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JCO Global Oncology Mar 2023In the light of WHO's call for elimination of cervical cancer, primary human papillomavirus (HPV) screening through self-collection is a powerful tool that can improve... (Review)
Review
PURPOSE
In the light of WHO's call for elimination of cervical cancer, primary human papillomavirus (HPV) screening through self-collection is a powerful tool that can improve screening coverage. Challenges encountered during implementation of the program are unique to each country. We conducted this systematic review to list the challenges in implementing primary HPV screening through self-sampling in Indian context.
METHODS
A literature search was performed in PubMed, Embase, and Google Scholar since their inception till July 2022 for peer-reviewed articles published in the English. Non-Indian studies and those which did not mention implementation challenges were excluded. Articles were screened and reviewed independently by two authors. The results were discussed using a narrative synthesis.
RESULTS
All the eight original articles included in the review were of cross-sectional design. The challenges identified in these studies were grouped into beneficiary, health care provider, and health system perspectives. Beneficiary-related issues outnumbered other challenges in all the studies which included misconceptions and fear, lack of motivation, low self-efficacy in collection leading to poor sample quality, low socioeconomic status leading to lack of privacy, and refusal for screening and further treatment.
CONCLUSION
This review highlights the challenges for the implementation of HPV self-sampling in India. Future programs should incorporate context-specific solutions for the success of primary HPV screening and cervical cancer elimination.
Topics: Female; Humans; Uterine Cervical Neoplasms; Human Papillomavirus Viruses; Early Detection of Cancer; Papillomavirus Infections; Cross-Sectional Studies
PubMed: 36989463
DOI: 10.1200/GO.22.00401 -
Virology Journal Mar 2023To evaluate the clinical efficacy of different vaginal administration on cervical persistent high-risk human papillomavirus (HR-HPV) infection after excisional treatment... (Meta-Analysis)
Meta-Analysis Review
Evaluation of the clinical efficacy of vaginal treatment options for persistent high-risk human papillomavirus infection after excisional treatment of cervical high-grade squamous intraepithelial lesions: a systematic review and Bayesian network meta-analysis.
BACKGROUND
To evaluate the clinical efficacy of different vaginal administration on cervical persistent high-risk human papillomavirus (HR-HPV) infection after excisional treatment for high-grade squamous intraepithelial lesions (HSIL).
METHODS
Six databases (PubMed, EmBase, Cochrane Central, China Knowledge Network database, China Biomedical Literature Service, and WanFang database) were searched to collect randomized controlled trials (RCTs) of various types of vaginal administration compared to no treatment on persistent HR-HPV infection after HSIL excisional treatment, and comprehensive analysis of the clearance of different drugs on HR-HPV was performed using Bayesian reticulation meta-analysis.
RESULTS
The study analyzed the efficacy of eight interventions, including Interferon, Baofukang, Paiteling, Bletilla striata Sanhuang Powder, Lactobacilli vaginal capsules, Fuanning + Interferon, Interferon + Lactobacilli vaginal capsules, and Interferon + Baofukang, on the clearance of HR-HPV after excisional treatment through pooling and analyzing data from 52 RCTs. The results of the study demonstrated that Interferon + Lactobacilli vaginal capsules [OR 16.0 (95% CIs 8.1-32.0)], Interferon + Fuanning [OR 16.0 (95% CIs 1.1-52.0)], and Interferon + Baofukang [OR 14.0 (95% CIs 6.8-28.0)] were all found to significantly improve postoperative HR-HPV clearance rates when compared to no treatment. Furthermore, when studies with high-risk bias were excluded, Interferon + Lactobacilli vaginal capsules [OR 8.6 (95% CIs 4.7-19.0)] and Interferon + Baofukang [OR 22.0 (95% CIs 8.7-59.0)] were still found to be positively associated with increased postoperative HR-HPV clearance rate. Additionally, the study´s results also indicate that Interferon + Baofukang was effective in enhancing the postoperative HR-HPV clearance rates, mainly when the studies were restricted to a follow-up period of at least 12 months [OR 9.6 (95% CIs 2.9-34.0)]. However, it is important to note that the majority of the trials (29 out of 52, 51.6%) were rated as moderate to high risk of bias, and the certainty of the evidence was moderate to very low.
CONCLUSION
The application of various forms of vaginal administration, except for individual use of Lactobacilli vaginal capsules, is more efficacious than no treatment in patients with cervical persistent HR-HPV infection after excisional treatment. However, all of the estimates of the effect size for change in the efficiency of HR-HPV clearance are uncertain. Our confidence in effect estimates and ranking of treatments is low, which needs larger, more rigorous, and longer follow-up RCTs to resolve.
Topics: Female; Humans; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Papillomavirus Infections; Human Papillomavirus Viruses; Administration, Intravaginal; Network Meta-Analysis; Treatment Outcome; Squamous Intraepithelial Lesions; Interferons; Papillomaviridae
PubMed: 36935507
DOI: 10.1186/s12985-023-02001-6 -
Bioscience Reports Mar 2023Gastrointestinal cancers are the most common type of cancer affecting humans. High expression of HOX transcript antisense intergenic RNA (HOTAIR), a long noncoding RNA... (Meta-Analysis)
Meta-Analysis
Gastrointestinal cancers are the most common type of cancer affecting humans. High expression of HOX transcript antisense intergenic RNA (HOTAIR), a long noncoding RNA (lncRNA), in various types of different tumors may be associated with poor prognosis. In the present study, we performed a meta-analysis of the relationship between HOTAIR expression and gastrointestinal cancers. Five databases were comprehensively searched for all literature until January 2023. Moreover, the target genes of HOTAIR were predicted by coexpression analysis based on The Cancer Genome Atlas (TCGA) gene expression matrix for six gastrointestinal cancer types. Finally, the mechanism through which HOTAIR affects tumors of the digestive system was systematically reviewed. Our results showed that the high HOTAIR expression group had worse outcomes with a pooled hazard ratio (HR) of 1.56 (95% confidence interval [CI] = 1.38-1.75, P<0.001). Furthermore, HOTAIR was identified as an unfavorable prognostic factor for overall survival (OS) in the esophageal carcinoma (ESCA) and gastric cancer (GC), as the HR were 1.94 and 1.58, respectively. The high correlation between the expression of homeobox C (HOXC) family genes and HOTAIR, with correlation coefficients of 0.863 (HOXC11), 0.664 (HOXC10), 0.645 (HOXC8), and 0.581 (HOXC12). The 'cell cycle' pathway and pathways relating to infections, namely 'herpes simplex virus 1 infection' and 'complement and coagulation cascades' were significantly enriched in Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Also, we perform a systematic review to summarize the related oncogenic mechanism of HOTAIR. In conclusion, the HOTAIR has been identified as a potential prognostic factor in patients with gastrointestinal cancers.
Topics: Humans; Biomarkers; Esophageal Neoplasms; Gene Expression Regulation, Neoplastic; Homeodomain Proteins; Prognosis; RNA, Long Noncoding; Stomach Neoplasms
PubMed: 36924407
DOI: 10.1042/BSR20222174 -
Frontiers in Immunology 2023The Human T-lymphotropic virus type 1 (HTLV-1) was the first described human retrovirus. It is currently estimated that around 5 to 10 million people worldwide are...
INTRODUCTION
The Human T-lymphotropic virus type 1 (HTLV-1) was the first described human retrovirus. It is currently estimated that around 5 to 10 million people worldwide are infected with this virus. Despite its high prevalence, there is still no preventive vaccine against the HTLV-1 infection. It is known that vaccine development and large-scale immunization play an important role in global public health. To understand the advances in this field we performed a systematic review regarding the current progress in the development of a preventive vaccine against the HTLV-1 infection.
METHODS
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA®) guidelines and was registered at the International Prospective Register of Systematic Reviews (PROSPERO). The search for articles was performed in PubMed, Lilacs, Embase and SciELO databases. From the 2,485 articles identified, 25 were selected according to the inclusion and exclusion criteria.
RESULTS
The analysis of these articles indicated that potential vaccine designs in development are available, although there is still a paucity of studies in the human clinical trial phase.
DISCUSSION
Although HTLV-1 was discovered almost 40 years ago, it remains a great challenge and a worldwide neglected threat. The scarcity of funding contributes decisively to the inconclusiveness of the vaccine development. The data summarized here intends to highlight the necessity to improve the current knowledge of this neglected retrovirus, encouraging for more studies on vaccine development aiming the to eliminate this human threat.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero, identifier (CRD42021270412).
Topics: Humans; Human T-lymphotropic virus 1; HTLV-I Infections; Databases, Factual; Immunization; Vaccine Development
PubMed: 36860854
DOI: 10.3389/fimmu.2023.1073779 -
International Journal of Infectious... May 2023Herpesviruses are ubiquitous and after primary infection they establish lifelong latency. The impairment of maintaining latency with short-term or long-term consequences... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Herpesviruses are ubiquitous and after primary infection they establish lifelong latency. The impairment of maintaining latency with short-term or long-term consequences could be triggered by other infection. Therefore, reactivation of herpesviruses in COVID-19 patients represents an emerging issue.
DESIGN AND METHODS
This study provided the first systematic review with meta-analysis of studies that evaluated active human herpesvirus (HHV) infection (defined as the presence of IgM antibodies or HHV-DNA) in COVID-19 patients and included 36 publications collected by searching through PubMed, SCOPUS, and Web of science until November 2022.
RESULTS
The prevalence of active EBV, HHV6, HSV, CMV, HSV1, and VZV infection in COVID-19 population was 41% (95% CI =27%-57%), 3% (95% CI=17%-54%), 28% (95% CI=1%-85%), 25% (95% CI=1%-63%), 22% (95% CI=10%-35%), and 18% (95% CI=4%-34%), respectively. There was a 6 times higher chance for active EBV infection in patients with severe COVID-19 than in non-COVID-19 controls (OR=6.45, 95% CI=1.09-38.13, p=0.040), although there was no difference in the prevalence of all evaluated active herpesvirus infections between COVID-19 patients and non-COVID-19 controls.
CONCLUSIONS
Future research of herpesvirus and SARS-CoV-2 coinfections must be prioritized to define: who, when and how to be tested, as well as how to effectively treat HHVs reactivations in acute and long COVID-19 patients.
Topics: Humans; Post-Acute COVID-19 Syndrome; Herpesvirus 4, Human; Cytomegalovirus; COVID-19; SARS-CoV-2; Herpesviridae Infections; Herpesviridae; Simplexvirus; Herpesvirus 6, Human
PubMed: 36736577
DOI: 10.1016/j.ijid.2023.01.036 -
JCO Global Oncology Jan 2023The proportion of head and neck cancers (HNCs) with human papillomavirus (HPV) positivity in sub-Saharan Africa (SSA) is poorly characterized. Characterizing this has...
PURPOSE
The proportion of head and neck cancers (HNCs) with human papillomavirus (HPV) positivity in sub-Saharan Africa (SSA) is poorly characterized. Characterizing this has implications in staging, prognosis, resource allocation, and vaccination policies. This study aims to determine the proportion of HPV-associated HNC in SSA.
MATERIALS AND METHODS
This systematic review included searches from PubMed, EMBASE, Web of Science, African Index Medicus, Google Scholar, and African Journals Online. All English publications reporting the proportion of HNC specimens from SSA patients who tested positive for HPV and/or p16 were included. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Case Series Studies.
RESULTS
In this systematic review of 31 studies and 3,850 patients, the overall p16 positivity was 13.6% (41 of 1,037 patients tested) with the highest proportion among oropharyngeal cancers (20.3%, 78 of 384 patients) and the overall HPV polymerase chain reaction positivity was 15.3% (542 of 3,548 samples tested) with the highest proportion among nasopharyngeal cancers (16.5%, 23 of 139 patients). Among the 369 HPV strains detected, the most common genotypes were HPV 16 (226 patients, 59.2%) and HPV 18 (78, 20.4%).
CONCLUSION
HPV was found to be associated with a significant proportion of HNC in SSA. The genotypes reported suggest that the nine-valent vaccine and gender-neutral vaccination policies should be considered. Given that these studies may not accurately capture prevalence nor causation of HPV in HNC subsites, additional research is needed to provide a more thorough epidemiologic understanding of HPV-associated HNC in SSA, including risk factors and clinical outcomes.
Topics: United States; Humans; Human Papillomavirus Viruses; Papillomavirus Infections; Head and Neck Neoplasms; Papillomaviridae; Risk Factors
PubMed: 36730877
DOI: 10.1200/GO.22.00259 -
Revista de Saude Publica 2023To investigate the association between bacterial vaginosis and cervical human papillomavirus (HPV) infection in young and adult women. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the association between bacterial vaginosis and cervical human papillomavirus (HPV) infection in young and adult women.
METHODS
This systematic review and meta-analysis was based on the Prisma methodological guidelines. PubMed and Web of Science were searched using the following descriptors: "bacterial vaginosis and HPV", in June 2019. Articles published from 2012 to 2019 were included. Inclusion criteria were original studies that investigated the association between bacterial vaginosis and cervical HPV infection; articles published in English, Spanish or Portuguese; studies conducted in young and adult, non-pregnant, non-HIV-infected women; studies that used the Nugent criteria for the diagnosis of bacterial vaginosis and studies in which the detection of HPV used the polymerase chain reaction technique. Assembled data, odds ratio (OR) and respective 95% confidence intervals (95%CI) were estimated for the association between bacterial vaginosis and cervical HPV infection using random-effects models. A bilateral value of p < 0.05 was considered statistically significant.
RESULT
Six studies were selected for analysis and demonstrated association between bacterial vaginosis and cervical HPV infection (OR = 2.68; 95%CI: 1.64-4.40; p < 0.001).
CONCLUSION
Bacterial vaginosis was considered a risk factor for cervical HPV infection, since women with bacterial vaginosis were more likely to be infected with HPV.
Topics: Adult; Female; Humans; Vaginosis, Bacterial; Papillomavirus Infections; Human Papillomavirus Viruses; Brazil; Cervix Uteri; Uterine Cervical Neoplasms
PubMed: 36629704
DOI: 10.11606/s1518-8787.2022056004412 -
Frontiers in Public Health 2022A meta-analysis was conducted to examine the effectiveness of HPV self-sampling proposal on cervical cancer screening (CCS) uptake when compared with an invitation to... (Meta-Analysis)
Meta-Analysis
Does self-sampling for human papilloma virus testing have the potential to increase cervical cancer screening? An updated meta-analysis of observational studies and randomized clinical trials.
OBJECTIVES
A meta-analysis was conducted to examine the effectiveness of HPV self-sampling proposal on cervical cancer screening (CCS) uptake when compared with an invitation to have a clinician to collect the sample. Secondary outcomes were acceptability and preference of self-sampling compared to clinician-collected samples.
METHODS
The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies examining the CCS uptake comparing self-sampling over invitation to be sampled by an healthcare professional and examining the proportion of women accepting or preferring self-sampling vs. clinician-collected sampling were included. The CCS uptake was also explored according to strategy of self-samplers' distribution, collection device type and screening status. Peters' test and Funnel Plot inspection were used to assess the publication bias. Quality of the studies was assessed through Cochrane Risk of Bias and NIH Quality Assessment tools.
RESULTS
One hundred fifty-four studies were globally identified, and 482,271 women were involved. Self-sampling procedures nearly doubled the probability (RR: 1.8; 95% CI: 1.7-2.0) of CCS uptake when compared with clinician-collected samples. The opt-out (RR: 2.1; 95% CI: 1.9-2.4) and the door-to-door (RR: 1.8; 95% CI: 1.6-2.0) did not statistically significant differ ( = 1.177) in improving the CCS uptake. A higher relative uptake was shown for brushes (RR: 1.6; 95% CI: 1.5-1.7) and swabs (RR: 2.5; 95% CI: 1.9-3.1) over clinician-collected samples. A high between-studies variability in characteristics of sampled women was shown. In all meta-analyses the level of heterogeneity was consistently high ( > 95%). Publication bias was unlikely.
CONCLUSIONS
Self-sampling has the potential to increase participation of under-screened women in the CCS, in addition to the standard invitation to have a clinician to collect the sample. For small communities door-to-door distribution could be preferred to distribute the self-sampler while; for large communities opt-out strategies should be preferred over opt-in. Since no significant difference in acceptability and preference of device type was demonstrated among women, and swabs and brushes exhibited a potential stronger effect in improving CCS, these devices could be adopted.
Topics: Female; Humans; Uterine Cervical Neoplasms; Vaginal Smears; Human Papillomavirus Viruses; Early Detection of Cancer; Papillomavirus Infections; Randomized Controlled Trials as Topic
PubMed: 36568753
DOI: 10.3389/fpubh.2022.1003461 -
Viruses Dec 2022The Joint United Nations Program on HIV/AIDS (UNAIDS) has adopted the Sustainable Development Goals (SDGs) to end the HIV/AIDS epidemic by 2030. Several factors related... (Review)
Review
The Joint United Nations Program on HIV/AIDS (UNAIDS) has adopted the Sustainable Development Goals (SDGs) to end the HIV/AIDS epidemic by 2030. Several factors related to the non-suppression of HIV, including interruptions of antiretroviral therapy (ART) and opportunistic infections could affect and delay this projected epidemic goal. Human T-Cell leukemia virus type 1 (HTLV-1) appears to be consistently associated with a high risk of opportunistic infections, an early onset of HTLV-1 and its associated pathologies, as well as a fast progression to the AIDS phase in co-infected individuals, when compared to HIV-1 or HTLV-1 mono-infected individuals. In Gabon, the prevalence of these two retroviruses is very high and little is known about HTLV-1 and the associated pathologies, leaving most of them underdiagnosed. Hence, HTLV-1/HIV-1 co-infections could simultaneously imply a non-diagnosis of HIV-1 positive individuals having developed pathologies associated with HTLV-1, but also a high mortality rate among the co-infected individuals. All of these constitute potential obstacles to pursue targeted objectives. A systematic review was conducted to assess the negative impacts of HTLV-1/HIV-1 co-infections and related factors on the elimination of HIV/AIDS by 2030 in Gabon.
Topics: Humans; Human T-lymphotropic virus 1; Acquired Immunodeficiency Syndrome; Gabon; Coinfection; HIV Infections; HIV-1; HIV Seropositivity; Leukemia, T-Cell; Opportunistic Infections; HTLV-I Infections
PubMed: 36560812
DOI: 10.3390/v14122808 -
British Journal of Cancer Mar 2023Human papillomavirus (HPV) testing on self-samples represents a great opportunity to increase cervical cancer screening uptake among under-screened women. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Human papillomavirus (HPV) testing on self-samples represents a great opportunity to increase cervical cancer screening uptake among under-screened women.
METHODS
A systematic review and meta-analysis on randomised controlled trials (RCTs) were performed to update the evidence on the efficacy of strategies for offering self-sampling kits for HPV testing compared to conventional invitations and to compare different self-sampling invitation scenarios. Four experimental invitational scenarios were considered. Women in the control group were invited for screening according to existing practice: collection of a cervical specimen by a healthcare professional. Random-effects models were used to pool proportions, relative participation rates and absolute participation differences.
RESULTS
Thirty-three trials were included. In the intention-to-treat analysis, all self-sampling invitation scenarios were more effective in reaching under-screened women compared to controls. Pooled participation difference (PD) and 95% confidence interval (CI) for experimental vs. control was 13.2% (95% CI = 11.0-15.3%) for mail-to-all, 4.4% (95% CI = 1.2-7.6%) for opt-in, 39.1% (95% CI = 8.4-69.9%) for community mobilisation & outreach and 28.1% (23.5-32.7%) for offer at healthcare service. PD for the comparison opt-in vs. mail-to-all, assessed in nine trials, was -8.2% (95% CI = -10.8 to -5.7%).
DISCUSSION
Overall, screening participation was higher among women invited for self-sampling compared to control, regardless of the invitation strategy used. Opt-in strategies were less effective than send-to-all strategies.
Topics: Female; Humans; Uterine Cervical Neoplasms; Papillomavirus Infections; Early Detection of Cancer; Mass Screening; Specimen Handling; Papillomaviridae; Vaginal Smears; Self Care
PubMed: 36517552
DOI: 10.1038/s41416-022-02094-w