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Treatment and Follow-up of Human Papillomavirus Infected Women in a Municipality in Southern Brazil

  • Ruggeri, Joao Batista (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Agnolo, Catia Millene Dell (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Gravena, Angela Andreia Franca (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Demitto, Marcela de Oliveira (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Lopes, Tiara Cristina Romeiro (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Delatorre, Silvana (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Carvalho, Maria Dalva de Barros (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Consolaro, Marcia Edilaine Lopes (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa) ;
  • Pelloso, Sandra Marisa (Post-Graduate Program in Health Sciences, Maringa State University, Maringa, Parana, Programa de Pos Graduacao em Ciencias da Saude, Universidade Estadual de Maringa, Universidade Estadual de Maringa)
  • Published : 2015.10.06

Abstract

Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

Keywords

References

  1. Adler DH (2010). The impact of HAART on HPV-related cervical disease. Curr HIV Res, 8, 493-7. https://doi.org/10.2174/157016210793499240
  2. Albuquerque KM, Frias PG, Andrade CLT, et al (2009). Cobertura do teste de papanicolaou e fatores associados a nao realizacao: um olhar sobre o programa de prevencao do cancer do colo do utero, Brasil. Cad Saude Publica, 25, 301-9. https://doi.org/10.1590/S0102-311X2009001400012
  3. Ayres ARG, Silva GA (2010). Prevalencia de infeccao do colo do utero pelo HPV no Brasil: revisao sistematica. Rev Saude Publica, 44, 963-74.
  4. Bosch FX, Burchell AN, Schiffman M, et al (2008). Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine, 26, 1-16.
  5. Brasil. Ministerio da Saude (2002). Prevencao do cancer do colo do utero-manual tecnicoprofissionais da saude. Brasilia (DF).
  6. Brasil. Ministerio da Saude (2009). Instituto nacional de cancer (INCA). coordenacao de prevencao e vigilancia (Conprev). estimativa 2010. incidencia de cancer no Brasil. rio de janeiro (RJ).
  7. Burd EM (2003). Human papillomavirus and cervical cancer. Clin Microbiol Rev, 16, 1-17. https://doi.org/10.1128/CMR.16.1.1-17.2003
  8. Castle PE, Fetterman B, Poitras N, et al (2009). Five-year experience of human papillomavirus DNA and papanicolaou test cotesting. Obstet Gynecol, 113, 595-600. https://doi.org/10.1097/AOG.0b013e3181996ffa
  9. Castle PE, Gage JC, Partridge EE, et al (2013). Human papillomavirur genotypes detected in clinician-collected and self-collected specimens from women living in the mississippi delta. BMC Infectious Diseases, 13-5.
  10. Centers for disease control and prevention. human papillomavirus (HPV) infection. sexually transmitted diseases. treatment guidelines, 2010. Available from: http://www.cdc.gov/std/treatment/2010/hpv.htm
  11. Chao A, Huang HJ, Lai CH (2012). Human papillomavirus research on the prevention, diagnosis, and prognosis of cervical cancer in taiwan. Chang Gung Med J, 35, 297-308.
  12. Dunne EF, Unger ER, Sternberg M, et al (2007). Prevalence of HPV Infection among females in the United States. Jama, 297, 813-9. https://doi.org/10.1001/jama.297.8.813
  13. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  14. Fernandes JV, Meissner R de V, de Carvalho MG, et al (2009). Prevalence of HPV infection by cervical cytologic status in Brazil. Int J Gynecol Obstet, 105, 21-4. https://doi.org/10.1016/j.ijgo.2008.12.004
  15. Goncalves S, Merisio AL, Merlin JC, et al (2010). Mapeamento da incidencia do papiloma virus humano (HPV) por municipio da rede publica do estado do Parana, Brasil. RBAC, 42, 197-200.
  16. Harper DM, Demars LR (2014). Primary strategies for HPV infection and cervical cancer prevention. Clin Obstet-Gynecol, 57, 256-78. https://doi.org/10.1097/GRF.0000000000000027
  17. Instituto Nacional do Cancer. Brasil (2008). Ministerio da saude. instituto nacional do cancer. estimativa de cancer. Available from: www.inca.gov.br/estimativa/2008.
  18. Instituto Nacional de Cancer Jose Alencar da Silva (2014a). Incidencia de cancer no Brasil. estimativa 2014, 2014. Available from: http://www.inca.gov.br/estimativa/2014/estimativa-24042014.pdf
  19. Instituto Nacional de Cancer Jose Alencar da Silva (2014b). INCA e ministerio da saude apresentam estimativas de cancer para 2014 (in Portuguese). Available from: http://www2.inca.gov.br/wps/wcm/connect/agencianoticias/site$\pm$/home$\pm$/noticias/2013/inca_ministerio_saude_apresentam_estimativas_cancer_2014.
  20. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  21. Kasamatsu E, Cubilla AL, Alemany L, et al (2012). Type-specific human papillomavirus distribution in invasive cervical carcinomas in Paraguay. A study of 432 cases. J Med Virol, 84, 1628-35. https://doi.org/10.1002/jmv.23373
  22. Kim JY, Nam BH, Lee JA (2011). Is human papillomavirus genotype an influencing factor on radiotherapy outcome? Ambiguity caused by an association of HPV 18 genotype and adenocarcinoma histology. J Gynecol Oncol, 22, 32-8. https://doi.org/10.3802/jgo.2011.22.1.32
  23. Lockwood-Rayermann S, McIntyre SJ (2009). Understanding HPV disease and prevention: a guide for school nurses. J Sch Nurs, 25, 261-9. https://doi.org/10.1177/1059840509333787
  24. Lu-Lu S, Qiong J, Hui L, et al (2012). Population-based study on the prevalence of and risk factors for human papillomavirus infection in qujing of Yunnan province, Southwest China. Virol J, 8, 153.
  25. Martins LFL, Thuler LCS, et al (2005). Cobertura do exame de Papanicolaou no Brasil e seusfatoresdeterminantes: umarevisaosistematica da literatura. Rev Bras Ginecol Obstet, 27, 485-92. https://doi.org/10.1590/S0100-72032005000800009
  26. Matos E, Loria D, Amestoy GM, et al (2003). Prevalence of human papillomavirus infection among women in Concordia, Argentina: a population-based study. Sex Transm Dis, 30, 593-9. https://doi.org/10.1097/01.OLQ.0000085181.25063.6C
  27. Naucler P, Mabota da Costa F, da Costa JL, et al (2011). Human papillomavirus type-specific risk of cervical cancer in a population with high human immunodeficiency virus prevalence: case-control study. J Gen Virol, 92, 2784-91. https://doi.org/10.1099/vir.0.034298-0
  28. Nonnenmachera B, Breitenbacha V, Villab LL, et al (2002). Identificacao do papilomavirushumanoporbiologia molecular em mulheres assintomaticas. Rev Saude Publica, 36, 95-100. https://doi.org/10.1590/S0034-89102002000100015
  29. Noronha VL, Cruz EM, Pinho CN, et al (2011). Papilomavirus humano (HPV) em mulheres submetidas a rastreamento para cancer de cervice uterina, Belem-Para-Brasil. DST-J bras Doencas Sex Transm, 23, 5-11. https://doi.org/10.5533/2177-8264-201123103
  30. Paesi S, Correa L, Tregnago MC, et al (2014). Human papillomavirus among women with atypical squamous cells of undetermined significance in southern Brazil. Int J Gynecol Obstetrics. 2014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25257569.
  31. Pham TH, Nguyen TH, Herrero R, et al (2003). Human papillomavirus infection among women in South and North Vietnam. Int J Cancer, 104, 213-20. https://doi.org/10.1002/ijc.10936
  32. Picconi MA (2013). Deteccion de virus papilloma humano enla prevencion del cancer cervico-uterino. Medicina, 73, 585-96.
  33. Pinto DS, Fuzii HT, Quaresma JAS (2011). Prevalencia de infeccao genital pelo HPV em populacoes urbana e rural da amazonia oriental Brasileira. Cad. SaudePublica, 27, 769-78.
  34. Schiffman M (2007). Integration of human papillomavirus vaccination, cytology and human papillomavirus testing. Cancer, 111, 145-53. https://doi.org/10.1002/cncr.22751
  35. Schiffman M, Castle PE, Jeronimo J, et al (2007). Human papillomavirus and cervical cancer. Lancet, 370, 890-907. https://doi.org/10.1016/S0140-6736(07)61416-0
  36. Schuman P, Ohmit SE, Klein RS, et al (2003) HIV epidemiology research study (HERS) group: longitudinal study of cervical squamous intraepithelial lesions in human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women. J Infect Dis, 188, 128-36. https://doi.org/10.1086/375783
  37. Sesa (2005). Secretaria de saude do estado do parana. coeficiente de mortalidadeporneoplasiasmalignaspor100 mil, porRegionais de Saude,Municipios de Residencia, Parana, Available from: http://www.saude.pr.gov.br/
  38. Shi R, Devarakonda S, Liu L, et al (2014). Factors associated with human papillomavirus infection among adult females in the United States, NHANES 2007-2010. BMC Res Notes, 7, 544-51. https://doi.org/10.1186/1756-0500-7-544
  39. Shin HR, Lee DH, Herrero R, et al (2003). Prevalence of human papillomavirus infection in women in Busan, South Korea. Int J Cancer, 103, 413-21. https://doi.org/10.1002/ijc.10825
  40. Walboomers JM, Jacobs MV, Manos MM, et al (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol, 189, 12-9. https://doi.org/10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F
  41. Wang X, Gu D, Lou B, et al (2013). Hospital-based prevalence of high-risk cervical HPV types infecting the general population and female sex workers in Huzhou, China. Int J Gynecol Obstet, 120, 37-41. https://doi.org/10.1016/j.ijgo.2012.07.019
  42. Wheeler CM, Hunt WC, Cuzick J, et al (2013). A populationbased study of HPV genotype prevalence in the United States: baseline measures prior tomass HPV vaccination. Int J Cancer, 132, 198-207. https://doi.org/10.1002/ijc.27608
  43. World Health Organization (2012). International agency for research on cancer. Globocan. Available from: http://globocan.iarc.fr/
  44. World Health Organization (2013). Who guidelines for screening and treatment pre cancerous lesions for cervical cancer prevention, Available from: http://apps.who.int/iris/bitstream/10665/94830/1/9789241548694_eng.pdf