupos, conforme diagnostico histopatologico. O grupo A constituiu-se de 155 mulheres com carcinoma epidermoide invasor ou com adenocarcinoma, o grupo B de 54 portadoras de neoplasia intra-epitelial cervical grau II ou III, e o grupo C de 19 pacientes com cervicite cronica. Observaram-se prevalencias de HPV em 70,3%, 63,0% e 36,8% das mulheres dos grupamentos A, B e C, respectivamente, sendo o HPV 16 registrado em 60,4% das amostras positivas do grupo A e 54,5% daquelas do grupo B. Os tipos 16, 18 e 33 representaram 71,4% dos detectados no grupo C.

Human papillomavirus type 16 variants in cervical cancer from an admixtured population in Brazil.

Several studies indicate that molecular variants of HPV‐16 have different geographic distribution and risk associated with persistent infection and development of high‐grade cervical lesions. In the present study, the frequency of HPV‐16 variants was determined in 81 biopsies from women with cervical intraepithelial neoplasia grade III or invasive cervical cancer from the city of Belem, Northern Brazil. Host DNAs were also genotyped in order to analyze the ethnicity‐related distribution of these variants. Nine different HPV‐16 LCR variants belonging to four phylogenetic branches were identified. Among these, two new isolates were characterized. The most prevalent HPV‐16 variant detected was the Asian‐American B‐2, followed by the European B‐12 and the European prototype. Infections by multiple variants were observed in both invasive cervical cancer and cervical intraepithelial neoplasia grade III cases. The analysis of a specific polymorphism within the E6 viral gene was performed in a subset of 76 isolates. The E6‐350G polymorphism was significantly more frequent in Asian‐American variants. The HPV‐16 variability detected followed the same pattern of the genetic ancestry observed in Northern Brazil, with European, Amerindian and African roots. Although African ancestry was higher among women infected by the prototype, no correlation between ethnical origin and HPV‐16 variants was found. These results corroborate previous data showing a high frequency of Asian‐American variants in cervical neoplasia among women with multiethnic origin. J. Med. Virol. 80:1639–1645, 2008.

Segurança, imunogenicidade e eficácia protetora de duas doses da vacina RIX4414 contendo rotavírus atenuado de origem humana

OBJECTIVE: To determine the safety, immunogenicity and efficacy of two doses of rotavirus vaccine in healthy Brazilian infants. METHODS: A randomized, multicenter, double-blind, placebo-controlled trial was conducted in Brazil, Mexico and Venezuela. Infants received two oral doses of vaccine or placebo at 2 and 4 months of age, concurrently with routine immunizations, except for oral poliomyelitis vaccine (OPV). This paper reports results from Belem, Brazil, where the number of subjects per group and the viral vaccine titers were: 194 (104.7 focus forming units - FFU), 196 (105.2 FFU), 194 (105.8 FFU) and 194 (placebo). Anti-rotavirus (anti-RV) antibody response was assessed in 307 subjects. Clinical severity of gastroenteritis episodes was measured using a 20-point scoring system with a score of > 11 defined as severe GE. RESULTS: The rates of solicited general symptoms were similar in vaccine and placebo recipients. At 2 months after the second dose, a serum IgA response to RV occurred in 54.7 to 74.4% of vaccinees. No interference was seen in the immunogenicity of routine vaccines. Vaccine efficacy against any rotavirus gastroenteritis (RVGE) was 63.5% (95%CI 20.8-84.4) for the highest concentration (105.8 FFU). Efficacy was 81.5% (95%CI 44.5-95.4) against severe RVGE. At its highest concentration (105.8 FFU), RIX4414 provided 79.8% (95%CI 26.4-96.3) protection against severe RVGE by G9 strain. CONCLUSIONS: RIX4414 was highly immunogenic with a low reactogenicity profile and did not interfere with seroresponse to diptheria, tetanus, pertussis, hepatitis B and Hib antigens. Two doses of RIX4414 provided significant protection against severe GE caused by RV.

Papilomavírus humano (HPV) em mulheres submetidas a rastreamento para câncer de cérvice uterina, Belém - Pará - Brasil

Introduction: human papillomavirus (HPV) is the agent of cervical uterine cancer. Objective: determine the prevalence of genital infection due to HPV and their correlation with results in the oncotic cytology. Methods: in a cross-sectional study, 1021 women, age 30 to 45 years were enrolled and submitted to cervical cancer screening. All patients answered a standard protocol. Samples of the uterine cervix were sent to citopathological analysis and to identification of HPV. Results: prevalence of HPV was 12.4%; in women with normal cervical cytology the prevalence of HPV was 8,7% compared to 43,4% in women with altered cervical cytology (28.9% among women with ASCUS/AGUS; 60.0% among women with LSIL; 90.0% among women with HSIL and 100.0% both in women with invasive carcinoma and in situ adenocarcinoma). Chance of detection of HSIL was 94 times higher in women who had HPV in the uterine cervix. A separate analysis including only the 116 HPV infected women revealed that HPV oncogenic types corresponded to 79.3% of the cases (71.8% in women with negative cervical cytology and 91.1% in women with altered cervical cytology). The frequency of oncogenic HPV types in 116 women infected with HPV was 79.3% [71.8% in women with negative citology and 91.1% in women with abnormalities in the citology exam). The odds to detect abnormalities in the citopatology exam was four times greater in the presence of HPV of high risk. HPV 16 was the most frequent type observed (24.4% of women with abnormal cytology and in 7,0% of those with negative cytology). Multiinfection was detected in 5.7% of women with abnormal cytology and in 1.1% with negative cytology. Conclusion: in this study, HPV infection and abnormal cytological findings in the uterine cervix were frequently observed and there was an association between them.