HPV Medical Research - Detection and Treatment

HPV Medical Research - Article in Chinese

OBJECTIVE: To establish a method for detection of Human Papillomavirus (HPV) type16 E6 gene in Cervical carcinomas Specimens. To study the relationship between the quantities of HPV16 E6 (Human papillomavirus type16 E6 gene) in cervical tissues and the course of cervical disease in Xinjiang. METHODS: HPV16E6 gene and beta-actin was detected in parallel by FQ-PCR (fluorescence quantitative PCR). The number of copies of HPV16 E6 gene and beta-actin was detected in parallel by FQ-PCR (fluorescence quantitative PCR) in tissues of 69 cervical cancer, 65 cervical intraepithelial neoplasia (CIN), 33chronic cervicitis and samples of 96 cervical smear samples of vaginitis and cervicitis. The variation in HPV copies per genomic DNA equivalent can be estimated by dividing the HPV copy number by the beta-actin copy number. RESULTS: The positive rate of HPV16 E6 gene was 83.0%, 75.7%, 93.3% and 3.3% in tissues of cervical cancer, cervical intraepithelial neoplasia (CIN), chronic cervicitis and samples of cervical smear respectively. The amount of HPV16 E6 gene was gradually higher by the developing of the course of cervical disease. They have positive rank correlation, r = 0.83, P < 0.01. CONCLUSION: The study underscores the importance of the relationship between the HPV16 E6 gene and the course of cervical disease in Xinjiang. It also suggests that the quantification of HPV16 E6 gene may be useful as a prognostic tool to identify women who are at increased risk of developing cervical cancer. This method may be applied to studies of a number of issues related to the natural history of cervical cancer, such as the amounts of HPV in high- and low-grade lesions.

J Med Assoc Thai. 2004 Nov;87(11):1270-4.

Accuracy of Nugent's score and each Amsel's criteria in the diagnosis of bacterial vaginosis.

Chaijareenont K, Sirimai K, Boriboonhirunsarn D, Kiriwat O. Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

OBJECTIVE: To determine the diagnostic accuracy of Nugent's score and each Amsel's criterion in the diagnosis of bacteria vaginosis (BV), considering Amsel's criteria as the gold standard. DESIGN: Cross-sectional, descriptive study (diagnostic test) Setting: Family planning clinic, Siriraj Hospital, Mahidol University. SUBJECTS: A total of 217 women who attended the Family Planning Clinic at Siriraj Hospital between August and December 2003. METHOD: Pelvic examination was performed on each participant. Samples of vaginal discharge was tested for BV infection using both Amsel's criteria and Nugent's score. Interpretation was made blinded without knowledge of each test result. Using Amsel's criteria as a gold standard, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Nugent's score and each of Amsel's criteria were estimated. RESULTS: Considering Amsel's criteria as the gold standard, Nugent's score showed a sensitivity of 65.6% (95%CI 46.8%, 80.8%), specificity of 97.3% (95%CI 93.5%, 99.0%), positive predictive value (PPV) of 80.8% (95%CI 60.0%, 92.7%), negative predictive value (NPV) of 94.2% (95%CI 89.7%, 96.9%) and accuracy of 92.6% (95%CI 88.1%, 95.6%). Both vaginal pH and whiff test demonstrated 100% sensitivity. However, vaginal pH showed lower specificity than the whiff test (58.9% and 97.3% respectively). CONCLUSION: Nugent's score might not be suitable to use as a screening test for diagnosis of BV due to its low sensitivity. The whiff test is the best clinical criteria of Amsel's criterion in the diagnosis of BV due to its high sensitivity and specitivity.

Sex Transm Infect. 2005 Apr;81(2):155-7.

Methods employed by genitourinary medicine clinics in the United Kingdom to diagnose bacterial vaginosis.

Keane FE, Maw R, Pritchard C, Ison CA. Department of Genitourinary Medicine, Royal Cornwall Hospital, Treliske, Truro TR1 3LJ, UK.

OBJECTIVE: To determine the methods used by genitourinary medicine (GUM) clinics in the United Kingdom for the diagnosis of bacterial vaginosis (BV). METHODS: A questionnaire survey of UK GUM clinics was conducted. RESULTS: 148/221 (67%) clinics returned a questionnaire. 96/148 (64.9%) clinics reported using Amsel's criteria to diagnose BV but only 29 (30.5%) of these used all four of the composite criteria. 139/148 (93.9%) clinics used the appearance of a Gram stained vaginal smear as an aid in BV diagnosis, although a variety of scoring methods was employed. In the majority of clinics, 92/148 (62.2%), one staff discipline provided the microscopy service, in 50 (33.8%) clinics two staff disciplines provided microscopy services. The bulk of microscopy services within UK GUM clinics is provided by nurses. CONCLUSIONS: Most UK GUM clinics utilise the appearance of a Gram stained vaginal smear for the diagnosis of BV although there is little consensus at present about the type of scoring method employed. Adaptation of a uniform scoring method would have enormous benefits, including consistency and reproducibility of results and the development of quality assurance schemes for BV diagnosis on a national basis. There are important issues to be addressed regarding the initial training and ongoing support for nurses providing microscopy services within UK GUM clinics.

Publication Types:
• Multicenter Study

Int J Gynaecol Obstet. 2005 May;89(2):127-32.

Propolis solution for the treatment of chronic vaginitis.

Imhof M, Lipovac M, Kurz Ch, Barta J, Verhoeven HC, Huber JC. Department of Obstetrics and Gynecology, AKH Vienna, University of Vienna, Vienna, Austria.

OBJECTIVE: To evaluate the efficacy of 5% propolis solution in recurrent vaginitis. METHOD: Fifty-four patients with recurrent vaginal infections having undergone at least one cycle of antibiotic treatment were instructed to apply a 5% aqueous propolis solution as a vaginal douche for seven days. Vaginal smears and specific symptoms were evaluated at baseline and 14 days after treatment. Long-term well-being was assessed by telephone interview six months after follow-up. RESULT: At the follow-up, the vaginal smears of 41 patients (75.9%) had improved. Forty-seven patients (87%) reported reliefs concerning at least one complaint. Associated improvement of smear and well-being was observed in 36 women (66.7%). After 6 months, 33 patients (61.1%) were satisfied with their condition without having undergone further treatment. CONCLUSION: Propolis may have a role as an alternative treatment for chronic vaginal infection.

Semin Reprod Med. 2005 May;23(2):126-40.

Vaginal hormone therapy for urogenital and menopausal symptoms.

Ballagh SA. Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 601 Colley Avenue, Norfolk, VA 23507, USA.

Reduction of ovarian steroids at menopause leads to significant changes in the urogenital tract. These changes often worsen with time, particularly in nonsmokers, affecting up to 38% of menopausal women. Urogenital symptoms that clearly respond to estrogen therapy include atrophic vaginitis, dryness, and accompanying dyspareunia. Estrogen reduces urinary tract infections in women plagued by frequent recurrence. The sensation of urgency improves with estrogen but urge incontinence improvement is similar to that with placebo. Stress incontinence does not improve with estrogen. Until recently, vaginal therapy was reserved for local symptoms. Rings make systemic vaginal therapy acceptable and even preferred by some users. Vaginal delivery, like other parenteral therapies, bypasses the gastrointestinal tract, with less anticipated impact on lipids, globulins, clotting, and fibrinolytic factors. Evidence of a lowered risk of venous thromboembolism is reviewed. Options for estrogen therapy include native, synthetic, or biologically derived estrogens delivered by cream, gel, insert (pessary), ring, or tablet. Even the lowest dose estradiol (7.5 mug daily or 25 mug twice per week) shows evidence of systemic absorption. In long-term placebo-controlled studies, bone density was better preserved and lipid profiles were more favorable. Therefore, even these low dose therapies should be opposed by occasional progestogen to prevent endometrial carcinoma. Intermittent therapy is best given for a minimum of 12 days based on laboratory data. Less frequent dosing, although preferred by patients, likely confers a slightly increased risk of hyperplasia. No combination estrogen/progestogen vaginal product is currently available. The best dose to reduce risk of endometrial pathology adequately in the lower dose therapies will be defined not only by the dose and potency of the exogenous estrogen but by the individual is body habitus and lifestyle choices.

Publication Types:
• Review
• Review, Tutorial

HPV Medical Research - HPV Detection and Treatment Links

Detection and Treatment of HPV - Queensland Management Guidelines for the Detection and Treatment of Human Papillomavirus.

Duke Student Health Center: HPV - General Info on subclinical HPV infection.