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: 6274039
• 负责人: Peter George Pappas
• 金额: $ 2.59万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-01-26 至 1998-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6274039
• 关键词: artificial immunosuppression; biopsy; cellular immunity; 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 fourth 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. External abnormalities attributed to HPV infection will be biopsied. A pap smear; cervical cultures 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 Obstetrics and Gynecology for further evaluation and treatment. Clinical, cytologic and, when indicated, histologic manifestations of HPV infetion will be described. Data from this study will provide important insights into the natural history of genital HPV infection in a select immunocompromised population.

生殖器人类乳头瘤病毒（HPV）感染是非常常见的。这