MARIA LUIZA BAGGIO GARCIA PINTO
Índice h a partir de 2011
12
Projetos de Pesquisa
Unidades Organizacionais
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
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- Oral HPV prevalence assessment by Linear Array vs. SPF10 PCR-DEIA-LiPA(25) system in the HPV Infection in Men (HIM) study(2020) BETTAMPADI, Deepti; SIRAK, Bradley A.; FULP, William J.; ABRAHAMSEN, Martha; VILLA, Luisa L.; LAZCANO-PONCE, Eduardo; SALMERON, Jorge; ISAACS-SORIANO, Kimberly A.; BAGGIO, Maria L.; TRENADO, Manuel Quiterio; GIULIANO, Anna R.Introduction: Oral human papillomavirus (HPV) attributable oropharyngeal cancers are on the rise in many countries. Oral HPV infections among healthy individuals are commonly detected using oral gargle samples. However, the optimal method for HPV genotyping oral gargle specimens in research studies has not been previously evaluated. Materials and methods: Oral gargle samples from 1455 HPV Infection in Men (HIM) study participants were HPV genotyped using two different methods: Linear Array and the SPF10 PCR-DEIA-LiPA(25). The sensitivity of the two tests for detecting individual HPV types and grouped HPV types, high-risk HPV, low-risk HPV, grouped 4-HPV-vaccine types, and grouped 9-HPV-vaccine-types, and the degree of concordance between the two tests was assessed. We also examined whether socio-demographic-behavioral factors were associated with concordance between the two assays. Results: The sensitivity of SPF10 PCR-DEIA-LiPA(25) was higher than Linear Array, with the exception of HPV 70, for the detection of oral HPV. The prevalence ratio of SPF10 PCR-DEIA-LiPA(25) to Linear Array varied between 1.0 and 9.0 for individual HPV genotypes, excluding HPV 70, and between 3.8 and 4.4 for grouped 4-valent and 9-valent HPV vaccine types, respectively. There was no association between socio-demographic-behavioral factors and discordance in results between the two tests for oral HPV 16 detection. Discussion: SPF10 PCR-DEIA-LiPA(25) was more sensitive than Linear Array for detecting HPV in oral gargle samples. Given the growing importance of detecting oral HPV infection for research studies of oral HPV natural history and vaccine effectiveness evaluation, we recommend using methods with higher sensitivity such as SPF10 PCR-DEIA-LiPA(25) for detecting HPV in oral gargle samples.
- Human Papillomavirus Prevalence Among 88 Male Virgins Residing in Brazil, Mexico, and the United States(2016) LIU, Zhiyue; NYITRAY, Alan G.; HWANG, Lu-Yu; SWARTZ, Michael D.; ABRAHAMSEN, Martha; LAZCANO-PONCE, Eduardo; SALMERN, Jorge; QUITERIO, Manuel; VILLA, Luisa L.; BAGGIO, Maria Luiza; SILVA, Roberto J. C.; GIULIANO, Anna R.This study determined the prevalence and risk factors for genital human papillomavirus (HPV) detection among men who deny ever engaging in penetrative sex. A questionnaire was administered to 4123 men from a cohort study of HPV natural history. Genital exfoliated cells were collected and genotyped for 36 HPV types. Eighty-eight men were classified as virgins. Log-binomial regression models identified factors associated with genital HPV detection. The prevalence of any and high-risk HPV types among 88 male virgins was 25.0% and 18.2%, respectively. Age and smoking status were associated with HPV detection. Further studies are needed to better understand the risk for HPV infection among male virgins.
- The Natural History of Genital Human Papillomavirus Among HIV-Negative Men Having Sex With Men and Men Having Sex With Women(2015) NYITRAY, Alan G.; CHANG, Mihyun; VILLA, Luisa L.; SILVA, Roberto J. Carvalho da; BAGGIO, Maria Luiza; ABRAHAMSEN, Martha; PAPENFUSS, Mary; QUITERIO, Manuel; SALMERON, Jorge; LAZCANO-PONCE, Eduardo; GIULIANO, Anna R.Background. Although human immunodeficiency virus (HIV)-negative men having sex with men (MSM) bear a substantial burden of human papillomavirus (HPV)-associated disease, prospective studies of genital HPV infection in this population are scarce. Methods. HPV genotyping was conducted on genital samples from men (aged 18-70 years) from Brazil, Mexico, or the United States who provided specimens at 6-month intervals for up to 4 years. Eligibility criteria included no history of genital warts or HIV infection. Evaluable specimens were collected from 564 MSM and 3029 men having sex with women (MSW). Incidence and clearance estimates with 95% confidence intervals were calculated. Results. The 12-month cumulative incidence of genital HPV was high in both MSM (25%; 95% confidence interval, 21%-30%) and MSW (21%; 20%-23%). After stratifying by city, MSM and MSW incidence rates were comparable, with 3 exceptions where MSM had higher incidence in >= 1 city: the group of quadrivalent vaccine types, HPV-45, and HPV-11. Median times to HPV-16 clearance were also comparable, with point estimates of >6 months for both MSM and MSW. Conclusions. Unlike with many other sexually transmitted infections, genital HPV natural history may be similar in HIV-negative MSM and MSW. Study periods of <= 6 months, however, may not be long enough to accurately measure the persistence of these infections in men.
- Country-specific HPV-related genital disease among men residing in Brazil, Mexico and The United States: The HIM study(2017) SUDENGA, Staci L.; TORRES, B. Nelson; FULP, William J.; SILVA, Roberto; VILLA, Luisa L.; LAZCANO-PONCE, Eduardo; INGLES, Donna J.; STOLER, Mark; MESSINA, Jane L.; ABRAHAMSEN, Martha; BAGGIO, Maria Luiza; SALMERON, Jorge; QUITERIO, Manuel; GIULIANO, Anna R.The purpose of this study was to assess whether the incidence of histopathologically confirmed condyloma and penile intraepithelial neoplasia (PeIN) and rates of genital HPV infection progression to these lesions differs by country (Brazil, Mexico and the U.S.). At each visit, lesions were biopsied and were categorized by pathologic diagnoses. The Linear Array genotyping method was used to identify HPV genotypes from genital swabs, while the INNO-LiPA HPV Genotyping Extra method was used for tissue specimens. Age-specific analyses were conducted for lesion incidence by country, with Kaplan-Meier estimation of cumulative incidence. The proportion of HPV infections that progressed to condyloma and PeIN, the median time to lesion development and the incidence rates were estimated by country. When comparing demographic and sexual characteristics across the three countries, sexual orientation (p = 0.008) and lifetime number of female sexual partners (p < 0.0001) were differentially associated with lesion incidence in the three countries. Condyloma incidence in Brazil and the U.S. decreased with age, while incidence remained constant across the lifespan in Mexico. There were no differences by country and age for PeIN incidence. HPV types 6 and 11 were the most common types to progress to condyloma and HPV types 16, 6 and 11 were the most common types to progress to PeIN in all three countries. The continuous risk of condyloma and PeIN across all age groups and countries in this study emphasizes the need to ensure that strong HPV immunity, such as that obtained through vaccination, is maintained across the lifespan of men.
- High genital prevalence of cutaneous human papillomavirus DNA on male genital skin: the HPV Infection in Men Study(2014) SICHERO, Laura; CAMPBELL, Christine M. Pierce; FULP, William; FERREIRA, Silvaneide; SOBRINHO, Joao S.; BAGGIO, Maria Luiza; GALAN, Lenice; SILVA, Roberto C.; LAZCANO-PONCE, Eduardo; GIULIANO, Anna R.; VILLA, Luisa L.Background: The genital skin of males hosts a diversity of HPV genotypes and uncharacterized HPV genotypes. Previously we demonstrated that a specific viral genotype was not identified in 14% of all genital specimens (i.e., HPV unclassified specimens) using the Roche Linear Array method. Our goal was to identify and assess the prevalence of individual HPV types among genital HPV unclassified specimens collected in the HIM Study population, at enrollment, and examine associations with socio-demographic and behavioral characteristics. Methods: Genital skin specimens of men that were considered unclassified (HPV PCR positive, no genotype specified) at enrollment were typed by sequencing amplified PGMY09/11 products or cloning of PGMY/GP+ nested amplicons followed by sequencing. PGMY/GP+ negative specimens were further analyzed using FAP primers. HPV type classification was conducted through comparisons with sequences in the GenBank database. Results: Readable nucleotide sequences were generated for the majority of previously unclassified specimens (66%), including both characterized (77%) and yet uncharacterized (23%) HPV types. Of the characterized HPV types, most (73%) were Beta [beta]-HPVs, primarily from beta-1 and beta-2 species, followed by Alpha [alpha]-HPVs (20%). Smokers (current and former) were significantly more likely to have an alpha-HPV infection, compared with any other genus; no other factors were associated with specific HPV genera or specific beta-HPV species. Conclusions: Male genital skin harbor a large number of beta-HPV types. Knowledge concerning the prevalence of the diverse HPV types in the men genital is important to better understand the transmission of these viruses.
- HPV-11 variability, persistence and progression to genital warts in men: the HIM study(2017) FLORES-DIAZ, Ema; SEREDAY, Karen A.; FERREIRA, Silvaneide; SIRAK, Bradley; SOBRINHO, Joao Simao; BAGGIO, Maria Luiza; GALAN, Lenice; SILVA, Roberto C.; LAZCANO-PONCE, Eduardo; GIULIANO, Anna R.; VILLA, Luisa L.; SICHERO, LauraHPV-11 and HPV-6 are the etiological agents of about 90% of genital warts (GWs). The intra-typic variability of HPV-11 and its association with infection persistence and GW development remains undetermined. Here, HPV infection in men (HIM) participants who had an HPV-11 genital swab and/or GW, preceded or not by a normal skin genital swab were analysed. Genomic variants were characterized by PCR-sequencing and classified within lineages (A, B) and sublineages (A1, A2, A3, A4). HPV-11 A2 variants were the most frequently detected in the genital swab samples from controls and in both genital swabs and GW samples from cases. The same HPV-11 variant was detected in the GW sample and its preceding genital swab. There was a lack of association between any particular HPV-11 variant and the increased risk for GW development.
- Genital Wart Recurrence Among Men Residing in Brazil, Mexico, and the United States(2019) GIULIANO, Anna R.; SIRAK, Bradley; ABRAHAMSEN, Martha; SILVA, Roberto J. C.; BAGGIO, Maria L.; GALAN, Lenice; CINTRA, Ricardo C.; LAZCANO-PONCE, Eduardo; VILLA, Luisa L.Background Genital wart (GW) incidence is high among men. The percentage and rate at which subsequent GW events occur are understudied. The purpose of this study was to describe the rate of subsequent GWs, associated human papillomavirus (HPV) types, and time to subsequent GW event among unvaccinated men. Methods The study was nested within a multinational prospective HPV natural history study of men aged 18-70 years in the United States, Mexico, and Brazil, examined every 6 months for a median follow-up of 50.4 months. Subsequent GW events were defined as GWs detected after 16 weeks of the prior event. Results Forty-four percent of men experienced 1 GW following the initial episode. Men with 2 subsequent events were at highest risk of continued GW experiences, with as high as 10 postinitial GW events. The incidence rate of each subsequent GW increased with increasing events (incidence of first subsequent event was 13.1 vs 36.6/1000 person-months for the fourth event). The proportion of GWs among HPV-6 and/or -11-positive patients remained constant across events. Approximately 63%-69% were positive for 1 of the 9-valent HPV vaccine types. Conclusions These data highlight the high burden of GWs among men across the lifespan and the need for vaccination to prevent multiple GW episodes. This is the first report to examine rates of genital wart (GW) recurrence among men. The high observed rate of GW recurrence supports the public health strategy of broadly vaccinating males to prevent multiple GW episodes and HPV transmission.
- Comparison of anal HPV natural history among men by country of residence: Brazil, Mexico, and the United States(2017) SUDENGA, Staci L.; NYITRAY, Alan G.; TORRES, B. Nelson; SILVA, Roberto; VILLA, Luisa; LAZCANO-PONCE, Eduardo; ABRAHAMSEN, Martha; BAGGIO, Maria Luiza; SALMERON, Jorge; QUITERIO, Manuel; GIULIANO, Anna R.Objectives: Globally, anal cancer incidence is rare, but is increasing in some world regions. Our objective was to assess differences in anal HPV natural history in three countries. Methods: Men aged 18-70 years were recruited from the US (n = 634), Mexico (n = 665), and Brazil (n = 731). Anal specimens were collected every six-months. HPV genotyping was assessed by Linear Array. Anal HPV prevalence was compared using the Fisher's exact test. HPV infection incidence rates (IR) and 95% confidence intervals (CI) were calculated. Results: Any anal HPV prevalence was highest among men from Brazil (24%) compared to Mexico (15%) and the US (15%). When stratified by sexual history, the prevalence of any HPV among MSM/MSMW was 43%, 37%, and 45% and 9%, 12%, and 10% for MSW from Brazil, Mexico, and US, respectively. Any HPV incidence was significantly higher among men from Brazil compared to US men (IRR = 2.4, 95% CI = 1.7-3.4) and comparable between men from Mexico and the US (IRR = 1.2, 95% CI = 0.8-1.8). Conclusion: Men in Brazil and Mexico often have similar, if not higher incidence of anal HPV compared to men from the U.S., and may benefit from gender neutral HPV vaccine policies.
- The association between body mass index and anal canal human papillomavirus prevalence and persistence: the HIM study(2019) NYITRAY, Alan G.; PENG, Fen; DAY, Rena S.; SILVA, Roberto J. Carvalho Da; BAGGIO, Maria Luiza; SALMERON, Jorge; QUITERIO, Manuel; ABRAHAMSEN, Martha; LAZCANO-PONCE, Eduardo; VILLA, Luisa L.; GIULIANO, Anna R.Background: While receptive anal sex is an established risk factor for anal human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA), people with anal HPV infection and SCCA commonly report no lifetime receptive anal sex suggesting other factors may also increase risk for anal HPV infection and persistence. Given potential associations between obesity and conditions that may cause perianal or anal canal lesions, we hypothesized that body mass index (BMI) was associated with HPV infection.Methods: Genotyping for 36 HPV types was conducted on anal canal specimens from men, ages 18-70, from Brazil, Mexico, and the USA. Eligibility included no history of genital warts or HIV. Evaluable specimens were collected from 328 men having sex with men (MSM) and 1348 men having sex with women (MSW) who reported no lifetime receptive anal sex. Prevalence of anal HPV infection and six-month persistence by BMI were estimated in addition to adjusted prevalence ratios for the association between BMI and HPV infection.Results: Among MSW, obese men had a higher prevalence of HPV-16 in the anal canal (3.1%), compared to normal weight men (1.3%) although 95% CI overlapped. Among MSM, prevalence of HPV decreased with increasing BMI. A similar pattern was observed for persistence. After adjustment for confounders, obese MSW had 2.4 times higher odds of HPV-16 compared to normal weight men.Conclusions: BMI may be positively associated with anal HPV (especially HPV-16) among MSW and negatively associated with anal HPV among MSM which supports continued universal HPV vaccination programs.
Prevalence and persistence of HPV-16 molecular variants in the anal canal of men: The HIM study
(2022) GONCALVES, Milena Giulia; FERREIRA, Matthew Thomas; LOPEZ, Rossana Veronica Mendoza; FERREIRA, Silvaneide; SIRAK, Bradley; BAGGIO, Maria Luiza; LAZCANO-PONCE, Eduardo; NYITRAY, Alan G.; GIULIANO, Anna R.; VILLA, Luisa L.; SICHERO, LauraBackground: HPV-16 causes approximately 90% of anal canal (AC) cancers worldwide. This study aimed to evaluate the prevalence and persistence of HPV-16 genetic variants in the AC of men from three different countries (Brazil, Mexico and United States) and to further identify sociodemographic and behavioral factors associated with these infections.& nbsp;Methods: Participants from the multinational prospective HPV Infection in Men (HIM) Study who had at least one HPV-16 positive AC swab were included. Characterization into HPV-16 genetic variants was successfully performed by PCR-sequencing in 95.6% (217/227) samples and these were classified into HPV-16 lineages and sublineages.& nbsp;Results: We observed higher prevalence of lineage A variants, mainly from A1 sublineage, in all countries. Non-A lineage variants were mostly detected in men from Brazil, where higher diversity of sublineage variants was detected during follow-up. Compare to men detected with Non-A HPV-16 lineage variants, men infected with lineage A reported a higher lifetime number of female sexual partners. Finally, a significantly higher prevalence of Non-A lineage variants was observed among men who have sex with men (MSM) with a transient HPV-16 AC infection (p = 0.033), but no significant differences regarding variants lineages and persistence status were observed when stratified by country, self-reported ethnicity or age.& nbsp;Conclusions: Our data extend previous reports which indicate that globally HPV-16 variants are unevenly distributed, and contribute further to studies of the natural history of AC HPV infections in men.