Le cancer du col de l’utérus est la première cause de cancer chez la femme en Afrique de l’Ouest, une région du monde où le virus de l’immunodéficience humaine (VIH) sévit de manière endémique. Ce travail s’inscrit dans le cadre de l’étude du lien entre ces deux pathologies ainsi que des spécificités du dépistage du cancer du col dans le contexte de l’infection à VIH.Notre travail de recherche a été conduit en plusieurs étapes. Une enquête hospitalière a tout d’abord comparée la fréquence du VIH chez des femmes atteintes de cancer du col et chez des femmes atteintes d’autres cancers. Nous avons ensuite mis en place un programme de dépistage des cancers du col par inspection visuelle au sein de trois cliniques VIH à Abidjan offrant cette intervention pendant une période de plusieurs mois. Un échantillon de ces femmes dépistées a enfin été prélevé pour la recherche de papillomavirus humains (PVH). Sur les 152 cas de cancer du col inclus dans la première enquête, 25% étaient VIH-positifs contre 4,7% chez les 257 patientes du groupe de comparaison, donnant un Rapport de Côte (RC) ajusté de 7,6 (3,6 – 16,2) pour l’association entre ces deux morbidités sévères. Un total de 4 046 femmes a été dépisté par inspection visuelle. La fréquence d’un test positif était de 9,0% (8,0 – 10,0) chez les 2 998 femmes VIH-positives et 3,9% (2,7 – 5,1) chez les 1 048 femmes VIH-négatives. La prévalence de l’infection à PVH oncogène était de 33,0% chez les 191 femmes VIH-négatives et de 52,8% chez les 254 femmes VIH-positives ayant pu être testé par PCR. Un taux de CD4<200 cellules/mm3 était associé à la présence d’un PVH oncogène (RC= 2,8 [1,1 – 8,3] Ref. CD4 ≥500). L’infection à VIH est fortement associée au risque de cancer du col ainsi qu’à la présence de ses précurseurs que sont les PVH. La mise en place de programmes de dépistage associé à une bonne reconstitution immunitaire semble être des mesures essentielles pour réduire le fardeau de ce cancer chez les femmes VIH-positives en Afrique de l’Ouest à l’ère de l’accès élargi aux antirétroviraux. / Cervical cancer is the leading cause of cancer among women in West Africa, where infection with the Human Immunodeficiency Virus (HIV) is endemic. This work study the link between these two pathologies as well as the specificities linked to cervical cancer screening in the context of HIV infection. Our research project was conducted in several stages. A first hospital-based study compared the prevalence of HIV in women with cervical cancer and in women with other cancers. We then implement a cervical cancer screening program with visual inspection methods in three HIV clinics in Abidjan during several months. A sample of women screened was finally selected and collected for human papillomavirus (HPV) identification. Of the 152 cases of cervical cancer included during the first study, 25% were HIV-positive compared to 4.7% among the 257 patients of the comparison group, giving an adjusted odd ratio (OR) of 7.6 (3.6 - 16.2). A total of 4,046 women were screened by visual inspection. The frequency of a positive test was 9.0% (8.0 - 10.0) in the 2,998 HIV-positive women and 3.9% (2.7 - 5.1) in the 1,048 HIV-negative women. The prevalence of oncogenic HPV was 33.0% in the 191 HIV-negative women and 52.8% in the 254 HIV-positive women that underwent PCR testing. A CD4 count <200 cells/mm3 was associated with the presence of oncogenic HPV (OR = 2.8 [1.1 - 8.3] Ref. CD4≥500). HIV infection is strongly associated with cervical cancer and the presence of its precursors, oncogenic HPV. The implementation of adapted screening programs combined with good immune reconstitution seems to be key measures to reduce the burden of cervical cancer in HIV-positive women in West Africa in the era of expanded access to antiretroviral drugs.

Thesis advisor: Junona Moroianu / During the papillomavirus replication cycle, the L2 minor capsid protein enters the nucleus in the initial phase after uncoating of the incoming virions and in the productive phase when L2 together with L1 major capsid protein mediate the encapsidation of the newly replicated viral genome. L2 proteins of both high risk HPV16 L2 and low risk HPV11 L2 have two nuclear localization signals (NLSs): one at the N-terminus (nNLS) and one at the C terminus (cNLS). The purpose of these experiments is to determine the minimal mutations necessary to inhibit the function of the NLSs. In this study, subcellular localization of enhanced green fluorescent protein (EGFP) fusions with full length L2 and L2 mutants lacking either the cNLS (EGFP-L2ΔC), nNLS (EGFP-L2ΔN), or both NLSs (EGFP-L2ΔNΔC) was analyzed in HeLa cell transfection assays. Full length HPV16 L2 and HPV11 L2 proteins localize to the nucleus. For both HPV16 and 11 L2, each NLS could independently mediate nuclear import in vivo. EGFP fusions were also made with mutated nNLS (EGFP-L2ΔCSbN) or mutated cNLS (EGFP-L2ΔNSbC). Transfected HeLa cells were examined by fluorescence microscopy and quantitative studies were done. In both HPV16 and 11 L2 proteins, mutation of basic residues in either NLS inhibited its nuclear import ability. / Thesis (BS) — Boston College, 2008. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Biology. / Discipline: College Honors Program.

Thesis advisor: James Lubben / In 2011, an estimated 12,710 women suffered from cervical cancer and 4,290 died from it in the U.S. HPV vaccination (HPV-V) and PAP screening (PAP-S) could reduce this burden. Using 2010 National Health Interview Survey data, current disparities in the use of PAP-S and HPV-V in U.S. women aged 18-30 years were investigated. An adapted Behavioral Model of Health Care Utilization guided the study. Main outcomes were PAP-S in prior year and ever-HPV-V, both initiation and completion. Adjusted predictor estimates were obtained through multivariate logistic regressions with appropriate statistical procedures and weights for complex survey design. A sub-analysis focused on unvaccinated women. The sample had 3,129 women aged 18-30 years, representing about 27 million women of similar age in the U.S. PAP-S, HPV-V initiation and completion rates were 53.5%, 17.9%, and 10.3%, respectively. Hispanics were 33% less likely than Non-Hispanic-Whites to initiate HPV-V. Non-Hispanic-Blacks were 55% more likely and 57% less likely than Non-Hispanic-Whites to receive PAP-S and complete HPV-V, respectively. Non-Hispanic Asians were 36% less likely than Non-Hispanic-Whites to receive PAP-S, but this result was borderline significant. Younger age and being unmarried were predictors of lower PAP-S but higher HPV-V. Ever gave birth was a predictor of higher PAP-S but lower HPV-V. Preventative behaviors (PAP-S and flu vaccination) were predictors of higher HPV-V. STI-history was a predictor of higher HPV-V and PAP-S. Not having health insurance for over one year or recent health provider visit were predictors of lower PAP-S and HPV-V. Living in the South was a predictor of lower HPV-V. Household income was not a predictor of any outcomes. Most common reported reason for no HPV-V was "no need." Study findings indicate interventions to mitigate disparities in cervical cancer prevention are needed. Tailored education interventions for both women and health care providers along with opportunities associated with the 2010 Affordable Care Act, such as broader access to health care, emphasis on health information technology, and initiatives with PAP screening and adult vaccination as potential quality indicators for performance/payment, can reduce these disparities. Future research should focus on the feasibility of alternative venues for receiving HPV-V and PAP-S. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Made available in DSpace on 2016-08-10T10:39:22Z (GMT). No. of bitstreams: 1 Fernando Cristina Lima.pdf: 6153916 bytes, checksum: 8dace7e61dc94d086253d97a1190122b (MD5) Previous issue date: 2009-03-16 / O fato de que a infecção pelo HPV é fator causal no desenvolvimento do câncer cervical fornecem o requisito necessário para a inclusão dos testes de detecção de HPV na rotina ginecológica. A detecção do vírus permite a detecção precoce da infecção pelo HPV, possibilitando intervenções no desenvolvimento de lesões precursoras e dessa forma, diminuindo o risco de progressão para o câncer cervical. Diferenças existentes nas sequências de nucleotídeos que determinam as regiões precoces e tardias do genoma do HPV são responsáveis pela existência dos diversos tipos de HPVs conhecidos. Essas variações também são responsáveis pelo grau de transformação e potencial oncogênico do vírus. Assim, tais regiões podem ser exploradas para o desenvolvimento de testes moleculares tipo-específicos ou que envolvam o maior número possível de tipos de HPV. Existem dois grupos de métodos principais para a detecção de HPV: a hibridização direta (Southern blot, dot blot, e hibridização in situ) e a amplificação gênica (técnicas baseadas na reação em cadeia da polimerase - PCR). As metodologias baseadas em PCR, utilizando primers consensuais, permitem a detecção de um grande número de tipos de HPV simultaneamente. Os primers são desenvolvidos tendo como alvo regiões conservadas do genoma do HPV entre diferentes tipos virais. O objetivo deste estudo foi avaliar a infecção pelo HPV em dois grupos de mulheres, HIV-positivas e HIV-negativas, comparando as três metodologias de PCR mais utilizadas na detecção do HPV atualmente, utilizando os conjuntos de primers GP5+/GP6+; MY09/11 e PGMY09/11. Utilizando os primers GP5+/6+, a detecção de HPV foi positiva em 27/57 (47%) mulheres HIV-positivas e em 15/57 (26%) mulheres HIV-negativas. Com os primers MY09/11, a detecção foi positiva em 35/57 (61%) mulheres HIV-positivas e em 17/57 (30%) mulheres HIV-negativas. Utilizando os primers PGMY09/11, a detecção de HPV foi positiva em 41/57 (72%) mulheres HIV-positivas e em 21/57 (37%)...

Tin-hung Ho. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1990. / Bibliography: leaves 137-151. / ACKNOWLEDGEMENT --- p.1 / CONTENT --- p.3 / ABBREVIATIONS --- p.7 / ABSTRACT --- p.8 / Chapter CHAPTER 1 --- INTRODUCTION --- p.10 / Chapter CHAPTER 2 --- LITERATURE REVIEW / Chapter 2.1 --- The cervix and cervical cancer --- p.12 / Chapter 2.2 --- Human papillomaviruses --- p.23 / Chapter 2.3 --- Culture of cancer cells --- p.36 / Chapter 2.4 --- Methods for the detection of HPV infection --- p.40 / Chapter CHAPTER 3 --- MATERIALS AND METHODS / Chapter 3.1 --- Characterization of cervical carcinoma cell lines / Chapter 3.1.1 --- Materials and solutions --- p.47 / Chapter 3.1.2 --- Establishment of cervical carcinoma cell lines --- p.50 / Chapter 3.1.3 --- Morphological studies of cervical carcinoma cells --- p.52 / Chapter 3.1.4 --- Examination of cervical carcinoma cells cultured on collagen gel --- p.54 / Chapter 3.1.5 --- Growth kinetics study --- p.55 / Chapter 3.1.6 --- Plating efficiency test --- p.56 / Chapter 3.1.7 --- Spheroid formation assay --- p.56 / Chapter 3.1.8 --- Chromosome number study --- p.57 / Chapter 3.2 --- Immunocytochemical studies / Chapter 3.2.1 --- Materials and solutions --- p.58 / Chapter 3.2.2 --- Immunocytochemical test for keratin --- p.59 / Chapter 3.2.3 --- Test for HPV capsid antigens --- p.60 / Chapter 3.3 --- Molecular studies of HPV in cervical carcinoma cells / Chapter 3.3.1 --- Materials and solutions --- p.62 / Chapter 3.3.2 --- Preparation of HPV DNA probes --- p.66 / Chapter 3.3.3 --- DNA extraction from the cervical carcinoma cells --- p.74 / Chapter 3.3.4 --- Detection of HPV DNA sequences by the use of hybridization techniques --- p.76 / Chapter 3.3.5 --- Copy number and physical state studies of HPV --- p.81 / Chapter 3.3.6 --- Study of the transcriptional activity of HPV DNA in cultured cervical carcinoma cells --- p.83 / Chapter CHAPTER 4 --- RESULTS / Chapter 4.1 --- Characterization of cervical carcinoma cell lines / Chapter 4.1.1 --- Morphological studies --- p.89 / Chapter 4.1.2 --- Examination of cervical carcinoma cells cultured on collagen gel --- p.90 / Chapter 4.1.3 --- Growth kinetics study --- p.93 / Chapter 4.1.4 --- Plating efficiency test --- p.94 / Chapter 4.1.5 --- Spheroid formation assay --- p.95 / Chapter 4.1.6 --- Chromosome number study --- p.98 / Chapter 4.2 --- Immunocytochemical studies / Chapter 4.2.1 --- Immunocytochemical test for keratin --- p.99 / Chapter 4.2.2 --- Test for HPV capsid antigen --- p.99 / Chapter 4.3 --- Molecular studies of HPV in cervical carcinoma cell lines / Chapter 4.3.1 --- Preparation of HPV DNA probes --- p.101 / Chapter 4.3.2 --- Detection of HPV DNA by the use of hybridization techniques --- p.102 / Chapter 4.3.3 --- Copy number and physical state studies --- p.105 / Chapter 4.3.4 --- Analysis of the transcriptional activity --- p.108 / Chapter CHAPTER 5 --- DISCUSSIONS / Chapter 5.1 --- Characterization of cervical carcinoma cell lines / Chapter 5.1.1 --- Morphological features of two cervical carcinoma cell lines --- p.110 / Chapter 5.1.2 --- Other characteristics of the cell lines --- p.112 / Chapter 5.2 --- Immunocytochemical studies / Chapter 5.2.1 --- Test for keratin antigens --- p.117 / Chapter 5.2.2 --- Test for HPV capsid antigens --- p.117 / Chapter 5.3 --- Molecular studies of HPV in cervical carcinoma cell lines / Chapter 5.3.1 --- Establishment of methods --- p.121 / Chapter 5.3.2 --- Detection of HPV DNA sequences by nucleic acid hybridizations --- p.123 / Chapter 5.3.3 --- Copy number and physical state studies --- p.128 / Chapter 5.3.4 --- Transcriptional analysis of HPV DNA in cervical carcinoma cell lines --- p.132 / CONCLUSION --- p.134 / REFERENCES --- p.137 / ILLUSTRATIONS --- p.152

PURPOSE: To understand why adolescents who initiate the HPV vaccine series fail to complete all three shots. METHODS: Semi-structured interviews were performed with parents/guardians of 11-17 year old daughters and pediatric primary care providers in one inner-city public clinic and three private practices to determine why girls who received at least one dose of the HPV vaccine did or did not complete the series. The number of shots received was confirmed by electronic medical record review. Content analysis was used to identify themes related to series completion. RESULTS: 65 parents/guardians participated: 37 whose daughters received 1 or 2 doses of HPV vaccine and 28 whose daughters completed 3 doses. Most (n=24, 65%) parents/guardians failed to complete the series because they thought the clinics would remind them of subsequent doses. 9 (24%) cited logistical barriers. 4 (11%) decided to stop the vaccine series. 33 providers participated: 24 physicians, 3 nurse practitioners, and 6 registered nurses. 52% of providers told parents to schedule appointments, 41% scheduled the second dose at the time the first dose was given, and 7% tried to immunize patients when they returned for other appointments; providers confirmed that few parents chose to stop the series. No practice had a system in place to ensure series completion. CONCLUSIONS: Most failure to complete the HPV vaccine series occurred because providers expected parents to make appointments while parents expected to be reminded. Increased use of reminder/recall systems and clear communication of expectations regarding appointment scheduling could improve completion rates.

by Yam Hin Fai. / "June 1998." / Thesis (Ph.D.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (p. 118-151). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstract in Chinese.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2017-03-30T12:06:18Z No. of bitstreams: 1 guilherme bicca.pdf: 680711 bytes, checksum: e28a5595678fe9a4a9acbdac5079e73b (MD5) / Made available in DSpace on 2017-03-30T12:06:18Z (GMT). No. of bitstreams: 1 guilherme bicca.pdf: 680711 bytes, checksum: e28a5595678fe9a4a9acbdac5079e73b (MD5) Previous issue date: 2014-01-29 / Cervical cancer is currently the third malignancy on number of female deaths in the world. Studies have shown that persistent HPV infection is the main agent involved in cervical cancer development. Particularly of high risk (HR) HPV types 16 and 18, accountable for approximately 75% of cervical cancer cases. Knowledge on infection persistence and correlation with cervical cancer has increased the demand for HPV detection molecular tests. The most used techniques are PCR and Hybrid Capture 2 (HC2). However, techniques for detection of HPV E6/E7 mRNA and p16INK4a have been developed, which are still being validated. These tests may help distinguish transient from persistent HPV infections. Working on reducing the number of cervical cancer cases, screening strategies have been adjusted to contain the best combination of cytological and molecular tests. The ideal screening strategy would require high sensitivity to minimize false negative results, as well as high specificity, in order to avoid false positives and overreferral. Optimization may be achieved by using by cotesting: a combination of HPV genotyping and either cytology triage with low-grade intraepithelial lesions (LSILs) or with atypical squamous cells of undetermined significance (ASC-US). An important measure to reduce cervical cancer cases in prevention through the use of vaccination. Quadrivalent and bivalent vaccines have been approved and used in different countries. The Brazilian National Health System will, from 2014, offer the quadrivalent HPV vaccine free of cost for the vaccination of girls aged between 10 and 11 years old. / Introdução: Atualmente o câncer de colo uterino é a terceira causa de morte em mulheres no mundo. Estudos têm demonstrado que infecção persistente pelo HPV é o principal agente envolvido no desenvolvimento do câncer de colo uterino. Especialmente HPV de alto risco (AR), tipos 16 e 18, são responsáveis por aproximadamente 75% dos casos de câncer de colo uterino. O conhecimento da persistência da infecção bem como de sua relação com o câncer de colo uterino promoveu um incremento na demanda de testes moleculares para detecção de HPV. As técnicas mais utilizadas são a PCR e a captura híbrida. Contudo, técnicas para detecção de RNAm de HPV E6/E7 e p16NK4 já foram desenvolvidas e estão em fase de validação. Estes testes poderão auxiliar na distinção de infecções transientes e persistentes. Buscando reduzir o número de casos de câncer de colo uterino, estratégias de seleção/diagnóstico combinando testes citológicos e moleculares tem sido ajustadas. As estratégias de screening ideais requerem alta sensibilidade para minimizar resultados falso negativos assim como alta especificidade a fim de evitar falsos positivos e excesso de encaminhamentos. A otimização pode ser obtida utilizando combinações testes de genotipagem de HPV com triagens citológicas. Uma medida importante para redução dos casos de câncer de colo de útero é a vacinação preventiva, vacinas quadrivalentes e bivalentes tem sido aprovados e utilizados em diferentes países. O Ministério da Saúde, a partir de 2014, oferecerá a vacina quadrivalente gratuitamente para imunização de meninas entre 10 e 11 anos de idade.

Magister Public Health - MPH / The study aimed to describe the knowledge and awareness of HPV infection and vaccine of female university students and to determine the predictors of vaccine acceptability. The study found that 70% of the participants were sexually active. Awareness and knowledge on HPV/vaccine were poor; with only 22% being aware of HPV and that a HPV vaccine was available in South Africa. A greater proportion (80%) reported willingness to be vaccinated. Being aware of the existence of a pap smear, higher knowledge about HPV, higher perceived vaccine effectiveness and higher perceived severity of HPV infection were significantly associated with increased willingness to be vaccinated. / South Africa

Excerpt: According to the United States Centers for Disease Control and Prevention (CDC), approximately 20 million Americans are currently infected with human papillomavirus (HPV), and another 6 million will become newly infected each year.