Anogenital HPV Infection in a Population-Based Sample of Puerto Rican Women

波多黎各女性人群样本中的肛门生殖器 HPV 感染

• 批准号: 8240442
• 负责人: ANA Patricia ORTIZ
• 金额: $ 14.85万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8240442
• 关键词: Accounting; Adolescent; Age-Years; Agreement; American; Americas; Anogenital Human Papilloma Virus Infection; Anogenital cancer; Anus; Area; Award; California; Cervical; Cervix Uteri; Characteristics; Clinic; Collection; Computer Assisted; Confounding Factors (Epidemiology); Consensus; Data; Developed Countries; Development; Diagnosis; Dot Immunoblotting; Effectiveness; Epidemic; Epidemiologic Studies; Epidemiology; Etiology; Frequencies; Future; Genes; Genital Human Papilloma Virus Infection; Genital system; Grant; HPV-High Risk; Health Status; Hispanics; Histology; Household; Human; Human Papilloma Virus Vaccine; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Human papilloma virus infection; Human papillomavirus 16; Incidence; Individual; Infection; Interview; Island; Knowledge; Life; Life Style; Logistic Regressions; Malignant Neoplasms; Malignant neoplasm of anus; Malignant neoplasm of cervix uteri; Manuscripts; Marketing; Methodology; Modeling; Neoplasms; Oral cavity; Pharyngeal structure; Population; Population Study; Populations at Risk; Positioning Attribute; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Primary Prevention; Principal Investigator; Puerto Rican; Puerto Rico; Research Personnel; Risk; Risk Factors; Sampling; San Francisco; Secondary Prevention; Sexually Transmitted Diseases; Site; Specimen; Squamous intraepithelial lesion; Surveys; Swab; System; Testing; Time; United States; Universities; Vaccines; Vagina; Variant; Vial device; Vulva; Woman; Writing; aged; base; beta Globin; burden of illness; cancer epidemiology; carcinogenesis; design; epidemiology study; experience; insight; metropolitan; parkin gene/protein; penis; population based; programs; prophylactic; public health relevance; sample collection; sexually active; skills; statistics; transmission process; tumor; vaccine evaluation; viral DNA; young adult

DESCRIPTION (provided by applicant): Although genital human papilloma virus (HPV) infection is the most commonly diagnosed sexually transmitted infection among young sexually active populations worldwide, no epidemiological studies of anogenital HPV infection have been conducted in Puerto Rico. Given that infection with certain types of HPV has been associated with cancer of the anus and cervix, information on the distribution of HPV types at anogenital sites is essential for the design, implementation and evaluation of vaccine studies and programs. Given the lack of available data for Puerto Rico, this study aims to determine the prevalence of cervical, anal and concurrent cervical/anal HPV infection and factors associated to HPV anogenital infection among a population-based sample of 600 women aged 18 to 64 years living in the San Juan, Metropolitan area of Puerto Rico, using a self-sampling collection methodology previously tested in a clinic-based sample population. In addition, we aim to determine the concordance of HPV types in the anus and cervix among infected women and to explore the frequency distribution of HPV variants among women with concurrent infection with HPV types 16, 18 and 31. A face-to-face interview and a computer-assisted self-interview (Audio CASI system) will collect information on risk factors for HPV infection including demographic characteristics and lifestyles. Anal and cervical specimens will be collected using Dracon swabs, which will be placed in separate 5-mL vials containing 1 mL Qiagen Specimen Sample Transport Medium (Qiagen Corp.) after collection. HPV DNA testing will be performed at the University of California, San Francisco, using a modified pool of MY09/MY11 consensus HPV L1 primers as well as primers for amplification of the human beta-globin gene. PCR products from positive samples will be typed by dot-blot hybridization using 39 individual type-specific probes. Strain variant typing from the E6 region will also be done. HPV-DNA prevalence will be calculated by HPV-type and all types combined. Crude and covariate adjusted Prevalence Odds will be estimated by logistic regression models. Three different logistic regression models will be constructed to evaluate factors associated with the following infection status: 1) anus HPV+/cervix HPV- , 2) anus HPV-/cervix HPV+, and 3) anus HPV+/cervix HPV+. On each of these models, women negative for both anal and cervical HPV infection (anal HPV-/ cervix HPV-) will be used as the reference group. Concordance of HPV-type among HPV infected individuals will be assessed by the kappa statistic and the concordance rate. This study will provide insights on the epidemiology of anogenital HPV infection and it will explore the distribution of HPV 16, 18 and 31 variants in this population in Puerto Rican women. This information is relevant to identify groups of population at risk for HPV infection and related anogenital cancers and to assess the impact of HPV vaccine programs. PUBLIC HEALTH RELEVANCE: The proposed study will be the first to estimate the prevalence of anogenital and concurrent (anus and cervix) HPV infection, to describe the distribution of HPV types, and to assess factors associated with HPV anogenital infection in a population-based sample of Puerto Rican women. In addition we will explore the distribution of HPV 16, 18 and 31 variants in this population. To our knowledge, this will be the first study to assess anal infection among a homogenous Hispanic population in the U.S. This study will provide insights on the epidemiology of HPV infection and of the relationship between anal and cervical HPV infection in this population, information that will contribute to the development of future studies of the etiology and transmission dynamics of HPV infection in Puerto Rico. Further, it will allow us to explore the burden of HPV types currently included (6, 11, 16 and 18) and not included in the available vaccines. These assessments are necessary to understand the burden of HPV in this population, to identify groups at risk for HPV infection, cervical cancer and other HPV related malignancies, and to determine the impact of vaccine programs. Information on the distribution of HPV types at anogenital sites will also guide the development of effective primary and secondary prevention interventions to reduce the burden of HPV infection and anogenital cancers among the Puerto Rican population and will aid in the design and implementation of future HPV vaccines and vaccine studies in the island.

描述（由申请人提供）：尽管生殖器人乳头状瘤病毒（HPV）感染是全球年轻的性活性种群中最常见的性传播感染，但在波多黎各中没有对肛门生殖器HPV感染进行流行病学研究。鉴于某些类型的HPV感染与肛门和子宫颈的癌症有关，因此有关肛门生殖位点分布的信息对于疫苗研究和程序的设计，实施和评估至关重要。 Given the lack of available data for Puerto Rico, this study aims to determine the prevalence of cervical, anal and concurrent cervical/anal HPV infection and factors associated to HPV anogenital infection among a population-based sample of 600 women aged 18 to 64 years living in the San Juan, Metropolitan area of​​ Puerto Rico, using a self-sampling collection methodology previously tested in a clinic-based sample population.此外，我们旨在确定受感染妇女中肛门和子宫颈中HPV类型的一致性，并探索与HPV类型16、18和31的妇女中HPV变体的频率分布。面对面的访谈和计算机辅助的自我面试（Audio casi System）（Audio Casi System）将对HPV感染的风险感染范围，包括对HPV感染的风险感染的信息。收集后，将使用Dracon拭子收集肛门和宫颈标本，将其放置在包含1 ml QIAGEN样品样品传输培养基（Qiagen Corp.）的单独的5-mL小瓶中。 HPV DNA测试将在加利福尼亚大学旧金山分校进行，使用MY09/MY11共识HPV L1引物的修改池，以及用于扩增人β-珠蛋白基因的引物。来自阳性样品的PCR产物将使用39个单个类型特异性探针通过点印刷杂交键入。还将完成来自E6区域的应变变体键入。 HPV-DNA患病率将通过HPV型和所有类型的合并来计算。原油和协变量调整的患病率赔率将通过逻辑回归模型估算。将构建三个不同的逻辑回归模型，以评估与以下感染状态相关的因素：1）Anus HPV+/子宫颈HPV-，2）Anus HPV-/Cervix HPV+和3）Anus HPV+/Cervix HPV+。在这些模型中，肛门和宫颈HPV感染（肛门HPV-/子宫颈HPV-）的每个模型中的每一个都将用作参考组。 HPV感染者之间HPV型的一致性将通过KAPPA统计数据和一致性率进行评估。这项研究将提供有关肛门生殖器HPV感染的流行病学的见解，并将探索波多黎各妇女中该人群中HPV 16、18和31变体的分布。该信息与确定有HPV感染和相关肛门生殖器癌的人群群体有关，并评估HPV疫苗计划的影响。 公共卫生相关性：拟议的研究将是第一个估计肛门生殖器和并发（肛门和子宫颈）HPV感染的患病率的研究，以描述HPV类型的分布，并评估在波多黎各妇女的基于人群的样本中与HPV肛门生殖器感染相关的因素。此外，我们将探讨该人群中HPV 16、18和31变体的分布。据我们所知，这将是评估美国同质西班牙裔人群中肛门感染的第一项研究，这项研究将提供有关HPV感染的流行病学的见解，以及该人群中肛门与宫颈HPV感染之间的关系，这些信息将有助于HPV感染的未来研究和PURETO RICO的HPV感染动态的发展。此外，这将使我们能够探索当前包括的HPV类型的负担（6、11、16和18），并且不包括在可用的疫苗中。这些评估对于了解HPV在该人群中的负担是必要的，以确定有HPV感染，宫颈癌和其他HPV相关的恶性肿瘤的群体，并确定疫苗计划的影响。关于肛门生殖位点HPV类型分布的信息还将指导开发有效的原发性和次要预防干预措施，以减轻波多黎各人种群中HPV感染和肛门生殖器癌的负担，并将有助于设计和实施该岛未来的HPV疫苗和疫苗研究。

项目成果

Seroprevalence of HPV 6, 11, 16 and 18 and correlates of exposure in unvaccinated women aged 16-64 years in Puerto Rico.

• DOI: 10.1016/j.pvr.2018.03.006
• 发表时间: 2018-06
• 期刊: Papillomavirus research (Amsterdam, Netherlands)
• 作者: Ortiz AP;Tortolero-Luna G;Romaguera J;Pérez CM;González D;Muñoz C;González L;Marrero E;Suárez E;Palefsky JM;Panicker G;Unger ER
• 通讯作者: Unger ER

Factors Associated with HPV Vaccine Awareness in a Population-Based Sample of Hispanic Women in Puerto Rico.

• DOI: 10.1007/s40615-015-0144-5
• 发表时间: 2016-06
• 期刊: Journal of racial and ethnic health disparities
• 影响因子: 3.9
• 作者: Romaguera J;Caballero-Varona D;Tortolero-Luna G;Marrero E;Suárez E;Pérez CM;Muñoz C;Palefsky J;Ortiz AP
• 通讯作者: Ortiz AP

Prevalence, genotyping, and correlates of anogenital HPV infection in a population-based sample of women in Puerto Rico.

• DOI: 10.1016/j.pvr.2016.04.002
• 发表时间: 2016-12
• 期刊: Papillomavirus research (Amsterdam, Netherlands)
• 作者: Ortiz AP;Romaguera J;Pérez CM;González D;Muñoz C;González L;Marrero E;Tortolero-Luna G;Suárez E;Palefsky J
• 通讯作者: Palefsky J

Seroprevalence of Human Papillomavirus (HPV) Type 6, 11, 16, 18, by Anatomic Site of HPV Infection, in Women Aged 16-64 Years living in the Metropolitan Area of San Juan, Puerto Rico.

根据 HPV 感染的解剖部位，居住在波多黎各圣胡安大都市区的 16-64 岁女性中人乳头瘤病毒 (HPV) 6、11、16、18 型的血清阳性率。

• 发表时间: 2018
• 期刊: Puerto Rico health sciences journal
• 影响因子: 0.5
• 作者: Pérez-Caraballo,AixaM;Suarez,Erick;Unger,ElizabethR;Palefsky,JoelM;Panicker,Gitika;Ortiz,AnaPatricia
• 通讯作者: Ortiz,AnaPatricia

Methods in HPV Surveillance: Experiences from a Population-Based Study of HPV Infection among Women in the San Juan Metropolitan Area of Puerto Rico.

HPV 监测方法：波多黎各圣胡安都市区女性 HPV 感染人群研究的经验。

• 发表时间: 2015
• 期刊: Puerto Rico health sciences journal
• 影响因子: 0.5
• 作者: Ortiz,AnaPatricia;Marrero,Edmir;Muñoz,Cristina;Pérez,CynthiaM;Tortolero-Luna,Guillermo;Romaguera,Josefina;Rodríguez,Nahir;González-Falero,Andrea;Palefsky,Joel;Suárez,Erick
• 通讯作者: Suárez,Erick