NATURAL HISTORY OF GENITAL HUMAN PAPILLOMAVIRUS IN RENAL TRANSPLANTS

肾移植中生殖器人乳头瘤病毒的自然史

• 批准号: 6244006
• 负责人: Peter George Pappas
• 金额: $ 2.46万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-02-10 至 1997-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6244006
• 关键词: artificial immunosuppression; biopsy; cervical /vaginal smear; clinical research; epidemiology; female; human papillomavirus; human subject; immunosuppressive; kidney transplantation; longitudinal human study; pathologic process; polymerase chain reaction; preoperative state; women's health

Genital human papillomavirus (HPV) infection is exceedingly common. This sexually transmitted disease may affect as many as 70% of all sexually active women at some time in their lives. Disease manifestations vary depending on the HPV type, the site of infection and host factors. HPV types 6 and 11 cause genital warts and low grade intraepithelial neoplasias. There is compelling evidence that types 16, 18 and 31 contribute to the development of high grade intraepithelial neoplasias and invasive anogenital cancers as part of the multistep process of carcinogenesis. The primary host defense against HPV appears to be cell mediated immunity. Conditions characterized by impairment of cellular immunity such as the iatrogenic immunosuppression of organ transplantation and human immunodeficiency virus infection are associated with an increase in the frequency and severity of genital warts and anogenital malignancies. In this study, we will establish the prevalence of genital HPV infection in a group of 60 women at the time they receive their renal allografts in the immediate preoperative period; and three groups of 30 women each who have had established allografts for: less than one year, one to five years, and greater than five years respectively. These cohorts will be followed at four month intervals for a year to determine incidence data. Patients will undergo routine pelvic examination including inspection of the external anogenital areas and speculum examination. A pap smear, cervical culture for chlamydia and HSV and cervical washings for HPV testing will be obtained. The polymerase chain reaction (PCR) will be used for detection of HPV and typing will be performed by standard techniques. In addition, patients will be asked to complete a sexual history at each visit. Immunosuppression data will be obtained from the patient's medical chart. Patients with external lesions will be treated with standard therapies. Patients with abnormal pap smears will be referred to the Department of OB/GYN for further evaluation and treatment. Data from this study will provide important insights into the natural history of genital HPV infection in a select immunocompromised population.

生殖器人乳头瘤病毒（HPV）感染是非常常见的。 这种性传播疾病可能会影响多达70%的所有 性生活活跃的女性 疾病 表现取决于HPV类型、感染部位和 宿主因素 HPV 6型和11型导致生殖器疣和低级别 上皮内瘤形成。 有令人信服的证据表明，16型， 18和31有助于高级别上皮内 肿瘤和浸润性肛门生殖器癌作为多步骤 致癌过程。 针对HPV的主要宿主防御似乎 是细胞免疫 以损害为特征的病症 细胞免疫，如器官的医源性免疫抑制 移植和人类免疫缺陷病毒感染， 与生殖器感染的频率和严重程度增加有关 疣和肛门生殖器恶性肿瘤。 在这项研究中，我们将建立 当时一组60名妇女的生殖器HPV感染率 他们在术前立即接受肾移植， 30名妇女组成的三个小组， 同种异体移植：小于1年，1 - 5年，大于 分别为五年。 将在4个月时对这些队列进行随访 间隔一年，以确定发病率数据。 患者将接受 常规盆腔检查，包括外部检查 肛门生殖器区域和窥镜检查。 子宫颈抹片 衣原体和HSV培养以及HPV检测的宫颈冲洗液将 获得。 聚合酶链反应（PCR）将用于 HPV检测和分型将通过标准技术进行。 此外，患者将被要求在每次检查时填写性史。 访问 免疫抑制数据将从患者的 医疗图表 外部病变患者将接受以下治疗： 标准疗法 子宫颈抹片检查异常的病人将被转介 到妇产科作进一步评估及治疗。 数据 这项研究将提供重要的见解， 特定免疫功能低下人群中生殖器HPV感染的比例。