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      Infección por virus de papiloma humano en mujeres: hallazgos paraclínicos

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          Abstract

          Objetivo: Describir hallazgos citológicos, colposcópicos, histopatológicos y reacción en cadena de polimerasa de pacientes con infección por virus papiloma humano. Métodos: Estudio retrospectivo y descriptivo. Muestra: 187 pacientes con infección por virus papiloma humano. Ambiente: Consulta de Ginecología del Hospital Universitario Dr. Ángel Larralde Resultados: La media de edad fue de 40,4±11,6 años. Hallazgo citológico predominante: lesión intraepitelial escamosa de bajo grado (51,7 %). Estudio colposcópico reveló epitelio acetoblanco (28,3 %) como atipia más frecuente. En biopsia de cuello uterino, 16,5 % tuvieron algún grado de neoplasia intraepitelial cervical y 2,6 % carcinoma epidermoide. Las mujeres con reacción en cadena de polimerasa positiva presentaron genotipos de virus papiloma humano de alto riesgo en 43,9 %. Conclusión: Se debe enfatizar en la evaluación ginecológica anual, con por lo menos la citología cervicouterina, para así diagnosticar, tratar oportunamente y disminuir la prevalencia de lesiones por virus papiloma humano y cáncer de cuello uterino.

          Translated abstract

          Objective: To describe cytological, colposcopical, histopathological findings and polymerase chain reaction in patients with infection by human papilloma virus. Methods: Retrospective and descriptive study. Sample: 187 patients with infection by human papilloma virus. Setting: Out patient clinic of Gynecolog, Hospital Universitario Dr. Angel Larralde, Valencia, Edo. Carabobo. Results: The average age was 40.4±11.6 years. Predominant cytological finding: low grade squamous intraepithelial lesion (51.7 %). The colposcopic study revealed that acetowhite epithelium (28.3 %) was the more frequent atypia. In biopsy of uterine cervix, 16.5 % had some degree of cervical intraepithelial neoplasia and 2.6 % squamous cell carcinoma. 43.9 % of the women with positive polymerase chain reaction presented genotypes of high risk human papilloma virus. Conclusion: It is important to make emphasis in making an annual gynecological evaluation, with at least the endo-exocervical cytology, thus to search, to treat timely and to diminish the prevalence of injuries by human papilloma virus and uterine cervical neoplasm.

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          Most cited references37

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          Environmental co-factors in HPV carcinogenesis.

          Epidemiological studies have shown that only a small fraction of women infected with oncogenic HPV types will eventually progress to high-grade intraepithelial lesions (HSIL) and cervical cancer (CC). Because infection by oncogenic HPVs is a necessary but not a sufficient cause of CC, it has been assumed that other factors, acting in conjunction with HPV, influence the risk of transition from cervical HPV infection to cervical malignancy. This paper reviews the epidemiological evidence for the role of environmental co-factors in HPV carcinogenesis as assessed from selected studies that report associations within a well-defined HPV-DNA positive group. Co-factors assessed include parity, use of oral contraceptives, tobacco smoking, infection with other sexually transmitted diseases, and dietary and nutritional factors. Based on the evidence provided by the largest epidemiological studies that using sensitive detection methods allowed for the effects of HPV, it can be concluded that, among HPV positive women, high parity, long-term OC use, smoking, and co-infection with other sexually transmitted agents are the most consistently identified environmental co-factors likely to influence the risk of progression from cervical HPV infection to HSIL and invasive CC. There is limited evidence for a role of dietary factors in HPV carcinogenesis. On-going epidemiological studies will shed more light into the role of these and other co-factors, but if confirmed, these conclusions may imply that multiparous women, women who are smokers, and women on long-term OC use, might need a closer cytological and HPV surveillance than women in the general population.
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            Anuario de Mortalidad 2006

            (2007)
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              Cervical coinfection with human papillomavirus (HPV) types and possible implications for the prevention of cervical cancer by HPV vaccines.

              Coinfection with multiple types of human papillomavirus (HPV) and its implications for the development of efficacious HPV vaccines is a subject of great interest. To describe the occurrence of concurrent infection with multiple HPV types and to determine whether genital HPV infection modifies the risk of acquiring a new HPV infection with another HPV type, 1610 subjects were monitored for an average of 4.1 years in Bogota, Colombia. Information on risk factors for HPV infection and cervical cells was collected for detection of HPV DNA of 36 types at study entry and at 6 consecutive 6-month follow-up visits. Clustering or the concurrent acquisition of multiple types occurred more often than would be expected by chance. Subjects with incident HPV-16 or -18 infection had 5-7 times higher odds of acquiring a subsequent HPV-58 infection than subjects not infected with HPV-16 or -18. This might affect the protection conferred by effective HPV vaccines.
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                Author and article information

                Contributors
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                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela (Caracas )
                0048-7732
                June 2010
                : 70
                : 2
                : 82-89
                Affiliations
                [1 ] Universidad de Carabobo Venezuela
                Article
                S0048-77322010000200003
                eb191f18-9091-4125-9b2f-40fb6387746c

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Human papilloma virus,Cervical cytology,Colposcopy,Biopsy,Polymerase chain reaction,Virus de papiloma humano,Citología cervical,Colposcopia,Biopsia,Reacción en cadena de la polimerasa

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