Banca de QUALIFICAÇÃO: Ísis de Araujo Oliveira Nakashoji

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : Ísis de Araujo Oliveira Nakashoji
DATE: 15/03/2024
TIME: 14:00
LOCAL: Plataforma Teams
TITLE:

HPV GENOTYPING AND CERVICAL CYTOPATHOLOGICAL EXAMINATION IN THE POPULATION ELIGIBLE FOR HPV VACCINATION (VACCINATED AND NON-VACCINATED)

KEY WORDS:

HPV, cytopatohology, cervix, vaccine

PAGES: 40
BIG AREA: Ciências da Saúde
AREA: Farmácia
SUMMARY:

INTRODUCTION. Cervical cancer is the fourth most common in incidence and mortality in the world and is associated with persistent infection with high-risk HPV types. OBJECTIVE. To evaluate the frequency of HPV infection and abnormal cervical cytopathological examination in patients in the eligible population for HPV vaccination (vaccinated and non-vaccinated). METHODOLOGY. Application of a questionnaire, collection and analysis of cervical samples through cytopathological examination of the cervix and HPV genotyping (35 different types of HPV, 18 high risk (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73 and 82) and 17 low risk (6, 11, 40, 42, 43, 44, 54, 55, 61, 62, 67, 69, 70, 71, 72, 81 and 84). RESULTS. Of the 256 patients, 55.47% used at least one dose of the vaccine, and of those vaccinated, 94.36% used two or three doses of the vaccine. Regarding risk factors for HPV infection (less education, first sexual intercourse, not using condoms and greater number of sexual partners), a significant difference was observed only when access to higher education, which was less frequent in patients with HPV compared to patients with a negative test (43.69% x 57.66%).In relation to HPV infection, in vaccinated women, when compared to nonvaccinated women, a reduction in the frequency of samples with: a) HPV infection (low or high risk) (40.85% x 50.88%); b) infection with at least 1 high-risk HPV type (30.28% x 34.21%); c) infection with at least 1 low-risk HPV type (22.83% x 28.95%); multiple infection (39.66% x 44.83%) and with only 1 type of HPV (55.17% x 60.34%); d) infection with at least 1 type of HPV associated with the quadrivalent vaccine (0% x 0.88%); e) infection with at least 1 type of HPV associated with the nonavalent vaccine (11.27% x 17.54%). Regarding HPV types, the majority of HPV infections were highrisk types in non-vaccinated (59.66%) and vaccinated (64.71%). In non-vaccinated individuals, the most common high-risk HPV types were 35, 52, 58, 56, 66 and 68 and the most common low-risk types were 42, 67 and 62/81. In vaccinated women, the most frequent high-risk HPV types were 52, 56, 51, 82, 39, 53, 58, 66 and 68 and the most frequent low-risk types were 42, 43 and 67. Regarding the types of HPV associated with vaccines, the only type of HPV associated with the quadrivalent vaccine identified was HPV 6 and in a single infection from an non-vaccinated patient corresponding to 0.84% (1/119) of the total infections of unvaccinated patients; as for the types associated with the nonavalent vaccine, 79.83% of HPV infections in non-vaccinated individuals and 82.35% of HPV infections in vaccinated individuals were not caused by HPV types associated with the nonavalent vaccine. In vaccinated women, when compared to nonvaccinated women, there was a significant reduction in the frequency of samples with HPV 35 (2.11% x 9.65%) and a significant reduction in the frequency of HPV 62/81 (0% x 6.14 %). Regarding the cytopathological examination of the cervix, in vaccinated women, when compared to non-vaccinated women, there was a reduction in the frequency of samples with: a) abnormal results (38.03% x 50%); b) abnormal results of diagnostic categories that may require repeat examination in a shorter period of time, depending on age, (ASC-US and LSIL) (35.21% x 43.86%); c) abnormal examination of the diagnostic categories that require colposcopy (ASC-H and HSIL) (2.82% x 6.14%). The majority of abnormal cytopathological exams in non-vaccinated and vaccinated patients were associated with HPV infection (low or high risk), 87.72% and 81.48% respectively; and infection with at least 1 high-risk HPV type, 59.65% and 59.26%, respectively. In the majority of abnormal cytopathological exams of nonvaccinated (58%) and vaccinated (63.64%), only 1 type of HPV was detected. The majority of cytopathological tests altered with infection in non-vaccinated (66%) and vaccinated (75%) do not present HPV types associated with the nonavalent vaccine. Abnormal cytopathological exams of patients with infection by only types associated with the nonavalent vaccine were observed in 10% and 11.36% of non-vaccinated and vaccinated women, respectively. In patients with abnormal cytopathological examination, HPV types 52, 68 and 82 were the most common high-risk types in vaccinated women, and HPV types 35, 58 and 52 in non-vaccinated women. CONCLUSION. The results show that although vaccination had an impact on reducing infection by types of HPV associated with the quadrivalent vaccine and on reducing abnormal cytopathological exams of the cervix, it only partially reduced the risk of infection by other types of HPV, which caused precancerous lesions. In the majority of samples from vaccinated and non-vaccinated people with infection, including those with abnormal cytopathological exams, the high-risk HPV types detected are not associated with the nonavalent vaccine; however, if the used vaccine had been the nonavalent vaccine, additional protection would likely have been observed, against types 31, 45, 52 and 58. The lower level of education of patients with HPV infection suggests that, in addition to vaccination, greater access to information about the infection can contribute to its prevention.

COMMITTEE MEMBERS:
Externo ao Programa - 2495913 - ANDERSEN CHARLES DAROS - UnBPresidente - 2499462 - FABIANA PIRANI CARNEIRO
Externo ao Programa - 4328671 - GUSTAVO HENRIQUE SOARES TAKANO - UnBExterna ao Programa - 3123142 - SALETE DA SILVA RIOS CHEN - UnB