Predictors associated with and the prevalence of condylomata acuminata infection among people in Southern Brazil
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Abstract
Objectives: To estimate the prevalence of condylomata acuminata/HPV and evaluate associated predictors in infected patients. Methods: In this cross-sectional and retrospective study, medical records of patients who attended a public health referral center located in Southern Brazil, Parana, between April 2012 and March 2017 were reviewed. Epidemiological, clinical, and laboratory data were analyzed using the chi-square and odds ratio (OR) with 95% confidence interval (CI). Results: The overall prevalence of condylomata acuminata/HPV in 3,447 patients was 33.1% (n = 1,140). Coinfection of condylomata/HPV with other STI was noted in 23.7% (n = 270) of cases. The population was characterized by a high prevalence (43.8%) in patients aged < 20 years, women (37.4%), white (33.3%), educational level with more than 8 years of study (33.7%), widowed (39.2%), heterosexual (36.7%), and ages between 13 and 19 years at first sexual intercourse (41.1%). A significant association was observed between male sex and multiple partners and between male sex and irregular use of condoms (p < 0.001). The predictors associated with HPV infection were the age group of up to 29 years (OR 2.0, 95% CI 1.3–3.7, p < 0.013) and homosexual/bisexual (OR 0.2, 95% CI 0.12–0.66, p = 0.003). Conclusion: The findings showed a high prevalence of condylomata acuminata in a public health center study, with emphasis on the age range below the third decade of life and sexual behavior predictors. These predictors are important for the determination of preventive measures against the transmission of infection and the development of cancer.
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References
Vesco KK, Whitlock EP, Eder M, Burda BU, Senger CA, Lutz K. Risk factors and other epidemiologic considerations for cervical cancer screening: a narrative review for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155(10):698-705, W216. https://doi.org/10.7326/0003-4819-155-10-201111150-00377 PMid:22006929 DOI: https://doi.org/10.7326/0003-4819-155-10-201111150-00377
Portugal. Direcção Geral de Saúde. Vacinação contra infecções por Vírus do Papiloma Humano (HPV). 2008 [cited 2021 Feb 01]; p. 43. Avaiable from: https://bit.ly/3pDWMD7
Muñoz N, Bosch FX, de Sanjosé S, Herrero R, Castellsagué X, Shah KV, et al.; International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003;348(6):518-27 https://doi.org/10.1056/NEJMoa021641 PMid:12571259 DOI: https://doi.org/10.1056/NEJMoa021641
Crosbie EJ, Einstein MH, Franceschi S, Kitchener HC. Human papillomavirus and cervical cancer. Lancet. 2013;382(9895):889-99. https://doi.org/10.1016/s0140-6736(13)60022-7 DOI: https://doi.org/10.1016/S0140-6736(13)60022-7
Nelson EL, Stockdale CK. Vulvar and vaginal HPV disease. Obstet Gynecol Clin North Am. 2013;40(2):359-76. https://doi.org/10.1016/j.ogc.2013.03.003 PMid:23732036 DOI: https://doi.org/10.1016/j.ogc.2013.03.003
Hoots BE, Palefsky JM, Pimenta JM, Smith JS. Human papillomavirus type distribution in anal cancer and anal intraepithelial lesions. Int J Cancer. 2009;124(10):2375-83. https://doi.org/10.1002/ijc.24215 PMid:19189402 DOI: https://doi.org/10.1002/ijc.24215
Damin DC, Ziegelmann PK, Damin AP. Human papillomavirus infection and colorectal cancer risk: a meta-analysis. Colorectal Dis. 2013;15(8):e420-8. https://doi.org/10.1111/codi.12257 PMid:23895733 DOI: https://doi.org/10.1111/codi.12257
Wolf R, Davidovici B. Treatment of genital warts: Facts and controversies. Clin Dermatol. 2010;28(5):546-8. https://doi.org/10.1016/j.clindermatol.2010.03.013 PMid:20797516 DOI: https://doi.org/10.1016/j.clindermatol.2010.03.013
Ghosh I, Ghosh P, Bharti AC, Mandal R, Biswas J, Basu P. Prevalence of human papillomavirus and co-existent sexually transmitted infections among female sex workers, men having sex with men and injectable drug abusers from eastern India. Asian Pac J Cancer Prev. 2012;13(3):799-802. https://doi.org/10.7314/APJCP.2012.13.3.799 PMid:22631651 DOI: https://doi.org/10.7314/APJCP.2012.13.3.799
von Krogh G, Lacey CJ, Gross G, Barrasso R, Schneider A; European Course on HPV Associated Pathology (ECHPV); European Branch of the International Union against Sexually Transmitted Infection and the European Office of the World Health Organization. European guideline for the management of anogenital warts. Int J STD AIDS. 2001;12 Suppl 3:40-7. https://doi.org/10.1258/0956462011924100 PMid: 11589796 DOI: https://doi.org/10.1258/0956462011924100
Chan PKS, Luk ACS, Luk TNM, Lee KF, Cheung JLK, Ho KM, et al. Distribution of human papillomavirus types in anogenital warts of men. J Clin Virol. 2009;44(2):111-4. https://doi.org/10.1016/j.jcv.2008.11.001 PMid:19097933 DOI: https://doi.org/10.1016/j.jcv.2008.11.001
Insinga RP, Dasbach EJ, Elbasha EH. Assessing the annual economic burden of preventing and treating anogenital human papillomavirus-related disease in the US: Analytic framework and review of the literature. Pharmacoeconomics. 2005;23(11):1107-22. https://doi.org/10.2165/00019053-200523110-00004 PMid:16277547 DOI: https://doi.org/10.2165/00019053-200523110-00004
Ministério da Saúde. Instituto Nacional de Cancer José Alencar Gomes da Silva. Estimativa 2016: incidência e cancer no Brasil. Rio de Janeiro: INCA; 2015 [cited 2021 Feb 01]. 122 p. Avaiable from: https://bit.ly/2MiNnT4
Myers ER, McCrory DC, Nanda K, Bastian L, Matchar DB. Mathematical model for the natural history of human papillomavirus infection and cervical carcinogenesis. Am J Epidemiol. 2000;151(12):1158-71. https://doi.org/10.1093/oxfordjournals.aje.a010166 PMid:10905528 DOI: https://doi.org/10.1093/oxfordjournals.aje.a010166
Burd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev. 2003 Jan;16(1):1-17. https://doi.org/10.1128/CMR.16.1.1-17.2003 PMid:12525422 PMCid:PMC145302 DOI: https://doi.org/10.1128/CMR.16.1.1-17.2003
Satterwhite CL, Torrone E, Meites E, Dunne EF, Mahajan R, Ocfemia MC, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40(3):187-93. https://doi.org/10.1097/OLQ.0b013e318286bb53 PMid:23403598 DOI: https://doi.org/10.1097/OLQ.0b013e318286bb53
Smith JS, Melendy A, Rana RK, Pimenta JM. Age-specific prevalence of infection with human papillomavirus in females: a global review. J Adolesc Health. 2008;43(4 Suppl):S5-25, S25.e1-41. https://doi.org/10.1016/j.jadohealth.2008.07.009 PMid:18809145 DOI: https://doi.org/10.1016/j.jadohealth.2008.07.009
Bruni L, Diaz M, Castellsagué X, Ferrer E, Bosch FX, de Sanjosé S. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis. 2010;202(12):1789-99. https://doi.org/10.1086/657321 PMid:21067372 DOI: https://doi.org/10.1086/657321
Ayres ARG, Azevedo e Silva G. Cervical HPV infection in Brazil: Systematic review. Rev Saúde Pública. 2010;44(5):963-74. https://doi.org/10.1590/S0034-89102010000500023 PMid:20877926
Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in the World. Summary Report 27 July 2017.
Freire MP, Pires D, Forjaz R, Sato S, Cotrim I, Stiepcich M, Scarpellini B, Truzzi JC. Genital prevalence of HPV types and co-infection in men. Int Braz J Urol. 2014;40(1):67-71. https://doi.org/10.1590/S1677-5538.IBJU.2014.01.10 PMid:24642151 DOI: https://doi.org/10.1590/S1677-5538.IBJU.2014.01.10
Ayres ARG, Silva GA e. Cervical HPV infection in Brazil: systematic review. Rev Saude Publica. 2010;44(5):963-74. https://doi.org/10.1590/S0034-89102010000500023 PMid:20877926 DOI: https://doi.org/10.1590/S0034-89102010000500023
Ministério Público do Paraná. Saúde Pública. Regionais de Saúde - Centro de Apoio Operacional das Promotorias de Proteção à Saúde Pública. Avaiable from: https://saude.mppr.mp.br/modules/conteudo/conteudo.php?conteudo=522.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLoS Med. 2007;4(10):1623-7. https://doi.org/10.1371/journal.pmed.0040296 PMid:17941714 PMCid:PMC2020495 DOI: https://doi.org/10.1371/journal.pmed.0040296
Rio de Janeiro. Secretaria Municipal de Saúde. Guia de Referência Rápida: Infecções Sexualmente Transmissíveis [Internet]. 2016 [cited 2021 Feb 01];44. Avaiable from: https://bit.ly/2YAkJz7
Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução 466/2012/CNS/MS/CONEP. Diário Oficial da União. 2013 Jun 13;Sec 1:59. Avaiable from: https://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf
de Martel C, Plummer M, Vignat J, Franceschi S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int J Cancer. 2017;141(4):664-70. https://doi.org/10.1002/ijc.30716 PMid:28369882 PMCid:PMC5520228 DOI: https://doi.org/10.1002/ijc.30716
Inca. Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2016: incidência de câncer no Brasil/Instituto Nacional de Câncer José Alencar Gomes da Silva. Coordenação de Prevenção e Vigilância. Rio de Janeiro: INCA; 2015.
Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999;189(1):12-9. https://doi.org/10.1002/(sici)1096-9896(199909)189:1%3C12::aid-path431%3E3.0.co;2-f PMid: 10451482
Ribeiro AA, Costa MC, Alves RRF, Villa LL, Saddi VA, Carneiro MADS, et al. HPV infection and cervical neoplasia: associated risk factors. Infect Agent Cancer. 2015;10:16. https://doi.org/10.1186/s13027-015-0011-3 PMid:26244052 PMCid:PMC4524198 DOI: https://doi.org/10.1186/s13027-015-0011-3
Tota JE, Chevarie-Davis M, Richardson LA, Devries M, Franco EL. Epidemiology and burden of HPV infection and related diseases: implications for prevention strategies. Prev Med. 2011;53 Suppl 1:S12-21. https://doi.org/10.1016/j.ypmed.2011.08.017 PMid:21962466 DOI: https://doi.org/10.1016/j.ypmed.2011.08.017
Al-Daraji WI, Smith JH. Infection and cervical neoplasia: facts and fiction. Int J Clin Exp Pathol. 2009;2(1):48-64. PMid: 18830380 PMCid: PMC2491386
Liu ZC, Liu WD, Liu YH, Ye XH, Chen SD. Multiple sexual partners as a potential independent risk factor for cervical cancer: a meta-analysis of epidemiological studies. Asian Pac J Cancer Prev. 2015;16(9):3893-900. https://doi.org/10.7314/APJCP.2015.16.9.3893 PMid:25987056 DOI: https://doi.org/10.7314/APJCP.2015.16.9.3893
Lomalisa P, Smith T, Guidozzi F. Human immunodeficiency virus infection and invasive cervical cancer in South Africa. Gynecol Oncol. 2000;77(3):460-3. https://doi.org/10.1006/gyno.2000.5775 PMid:10831360 DOI: https://doi.org/10.1006/gyno.2000.5775
Kaasila M, Koskela P, Kirnbauer R, Pukkala E, Surcel HM, Lehtinen M. Population dynamics of serologically identified coinfections with human papillomavirus types 11, 16, 18 and 31 in fertile-aged Finnish women. Int J Cancer. 2009;125(9):2166-72. https://doi.org/10.1002/ijc.24539 PMid:19585500 DOI: https://doi.org/10.1002/ijc.24539
Cordeiro TI, Carestiato FN, Gouvêa TVD, Cavalcanti SMB. Human papillomavirus infection in multiple sites. DST J Bras Doenças Sex Transm. 2014;26(1-4):42-6. https://doi.org/10.5533/DST-2177-8264-2014261-409 DOI: https://doi.org/10.5533/DST-2177-8264-2014261-409
Moscicki A-B, Ma Y, Wibbelsman C, Powers A, Darragh TM, Farhat S, et al. Risks for cervical intraepithelial neoplasia 3 among adolescents and young women with abnormal cytology. Obstet Gynecol. 2008;112(6):1335-42. https://doi.org/10.1097/AOG.0b013e31818c9222 PMid:19037044 PMCid:PMC2735396 DOI: https://doi.org/10.1097/AOG.0b013e31818c9222
Gomes R, Nascimento EF do, Araújo FC de. Por que os homens buscam menos os serviços de saúde do que as mulheres? As explicações de homens com baixa escolaridade e homens com ensino superior? Cad Saúde Pública. 2007;23(3):565-74. https://doi.org/10.1590/S0102-311X2007000300015 PMid:17334571 DOI: https://doi.org/10.1590/S0102-311X2007000300015
De Sanjosé S, Diaz M, Castellsagué X, Clifford G, Bruni L, Muñoz N, et al. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis. 2007;7(7):453-9. https://doi.org/10.1016/S1473-3099(07)70158-5 DOI: https://doi.org/10.1016/S1473-3099(07)70158-5
Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine. 2006;24:S4-15. https://doi.org/10.1016/j.vaccine.2005.09.054 PMid:16406226 DOI: https://doi.org/10.1016/j.vaccine.2005.09.054
Bosch FX, Broker TR, Forman D, Moscicki AB, Gillison ML, Doorbar J, et al. Vaccine. 2013;31 Suppl 8(0 8):I1-31. https://doi.org/10.1016/j.vaccine.2013.07.026 PMid: 24229716 PMCid: PMC4062073 DOI: https://doi.org/10.1016/j.vaccine.2013.07.026
Smith JS, Gilbert PA, Melendy A, Rana RK, Pimenta JM. Age-specific prevalence of human papillomavirus infection in males: A global review. J Adolesc Heal. 2011;48(6):540-52. https://doi.org/10.1016/j.jadohealth.2011.03.010 PMid:21575812 DOI: https://doi.org/10.1016/j.jadohealth.2011.03.010
Giraldo PC, Eleutério J, Cavalcante DIM, Gonçalves AKS, Romão JAA, Eleutério RMN. The role of high-risk HPV-DNA testing in the male sexual partners of women with HPV-induced lesions. Eur J Obstet Gynecol Reprod Biol. 2008;137(1):88-91. https://doi.org/10.1016/j.ejogrb.2006.12.026 PMid:17485158 DOI: https://doi.org/10.1016/j.ejogrb.2006.12.026
Abbas A, Yang G, Fakih M. Management of anal cancer in 2010. Part 1: Overview, screening, and diagnosis. Oncology (Williston Park). 2010;24(4):364-9. PMid: 20464850
Dahlström LA, Andersson K, Luostarinen T, Thoresen S, Ögmundsdottír H, Tryggvadottír L, et al. Prospective seroepidemiologic study of human papillomavirus and other risk factors in cervical cancer. Cancer Epidemiol Biomarkers Prev. 2011;20(12):2541-50. https://doi.org/10.1158/1055-9965.EPI-11-0761 PMid:21994401 DOI: https://doi.org/10.1158/1055-9965.EPI-11-0761
Carvalho MC. Mulheres Portadoras de lesões Precursoras do câncer do colo do útero e HPV: descrição do perfil socioeconômico e demográfico. J Bras Doenças Sex Transm. 2011;23(1):28-33. https://doi.org/10.5533/2177-8264-201123107 DOI: https://doi.org/10.5533/2177-8264-201123107
Scheurer ME, Tortolero-Luna G, Adler-Storthz K. Human papillomavirus infection: biology, epidemiology, and prevention. Int J Gynecol Cancer. 2005;15(5):727-46. https://doi.org/10.1111/j.1525-1438.2005.00246.x PMid:16174218 DOI: https://doi.org/10.1111/j.1525-1438.2005.00246.x
Arbyn M, Castellsagué X, de sanjosé S, Bruni L, Saraiya M, Bray F, et al. Worldwide burden of cervical cancer in 2008. Ann Oncol. 2011;22(12):2675-86. https://doi.org/10.1093/annonc/mdr015 PMid:21471563 DOI: https://doi.org/10.1093/annonc/mdr015
Vardas E, Giuliano AR, Goldstone S, Palefsky JM, Moreira ED, Penny ME, et al. External genital human papillomavirus prevalence and associated factors among heterosexual men on 5 continents. J Infect Dis. 2011;203(1):58-65. https://doi.org/10.1093/infdis/jiq015 PMid:21148497 PMCid:PMC3086430 DOI: https://doi.org/10.1093/infdis/jiq015
de Souza AF, Costa LHR. Conhecimento de mulheres sobre HPV e câncer do colo do útero após consulta de enfermagem. Rev Bras Cancerol. 2015;61(4):343-50. https://doi.org/10.32635/2176-9745.RBC.2015v61n4.220 DOI: https://doi.org/10.32635/2176-9745.RBC.2015v61n4.220
Smith EM, Parker MA, Rubenstein LM, Haugen TH, Hamsikova E, Turek LP. Evidence for vertical transmission of HPV from mothers to infants. Infect Dis Obstet Gynecol. 2010;2010: 326369. https://doi.org/10.1155/2010/326369 PMid:20300545 PMCid:PMC2838362 DOI: https://doi.org/10.1155/2010/326369
Rombaldi RL, Serafini EP, Mandelli J, Zimmermann E, Losquiavo KP. Perinatal transmission of human papilomavirus DNA. Virol J. 2009;6(1):1. https://doi.org/10.1186/1743-422X-6-83 PMid:19545396 PMCid:PMC2717078 DOI: https://doi.org/10.1186/1743-422X-6-83