A NEW VIRAL INFECTION!?
Does a new papovavirus lurk around the corner, ready to strike at any immunocompromised individuals? Haycox et al describe an immunocompromised patient who had presented with progressive alopecia and erythematous, indurated papules. These formed plaques over his face and ears. Small white fibrious spines projected from the alopecic areas. Biopsies were negative for fungal, bacterial, and mycobacterial cultures. Electron microscopy revealed a virus that resembled a papovavirus. PCR and Southern Blots came up negative for the presence of HPV subtypes. BK was also lacking in the samples. The authors call this nasty condition Trichodysplasia spinulosa.
Haycox CL, Kim S,
Fleckman P, Smith LT, Peipkorn M, Sundberg JP, Howell DN, Miller
SE. "Trichodysplasia spinulosa a newly described
folliculocentric viral infection in an immunocompromised host"
Journal Investigation Dermatology Symposium Proceedings 1999
DOES THE SUBTYPE OF VIRUS YOU HAVE INFLUENCE YOUR PROGNOSIS?
The authors wished to determine whether the status of a patients HPV infection influence their prognosis. HPV-58 was more prevalent in the older populations. They found that the 5-year survival rates were 90.2% for HPV-58, 80% for HPV-16, and 74% for HPV-18 related groups. They also found that the occurrence of adenocarcinoma or adenosquamous carcinoma was higher in the HPV-18 group than either the HPV-16 or the HPV-58 groups. In addition the relative risk of death was lowest in the HPV-58 group. Therefor it appears that HPV-58 related genotypes correlate with a more favorable prognosis.
Lai HC, Sun CA, Yu MH,
Chen HJ, Liu HS, Chu TY "Favorable clinical outcome of cervical
cancers infected with human papilloma virus type 58 and related
types." International Journal of Cancer 1999 Dec
MAKE SURE TO TAKE YOUR VITAMINS
In an in vitro culture system Mason et al tested whether vitamins A,C, and E had an inhibitory effect on HPV-infected human oral epithelial cells in culture. Vitamins A and E had the highest inhibitory effect on growth curves, and the inhibition was greater in immortalized cells than in their normal counterparts. There was a reduction from 5 or more layers of cells to only one or two with vitamin E treatment. There were no other significant morphological changes except that the normal cells exhibited a slight keratinization.
Mason B, Ghanee N, Haigh WG, Lee SP, Oda D "Effect of vitamins A, C, and E on normal and HPV-immortalized human oral epithelial cells in culture." Anticancer Research 1999 Nov-Dec; 19(6B):5469-74
HELP FOR WARTS
Subjects with genital warts were given HPV6b virus like particles in three or more immunizations without adjuvant. Of the 33 patients 9 already had antibodies to HPV6b antibodies and 22 acquired the antibodies after immunization. 25 of 33 subjects experienced a complete regression of the warts within a 20-week period. The authors therefor concluded that this immunization may facilitate regression of tumors.
Zhang LF, Zhou J, Chen
S, Cai LL, Bao Qy, Zheng FY, Lu JQ, Padmanabha J, Hengst K, Malcolm K,
Frazer IH "HPV6b virus like particles are potent immunogens without
adjuvant in man" Vaccine 2000 Jan 6;18(11-12):1051-8
SV40ITS NOT JUST A CONCERN FOR ADULTS ANYMORE
Children under the age of 15 were tested for seropositivity to SV40 at in and outpatient clinics in Texas. Twenty tested positive, and seropositivity increased with age (9.1% of children ages 10-15 verses 1.1% of children under 4). SV40 had a high correlation with children that had undergone kidney transplants (40%). Many of the seropositive children were immunologically impaired. Therefor the authors conclude that SV40 causes natural infections in humans
Butal JS, Jafar S, Wong C, Arrington AS, Opekun AR, Finegold MJ, Adam e "Evidence of SV40 infections in hospitalized children" Human Pathology 1999 Dec;30(12):1496-502
CIDOFOVIR: A NEW HOPE FOR THE TREATMENT OF CERVIX INTRAEPITHELIAL NEOPLASIA GRADE III (CIN III)?
A new study shows that Cidofovir, an acyclic nucleoside phosphonate derivative may be effective in treating CIN III.
15 women with CIN III proven by biopsy were given treatment with Cidofovir 1% in gel. The antiviral was applied three times every other day on the cervix and within one month, cone biopsy was performed on the cervix to obtain a sample.
The results as determined by visual inspection and PCR for the presence of HPV were as follows. 2 patients showed no response. 7 patients showed a complete response with repair atypia in the regenerative epithelium and/or the absence of formerly present lesions. 5 patients had a partial response with persistence of lesions deep in the glands and disappearance of lesions only at the superficial epithelial layers. In one patient the CIN III lesions evolved to CIN I lesions. The drug was non-toxic and specific to the dysplastic epithelium, effecting no other tissues.
This is exciting because current treatment for CIN III is surgery based and some surgery on the cervix can lead to obstetric problems during subsequent pregnancy. Cidofovir looks promising as a non-surgical approach for CIN III treatment because unlike other non-surgical treatments it acts specifically on HPV-containing proliferating cells.
Journal of Medical Virolology2000 Feb;60(2):205-9
SELF TEST FOR HPV
In this 1999 study, cervical cell samples taken by patients appear to be more effective at detecting HPV than samples taken by a doctor. 247 women with high risk for cervical disease participated in this study. They collected samples from their own vaginas using a cytobrush and a collection tube. The doctor collected two additional samples in the exam following and all three samples were analyzed using a commercial signal-amplifying capture molecular hybridization assay. 94% of the patients preferred self-sampling. HPV was present in 53% of the patient samples and 42% of the doctors specimens.
Lancet1999 Dec 4;354(9194):1970
SELF TESTING FOR CERVICAL DISEASE
Self-collected vaginal swabs were shown to be as good as the pap test in detecting cancer of high grade CIN but not as good at detecting low grade CIN or ASCUS. I t was concluded that self-collected samples are less specific but as sensitive as pap smears in detecting cervical disease.
JAMA2000 Jan 5;283(1):81-6
ORAL CONTRACEPTIVES AS A RISK FACTOR FOR CERVICAL ADENOCARCINOMA
This paper tries to link the use of oral contraceptives to increased risk of adenocarcinomas. Three groups were studied: 124 patients with adenocarcinomas, 139 with squamous cell carcinomas, and 307 population controls. PCR was done on cervical samples to determine HPV genotype and questions were asked about history of oral contraceptive use. After accounting for HPV infection, cytological screening and sexual history, an association between oral contraceptives and higher risk for adenocarcinoma remained. I find these results problematic because it is almost impossible to separate the confounding variable of sexual activity from use of OCs. Increase sexual activity is associated with higher risk for HPV and almost all cervical cancer is linked to HPV.
Cancer Epidemiology Biomarkers Prev1999 Dec;8(12):1079-85
A VACCINE FOR PATIENTS WITH ADVANCED CERVICAL CARCINOMA?
Patients positive with HPV 16 and suffering from advanced cervical cancer were vaccinated with HPV16 E7 peptides. The clinical trials were done as a dose-escalation study, where groups of patients received larger and larger doses of the vaccine. There were no side effects in the 19 patients studied. 2 patients were stable with disease for at least a year after vaccination; 15 progressed in their disease and one of those died during treatment. The tumors of the last two patients regressed in response to chemotherapy after the vaccine. All patients had been previously resistant top therapy. This mild success with vaccination in patients with advanced disease is promising. The vaccine has even more potential to help patients who have early disease and are not immunocompromised.
European Journal of Cancer1999 Jun;35(6):946-52