Carga viral de seis tipos de Virus del Papiloma Humano de alto riesgo y su asociacion con lesiones cervicales
| Contribuinte(s) |
Soto De León, Sara Cecilia |
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| Data(s) |
26/05/2015
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| Resumo |
Introducción: La infección por un tipo de Virus del Papiloma Humano de alto riesgo (VPH-AR), es el factor principal en el desarrollo de Cáncer de Cérvix (CC). La carga viral puede modular esta asociación, por lo que resulta importante su cuantificación y el establecimiento de su relación con lesiones precursoras de CC. Metodología: 60 mujeres con lesiones escamosas intraepiteliales (LEI) y 120 mujeres sin LEI, confirmadas por colposcopia, fueron incluidas en el estudio. Se determinó la carga viral de 6 tipos de VPH-AR, mediante PCR en tiempo real. Se estimaron OR crudos y ajustados para evaluar la asociación entre la carga viral de cada tipo y las lesiones cervicales. Resultados: 93.22% de mujeres con LEI y 91.23% de mujeres negativas, fueron positivas para al menos un tipo de VPH. VPH-18 y VPH-16 fueron los tipos más prevalentes, junto con VPH-31 en mujeres sin LEI. No se encontraron diferencias estadísticamente significativas de las cargas virales entre éstos dos grupos, aunque se observó un mayor carga viral en lesiones para algunos tipos virales. Una mayor frecuencia de lesiones se asoció a infecciones con carga baja de VPH-16 (ORa: 3.53; IC95%: 1.16 – 10.74), en comparación a mujeres con carga alta de VPH-16, (ORa: 2.63; IC95%: 1.09 – 6.36). En infecciones por VPH-31, la presencia de carga viral alta, se asoció con una menor frecuencia de lesiones (ORa: 0.34; IC95%: 0.15 – 0.78). Conclusiones: La prevalencia tipo-específica de VPH se corresponde con las reportadas a nivel mundial. La asociación entre la carga viral del VPH y la frecuencia de LEI es tipo específica y podría depender de la duración de la infección, altas cargas relacionadas con infecciones transitorias, y bajas cargas con persistentes. Este trabajo contribuye al entendimiento del efecto de la carga viral en la historia natural del CC; sin embargo, estudios prospectivos son necesarios para confirmar estos resultados. Background: Infection with high risk of human papillomavirus (HR-HPV) is the main factor in the development of Cervical Cancer (CC). Viral load can modulate this relationship, so it is important to quantify and establish its association with CC precursor lesions. Methods: 60 women having cervical intraepithelial neoplasia (CIN) and 120 women without CIN and confirmed by colposcopy, were included in the study. Samples were tested for six high-risk HPV types to determine viral copy number by real-time PCR. Crude and adjusted odds ratios (ORa) were estimated for evaluating the association between each viral type’s DNA load and the risk of cervical lesions occurring. Results: 93.22% of women with CIN and 91.23% negative women were positive for at least one type of HPV. HPV-18 and HPV-16 were the most prevalent types, with HPV-31 in women without CIN. No statistically significant differences in viral load between these two groups were identified, although a higher viral load was observed in CIN regarding some viral types. Lesions were more frequent in HPV-16 patients having a low viral load (3.53 ORa, 1.16-10.74 95%CI) compared to those having high HPV-16 load (2.62 ORa, 1.08-6.35 95%CI). High viral load in HPV-31 patients was associated with lower CIN frequency (0.34 ORa, 0.15-0.78 95%CI). Conclusions: The type-specific prevalence of HPV is consistent with the reported worldwide. An association between HPV DNA load and CIN frequency was seen to be type-specific and may have depended on the duration of infection, high viral loads related to transient infections and low viral loads with persistent infections. This analysis has provided information for understanding the effect of HPV DNA load on cervical lesion development. However prospective studies are needed. |
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application/pdf |
| Identificador | |
| Idioma(s) |
spa |
| Publicador |
Facultad de medicina |
| Direitos |
info:eu-repo/semantics/openAccess |
| Fonte |
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| Palavras-Chave | #618.14 #Epidemiología #Cuello del útero #Neoplasias del cuello uterino #Virus del papiloma humano #Prueba de Papanicolaou #Uterine Cervical Dysplasia, High Risk Human Papillomavirus, Viral Load, Real-Time Polymerase Chain Reaction, Colombia. |
| Tipo |
info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion |
