Determinants of high-risk HPV persistence in female college students at USC

南加州大学女大学生高危 HPV 持续存在的决定因素

• 批准号: 7312674
• 负责人: Kim Creek
• 金额: $ 24.62万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7312674
• 关键词: African American; behavioral /social science research tag; biomarker; cancer risk; caucasian American; cervical /vaginal smear; clinical research; cytokine; disease /therapy duration; female; health disparity; health services research tag; human papillomavirus; human subject; lifestyle; racial /ethnic difference; university student; virus diseases; virus load

Cervical cancer is still a serious problem in South Carolina, and African American women are disproportionately affected by this disease. This proposal investigates the determinants of persistent high-risk human papillomavirus (HR-HPV) infection in female college students from the University of South Carolina (USC) and from Claflin University (CU), a Historically Black College/University (HBCU). The rationale for this study is: while HR-HPV infection is the major cause of cervical cancer, most HPV infections clear spontaneously in a matter of months, and only women who have persistent HR-HPV infection are truly at risk for cancer. However, in order to diagnose HPV infection as persistent, multiple HPV tests must be conducted at six month intervals for up to two years, and the specific HPV type must be identified each time. Hence, this approach is not applicable to large scale screening. If markers of HPV persistence could be identified at a first visit, then careful follow-up could be directed to those women that really need it, in a cost-effective and efficient fashion. We propose to recruit 300 female college students from USC and CU into this study. Both African American and Caucasian women are well represented in this cohort. Study participants will be followed from their freshman year and throughout the course of their college studies, with Pap smears and cervical mucus collections performed every six months. Specifically, we will monitor: cytology, HPV infection by specific type, viral load, HPV E7 mRNA expression in the Pap smear material, and the profile of 16 cytokines in the cervical mucus. Questionnaires administered at each visit collect information concerning lifestyle factors, stress, smoking, diet, and physical activity. Study Questions: 1. Is there a correlation between specific cytokine profiles and HR-HPV persistence? 2. Is there a correlation between viral load and HR-HPV persistence? 3. Is high E7 mRNA expression correlated with persistence? 4. Is there a relationship between HPV DMA viral loads and E7 mRNA expression? And 5. Is there a correlation between HR-HPV persistence and diet, stress, lifestyle factors, physical activity? By comparing the factors that determine HPV persistence in African American and Caucasian women who receive the same standard of care, we will identify factors that, together with access to care, may contribute to determining the disparity in cervical cancer incidence and mortality rates observed between these two ethnic groups in South Carolina.

宫颈癌在南卡罗来纳州仍然是一个严重的问题，非洲裔美国妇女是 不成比例地受到这种疾病的影响。该提案调查了南卡罗来纳州大学（USC）和克拉夫林大学（CU）（一所历史上的黑人学院/大学（HBCU））的女大学生中持续高危人乳头瘤病毒（HR-HPV）感染的决定因素。这项研究的基本原理是：虽然HR-HPV感染是宫颈癌的主要原因，但大多数HPV感染在几个月内自发清除，只有持续HR-HPV感染的女性才真正有患癌症的风险。然而，为了诊断HPV感染为持续性，必须每隔六个月进行多次HPV检测，最长持续两年，每次都必须确定特定的HPV类型。 因此，这种方法不适用于大规模筛选。如果HPV持续性的标志物可以在第一次就诊时确定，那么可以以具有成本效益和有效的方式对那些真正需要它的妇女进行仔细的随访。本研究拟招募300名南加州大学和加州大学的女大学生参与本研究。非裔美国人和高加索妇女在这一群体中都有很好的代表性。研究参与者将从大学一年级开始，在整个大学学习过程中进行跟踪，每六个月进行一次巴氏涂片和宫颈粘液收集。具体而言，我们将监测：细胞学检查、特定类型的HPV感染、病毒载量、巴氏涂片材料中的HPV E7 mRNA表达以及 宫颈粘液中的16种细胞因子在每次访问时管理的问卷收集有关生活方式因素，压力，吸烟，饮食和体育活动的信息。研究问题：1.特异性细胞因子谱与HR-HPV持续性之间是否存在相关性？2.病毒载量和HR-HPV持续性之间是否存在相关性？3.高E7 mRNA表达与持久性相关吗？4. HPV DNA病毒载量与E7 mRNA表达之间是否存在关系？和5. HR-HPV持续性与饮食、压力、生活方式因素、体力活动之间是否存在相关性？通过比较接受相同护理标准的非裔美国人和白人妇女中决定HPV持续性的因素，我们将 确定可能有助于确定南卡罗来纳州这两个族裔群体之间观察到的宫颈癌发病率和死亡率差异的因素以及获得护理的机会。