Human papillomaviruses in intraepithelial neoplasia and squamous cell carcinoma of the conjunctiva: A study from Mozambique

aDepartment of Pathology, Faculty of Medicine of the Eduardo Mondlane University and Maputo Central Hospital, Maputo bDepartment of Pathology, Beira Central Hospital, Beira, Mozambique cIPATIMUP - Institute of Molecular Pathology and Immunology dDepartment of Pathology, Faculty of Medicine eDepartment of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine of the University of Porto fInstitute of Public Health of the University of Porto (ISPUP), Porto, Portugal gDepartment of Pathology, Free University Hospital, Amsterdam, The Netherlands.
European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP) (Impact Factor: 3.03). 06/2013; 22(6). DOI: 10.1097/CEJ.0b013e328363005d
Source: PubMed


The infection with human papillomavirus (HPV) has been described as a risk factor for squamous cell carcinoma of the conjunctiva (SCCC), although the evidence is conflicting. To assess the relation between HPV infection and intraepithelial neoplasia or SCCC, we evaluated archived material from biopsies of the conjunctiva performed at the Maputo Central Hospital (Mozambique) in patients with suspected eye cancer. The quality of DNA was assessed by PCR using β-globin-specific primers. A total of 22 consecutive biopsies (intraepithelial neoplasia, SCCC, and benign conditions) positive for β-globin were further tested for HPV infection by PCR using the general primers GP5+/GP6+ and CPI/CPII. In addition, PCR with type-specific primers HPV 16 and HPV 18 was performed. Nineteen biopsies corresponded to intraepithelial neoplasia (two low-grade and nine high-grade) or SCCC (n=8), from which 11 (57.9%) tested positive for HPV infection; nine were positive for CPI/CPII, including one case also positive for GP5+/GP6+ and HPV 18, and the remaining two tested positive only for HPV 16. HPV DNA was not detected in any of the three biopsies of benign conditions. These results suggest a stronger association between infection with cutaneous HPV and SCCC than for mucosal HPV. However, further research is required to clarify the relation between HPV and SCCC as well as to understand the potential of the HPV vaccine currently available for cervical cancer to prevent SCCC.

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    • "The present systematic review included six additional studies (Auw-Haedrich et al, 2008; Guthoff et al, 2009; Ateenyi- Agaba et al, 2010; Asadi-Amoli et al, 2011; Chauhan et al, 2012; Carrilho et al, 2013) published since then, although only one provided information that could be used to assess the association between infection with cutaneous subtypes of HPV and SCCC. Our study also adds to the previous reports the assessment of a potential interaction between HIV and HPV infections, although further research is needed for more robust conclusions on this issue, and the demonstration that the published evidence on the association between mucosal HPV and SCCC overestimates the true association. "
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    ABSTRACT: Background: The frequency of ocular surface squamous neoplasias (OSSNs) has been increasing in populations with a high prevalence of infection with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and infection with human papillomavirus (HPV). We aimed to quantify the association between HIV/AIDS and HPV infection and OSSN, through systematic review and meta-analysis. Methods: The articles providing data on the association between HIV/AIDS and/or HPV infection and OSSN were identified in MEDLINE, SCOPUS and EMBASE searched up to May 2013, and through backward citation tracking. The DerSimonian and Laird method was used to compute summary relative risk (RR) estimates and 95% confidence intervals (95% CI). Heterogeneity was quantified with the I2 statistic. Results: HIV/AIDS was strongly associated with an increased risk of OSSN (summary RR=8.06, 95% CI: 5.29–12.30, I2=56.0%, 12 studies). The summary RR estimate for the infection with mucosal HPV subtypes was 3.13 (95% CI: 1.72–5.71, I2=45.6%, 16 studies). Four studies addressed the association between both cutaneous and mucosal HPV subtypes and OSSN; the summary RR estimates were 3.52 (95% CI: 1.23–10.08, I2=21.8%) and 1.08 (95% CI: 0.57–2.05, I2=0.0%), respectively. Conclusion: Human immunodeficiency virus infection increases the risk of OSSN by nearly eight-fold. Regarding HPV infection, only the cutaneous subtypes seem to be a risk factor.
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