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15 pages, 676 KiB  
Article
Integrating Molecular Diagnostics into Cervical Cancer Screening: A Workflow Using FFPE Tissue Samples
by Serena Varesano, Giulia Ciccarese, Paola Parente, Michele Paudice, Katia Mazzocco, Simone Ferrero and Valerio Gaetano Vellone
Curr. Issues Mol. Biol. 2025, 47(9), 679; https://doi.org/10.3390/cimb47090679 - 24 Aug 2025
Abstract
Cervical cancer screening plays a crucial role in preventing invasive disease through early detection of high-grade lesions. However, traditional cytology and histology often fail to reliably differentiate between transient HPV infections and those likely to progress. This study investigates the feasibility of integrating [...] Read more.
Cervical cancer screening plays a crucial role in preventing invasive disease through early detection of high-grade lesions. However, traditional cytology and histology often fail to reliably differentiate between transient HPV infections and those likely to progress. This study investigates the feasibility of integrating molecular HPV testing into histopathological workflows using FFPE tissue samples to improve diagnostic precision. A retrospective analysis was conducted on 55 FFPE cervical specimens from patients undergoing colposcopy with biopsy or conization. The workflow included automated DNA extraction and real-time PCR-based HPV genotyping with the Seegene Anyplex II HPV28 assay. HPV DNA was detected in 56.4% of samples, with 21 genotypes, including multiple high-risk types. High viral loads correlated with high-grade lesions, supporting the clinical value of HPV quantification. Compared to histology, molecular analysis reduced potential overdiagnosis by confirming HPV absence in morphologically suspicious but HPV-negative lesions. Integrating viral load and genotyping improved risk stratification, optimizing colposcopy referrals and reducing unnecessary follow-ups. This study introduces a novel, fully automated molecular workflow applicable to FFPE samples, enhancing cervical cancer screening beyond traditional methods. Although based on a limited sample, the findings support the method’s potential for broader implementation and further validation in multicenter settings. Full article
12 pages, 231 KiB  
Review
Review of Human Papillomavirus Vaccination Programs in United States Schools
by Cassandra Duran, Aditi Gupta, Lynda Aririguzo, Norma Castillo and Sanghamitra M. Misra
Vaccines 2025, 13(9), 894; https://doi.org/10.3390/vaccines13090894 - 23 Aug 2025
Abstract
Background: School vaccination programs (school-based and school-located) that include the human papillomavirus (HPV) vaccine have been implemented throughout the United States since 2009. Methods: We conducted a review of school HPV vaccination programs in PUBMED, Google Scholar, Web of Science, Ovid, Medline, and [...] Read more.
Background: School vaccination programs (school-based and school-located) that include the human papillomavirus (HPV) vaccine have been implemented throughout the United States since 2009. Methods: We conducted a review of school HPV vaccination programs in PUBMED, Google Scholar, Web of Science, Ovid, Medline, and Embase and included peer-reviewed studies originating in the United States that focused on any aspect of HPV school vaccination programs. Results: Our review yielded 47 articles that fell into several categories: (1) parent and child perceptions, (2) school nurse perceptions, (3) development, (4) implementation, (5) outcomes, and (6) barriers and facilitators of HPV vaccination programs in schools. Conclusions: School vaccination programs including the HPV vaccine have been implemented successfully all over the United States. Overall, nurse, parent, and student perceptions are positive, but there are various barriers to program success. Successes and failures of school HPV vaccination programs should be examined to develop best practices to sustain and expand these impactful programs. Full article
(This article belongs to the Special Issue HPV Vaccination Coverage: Problems and Challenges)
24 pages, 3238 KiB  
Systematic Review
Systematic Review and Meta-Analysis of Human Papillomavirus Prevalence and Genotypic Disparities Among Human Immunodeficiency Virus-Positive Women in Africa
by Yirga Amare, Dahabo Gelgalo, Éva Pozsgai and István Kiss
J. Clin. Med. 2025, 14(17), 5924; https://doi.org/10.3390/jcm14175924 - 22 Aug 2025
Viewed by 46
Abstract
Background: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection with significant health implications, especially for women living with human immunodeficiency virus (HIV). The variability in reported prevalence and genotype distribution of HPV among HIV-positive women across different regions in Africa [...] Read more.
Background: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection with significant health implications, especially for women living with human immunodeficiency virus (HIV). The variability in reported prevalence and genotype distribution of HPV among HIV-positive women across different regions in Africa necessitates a comprehensive and systemic examination. Methods: A systematic search was conducted across several databases. A random effect model was used to evaluate study heterogeneity through Q statistics and I2 measures. Publication bias was assessed using funnel plots and Egger’s tests. Risk factors for HPV among HIV-positive women were summarized qualitatively. This review was registered with PROSPERO: CRD42024525123. Result: Twenty-three studies involving 9954 HIV-positive women were combined to estimate HPV prevalence. The overall prevalence of all HPV types was 49.4% (95% CI: 42.43, 56.38), with evidence of heterogeneity (Q = 520.92, df = 16, I2 = 96.93%, p < 0.0001). The prevalence of high-risk HPV was 45.26% (95% CI: 31.02, 59.91), showing heterogeneity across studies (Q = 439.18, df = 10, p < 0.0001, I2 = 97.72%). Low-risk HPV had a prevalence of 24.98% (95% CI: 12.27, 40.41), with variation among studies (Q = 134.39, df = 6, p < 0.0001, I2 = 95.54%). The most frequent genotypes were 16, 18, 52, 33, and 35. A higher cluster of differentiation 4 (CD4) count is associated with a lower prevalence of HPV. Conclusions: The pooled HPV prevalence among HIV-positive women in Africa is lower compared to previous studies, but the slow decline poses challenges to meet the WHO’s goal of eliminating HPV-related cervical cancer by 2030. Therefore, enhanced prevention efforts, including HPV self-sampling, improved vaccination coverage, and early treatment interventions, are essential to meet the goal of eliminating HPV-related cervical cancer. Full article
(This article belongs to the Section Epidemiology & Public Health)
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17 pages, 1824 KiB  
Article
Evolving Public Attitudes Towards the HPV Vaccine in China: A Fine-Grained Emotion Analysis of Sina Weibo (2016 vs. 2024)
by Bowen Shi, Ruibo Chen, Xinyue Yuan and Junran Wu
Entropy 2025, 27(9), 887; https://doi.org/10.3390/e27090887 - 22 Aug 2025
Viewed by 115
Abstract
In the digital age, social media significantly shapes public attitudes and emotional responses towards health interventions, such as HPV vaccination, which is critical in developing countries. This study employed a deep learning model to identify fine-grained emotions of 38,615 HPV-related tweets from 2016 [...] Read more.
In the digital age, social media significantly shapes public attitudes and emotional responses towards health interventions, such as HPV vaccination, which is critical in developing countries. This study employed a deep learning model to identify fine-grained emotions of 38,615 HPV-related tweets from 2016 to 2024, revealing significant shifts in public emotions. Notably, skepticism about vaccine commercialization motives heightened anger, while university outreach initiatives fostered positive emotions. Structural entropy analysis highlighted polarized emotional communication networks: the network of joy exhibited lower entropy with centralized information flow, whereas other emotions displayed higher entropy, fragmented dissemination, and enhanced cross-community communication efficiency. New communicators, such as campus accounts and music bloggers, played pivotal roles in spreading positive emotions, while individual bloggers in specific fields amplified negative emotions like anger, particularly in closed networks. This research underscores the intricate dynamics of online health communication and the need for targeted interventions to address stigma and enhance public awareness of HPV vaccination, providing valuable insights for future public health policy. Full article
(This article belongs to the Special Issue Complexity of Social Networks)
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23 pages, 1080 KiB  
Review
Human Papillomavirus Across the Reproductive Lifespan: An Integrative Review of Fertility, Pregnancy Outcomes, and Fertility-Sparing Management
by Matteo Terrinoni, Tullio Golia D’Augè, Giuseppe Mascellino, Federica Adinolfi, Michele Palisciano, Dario Rossetti, Gian Carlo Di Renzo and Andrea Giannini
Medicina 2025, 61(8), 1499; https://doi.org/10.3390/medicina61081499 - 21 Aug 2025
Viewed by 224
Abstract
Background and Objectives: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection worldwide and, beyond its oncogenic potential, may impair reproductive health in both sexes. This review examines HPV’s effects on male and female fertility, obstetric outcomes, vertical transmission, and fertility-sparing [...] Read more.
Background and Objectives: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection worldwide and, beyond its oncogenic potential, may impair reproductive health in both sexes. This review examines HPV’s effects on male and female fertility, obstetric outcomes, vertical transmission, and fertility-sparing management in oncology. Materials and Methods: A systematic search of PubMed, Embase, and Scopus was conducted using terms related to HPV and reproduction. Additional search terms included those related to therapeutic vaccines, antivirals, and genotype prevalence. English-language human studies reporting clinical reproductive outcomes were included. Thirty-seven studies met the inclusion criteria. Two reviewers independently screened and assessed study quality using a simplified GRADE framework. Results: In men, seminal HPV infection correlates with reduced progressive motility (SMD ≈ −0.85), abnormal morphology, and increased DNA fragmentation. In women, high-risk HPV doubles the odds of infertility (OR ≈ 2.3) and is associated with endometrial involvement. High first-trimester viral load predicts vertical transmission (aOR 6.4), which is also increased by vaginal delivery (RR 1.8) and is linked to PROM (OR 1.8) and preterm birth (OR 1.8). Modeling suggests that nine-valent vaccination plus 5-year HPV-based screening could reduce CIN2+ by up to 80% and excisional treatments by >75%. Fertility-sparing surgery in early cervical cancer yields a <4% recurrence and up to 68% live birth rates. Conclusions: This review uniquely synthesizes reproductive and oncologic impacts of HPV and emphasizes risk stratification, multidisciplinary prevention, and fertility preservation. Integration of HPV DNA quantification, personalized care, and vaccine-based strategies offers a path toward optimized outcomes in both sexes. Full article
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14 pages, 632 KiB  
Article
Prevalence and Associated Factors for HPV in People Living with HIV: Are INSTIs Protective Against HPV-16? The GAIA Study
by Omar Hernández-López, Brenda Clara González-Contreras, Ana Luz Cano-Díaz, José Antonio Mata-Marín, Ericka Nelly Pompa-Mera, Javier Vicente Noyola-Gómez, Salma Triana-González, Paola Edith Padilla-Noguera, Alberto Chaparro-Sánchez, Sócrates Alberto García-Gutiérrez, Gustavo Barriga-Angulo and Jesús Enrique Gaytan-Martinez
Viruses 2025, 17(8), 1147; https://doi.org/10.3390/v17081147 - 21 Aug 2025
Viewed by 217
Abstract
Human papillomavirus (HPV) significantly contributes to anogenital cancers, with elevated risks among people living with HIV (PWH), particularly men who have sex with men (MSM). This study assessed anal HPV prevalence and associated risk factors in PWH in Mexico, focusing on the role [...] Read more.
Human papillomavirus (HPV) significantly contributes to anogenital cancers, with elevated risks among people living with HIV (PWH), particularly men who have sex with men (MSM). This study assessed anal HPV prevalence and associated risk factors in PWH in Mexico, focusing on the role of antiretroviral therapy (ART). Methods: A cross-sectional study at an HIV clinic in Mexico City (October 2023–December 2024) enrolled 214 MSM with HIV. The participants completed a validated risk factor questionnaire and provided anal samples for real-time PCR testing of 28 HPV genotypes. Logistic regression analyzed associations between HPV infection, ART regimens, and clinical/behavioral factors. Results: HPV prevalence was 89.3%, with HPV-16 (20.1%) being the most common high-risk genotype. Integrase inhibitor (INSTI) use was inversely associated with HPV-16 infection (OR: 0.42; 95% CI: 0.21–0.83; p = 0.011), while protease inhibitor use increased HPV-16 (OR: 2.16; 95% CI: 1.09–4.29; p = 0.025) and HPV-6 risks. Higher CD4+ counts (≥500 cells/mm3) and undetectable HIV viral load (<40 copies/mL) were protective against multiple HPV genotypes. Lower education and smoking increased HPV risk. Conclusions: This first Mexican study in the ART and HPV vaccination era highlights high anal HPV prevalence in PWH and suggests that INSTI-based regimens may reduce HPV-16 risk, informing ART selection for HPV prevention. Full article
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28 pages, 7062 KiB  
Article
Cervicovaginal Microbiome and HPV: A Standardized Approach to 16S/ITS NGS and Microbial Community Profiling for Viral Association
by Jane Shen-Gunther, Qingqing Xia, Hong Cai and Yufeng Wang
Int. J. Mol. Sci. 2025, 26(16), 8090; https://doi.org/10.3390/ijms26168090 - 21 Aug 2025
Viewed by 127
Abstract
16S rRNA next-generation sequencing (NGS) has significantly advanced cervicovaginal microbiome profiling, offering insights into the relationship between vaginal dysbiosis and HPV-associated carcinogenesis. However, reliance on a limited set of 16S hypervariable regions introduces inherent biases that impact results. This study developed standardized workflows [...] Read more.
16S rRNA next-generation sequencing (NGS) has significantly advanced cervicovaginal microbiome profiling, offering insights into the relationship between vaginal dysbiosis and HPV-associated carcinogenesis. However, reliance on a limited set of 16S hypervariable regions introduces inherent biases that impact results. This study developed standardized workflows for 16S/ITS NGS, with a focus on identifying methodological biases that influence microbial abundance and taxonomic specificity. Commercial NGS tools were employed, including the 16S/ITS QIAseq V1–V9 screening panel, ATCC vaginal microbial standard, and CLC Genomics Workbench integrated with a customized database (VAGIBIOTA) for analysis. The microbial communities of 66 cervical cytology samples were characterized. Among the regions tested, V3V4 exhibited the least quantitative bias, while V1V2 offered the highest specificity. Microbial profiles and Community State Types (CST) (I–V) were broadly consistent with prior studies, with Lactobacillus abundance clustering into three states: L.-dominant (CST I–III, V), L.-diminished (CST IV-A), and L.-depleted (CST IV-B). Differential abundance analysis revealed that anaerobic opportunistic pathogens dominant in CST IV-B (dysbiosis) were also enriched in HSIL and HPV-16 positive samples. Our findings revealed distinct differences in species identification across 16S rRNA hypervariable regions, emphasizing the importance of region selection in clarifying microbial contributions to HPV-associated carcinogenesis. Full article
(This article belongs to the Special Issue Recent Advances in Human Papillomavirus (HPV) Research)
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9 pages, 297 KiB  
Article
The Relationship Between Peripheral Inflammatory Markers and High-Grade Cervical Lesions: A Retrospective Cohort Study
by Aysun Alci, Necim Yalcin, Mustafa Gokkaya, Gulsum Ekin Sari, Harun Resit Turkmenoglu, Isin Ureyen and Tayfun Toptas
Diagnostics 2025, 15(16), 2107; https://doi.org/10.3390/diagnostics15162107 - 21 Aug 2025
Viewed by 132
Abstract
Background/Objectives: This study was designed to investigate the relationship between peripheral hematological inflammation markers, namely, neutrophil/lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune inflammation index (SII), and systemic inflammatory response index (SIRI) and high-grade cervical lesions (CIN2+). Methods: [...] Read more.
Background/Objectives: This study was designed to investigate the relationship between peripheral hematological inflammation markers, namely, neutrophil/lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune inflammation index (SII), and systemic inflammatory response index (SIRI) and high-grade cervical lesions (CIN2+). Methods: A retrospective cohort analysis was conducted on 358 patients who underwent cervical excision procedures. Patients were divided into two groups: <CIN2 and CIN2+. Preoperative complete blood count data were used to calculate the inflammation indices. HPV genotypes were also recorded. Logistic regression and ROC analyses were performed to evaluate the predictive performance. Results: CIN2+ lesions were detected in 69.6% of participants. In the univariate analysis, only age and HPV 16 positivity (p < 0.005) showed a significant association with the presence of CIN2+. NLR, PLR, MLR, SII, and SIRI values did not show significant differences between groups (all p > 0.05). In the multivariate analysis, increasing age was independently associated with a decrease in the risk of CIN2+ (OR = 0.96, 95% CI: 0.94–0.99), while HPV 16 positivity was associated with an increase in risk (OR = 2.44, 95% CI: 1.43–4.18). ROC analysis showed that combining age and HPV 16 status improved the specificity (85.1%) of predicting CIN2+ compared to using age alone (42.2%). Conclusions: Peripheral haematological inflammation markers (NLR, PLR, MLR, SII, and SIRI) did not show predictive value in predicting CIN2+ lesions. However, age and HPV 16 infection were found to be independent predictors. These findings suggest that haematological indices may reflect systemic inflammatory responses but are not sufficient on their own for the detection of CIN2+. HPV genotyping is of critical importance for the early detection of high-grade lesions. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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27 pages, 672 KiB  
Review
Targeted Screening Strategies for Head and Neck Cancer: A Global Review of Evidence, Technologies, and Cost-Effectiveness
by Orlando Guntinas-Lichius, Claudio Bücking, Sweet Ping Ng, Fernando López, Juan Pablo Rodrigo, Karthik N. Rao, Andrés Coca Pelaz, Luiz P. Kowalski, Cesare Piazza, Alessandra Rinaldo and Alfio Ferlito
Diagnostics 2025, 15(16), 2095; https://doi.org/10.3390/diagnostics15162095 - 20 Aug 2025
Viewed by 219
Abstract
Head and neck cancer (HNC) is the seventh most common cancer worldwide, with rising incidence particularly in oropharyngeal cancer subsites. Despite well-known risk factors, such as tobacco and alcohol consumption as well as human papillomavirus (HPV) infection, most HNCs are diagnosed at an [...] Read more.
Head and neck cancer (HNC) is the seventh most common cancer worldwide, with rising incidence particularly in oropharyngeal cancer subsites. Despite well-known risk factors, such as tobacco and alcohol consumption as well as human papillomavirus (HPV) infection, most HNCs are diagnosed at an advanced stage, resulting in poor prognosis. Early detection and screening are critical, especially in high-risk populations. Nevertheless, there is a lack of guidelines for a stratified HNC screening. A systematic literature review was conducted following PRISMA guidelines, using PubMed and ScienceDirect databases up to 30 June 2025. Search terms included “screening”, “early diagnosis”, and specific HNC subsites. A total of 199 records were screened, and 160 studies were included based on relevance and scientific rigor. The review concentrates on contemporary screening modalities, stratification of high-risk cohorts, emerging technologies, and cost-effectiveness evidence. Visual inspection and panendoscopy remain the standard tools for HNC screening, but have limited effectiveness and cost-efficiency. Opportunistic screening in high-risk individuals, especially in regions with high HNC prevalence, has shown benefits. Liquid biopsy techniques targeting HPV- and Epstein-Barr virus-related HNC demonstrate high sensitivity for early detection and recurrence monitoring. Novel imaging technologies like narrow-band imaging and Raman spectroscopy show promising diagnostic accuracy but require further validation. Most broad-based screening programs lack cost-effectiveness, while targeted strategies in high-risk groups appear more viable. Screening for HNC should be stratified by individual risk profiles and regional disease prevalence. Emerging technologies, particularly liquid and optical biopsy techniques, offer transformative potential. Future screening strategies must integrate technological advances into tailored, evidence-based protocols to improve early detection and patient outcomes in HNC. Full article
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12 pages, 786 KiB  
Article
Breaking the Oxygen Dogma: How High FiO2 May Disrupt Pulmonary Physiology in COVID-19
by Francisco Javier González Ruiz, Blanca Estela Broca-García, Daniel Manzur-Sandoval, Luis Efrén Santos-Martínez, Uriel Encarnación-Martínez, Emmanuel Adrián Lazcano-Díaz and Angel Ramos-Enriquez
COVID 2025, 5(8), 139; https://doi.org/10.3390/covid5080139 - 20 Aug 2025
Viewed by 141
Abstract
Background: High concentrations of supplemental oxygen (FiO2 > 0.6) are commonly used to treat acute hypoxemia in critically ill patients. However, the effects of High FiO2 in patients with COVID-19 remain unclear, particularly regarding its impact on hypoxic pulmonary vasoconstriction (HPV) [...] Read more.
Background: High concentrations of supplemental oxygen (FiO2 > 0.6) are commonly used to treat acute hypoxemia in critically ill patients. However, the effects of High FiO2 in patients with COVID-19 remain unclear, particularly regarding its impact on hypoxic pulmonary vasoconstriction (HPV) and ventilation–perfusion (V/Q) mismatch. Objective: This study aims to evaluate whether administering lower concentrations of inspired oxygen (FiO2 < 0.6) is associated with improved outcomes—namely reduced need for mechanical ventilation and mortality—in patients with COVID-19 and severe pulmonary involvement. Methods: This retrospective observational cohort included 201 patients with confirmed COVID-19. Patients were grouped by mean FiO2 during the first 24–48 h: High FiO2 (≥0.60) or Low FiO2 (<0.60). The primary outcome was the requirement for mechanical ventilation; the secondary outcome was in-hospital mortality. A composite endpoint (mechanical ventilation and in-hospital death) was also evaluated. Analyses included logistic regression and Kaplan–Meier survival with log-rank testing. Results: High FiO2 (≥0.60) was associated with higher odds of the composite outcome (mechanical ventilation and in-hospital death). In multivariable analysis, Low FiO2 remained associated with lower odds (adjusted OR 0.18; 95% CI 0.08–0.39; p < 0.001). Unadjusted rates were 43.1% vs. 16.1% for mechanical ventilation and 34.3% vs. 8.1% for in-hospital death (High vs. Low FiO2; both p < 0.001). Event-free survival favored the Low FiO2 group (log-rank p < 0.001). The model showed excellent discrimination (AUC 0.96; 95% CI 0.92–0.99). Conclusions: Higher early FiO2 exposure was associated with worse clinical outcomes in severe COVID-19. These findings are consistent with physiological models in which excess oxygen may attenuate hypoxic pulmonary vasoconstriction and increase shunt/dead space. Prospective studies are warranted to assess causality and refine oxygen targets. Full article
(This article belongs to the Section COVID Clinical Manifestations and Management)
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20 pages, 1450 KiB  
Review
Harnessing the Power of Microbiota: How Do Key Lactobacillus Species Aid in Clearing High-Risk Human Papilloma Virus Infection and Promoting the Regression of Cervical Dysplasia?
by Edyta Kęczkowska, Joanna Wrotyńska-Barczyńska, Aneta Bałabas, Magdalena Piątkowska, Michalina Dąbrowska, Paweł Czarnowski, Ewa E. Hennig, Maciej Brązert, Piotr Olcha, Michał Ciebiera and Natalia Zeber-Lubecka
Biology 2025, 14(8), 1081; https://doi.org/10.3390/biology14081081 - 19 Aug 2025
Viewed by 275
Abstract
Lactobacillus species play a fundamental role in maintaining a healthy vaginal microbiota and have been increasingly recognized for their protective effects against high-risk human papillomavirus (HR-HPV) infection and the progression of cervical intraepithelial neoplasia (CIN). These beneficial bacteria contribute to host defense through [...] Read more.
Lactobacillus species play a fundamental role in maintaining a healthy vaginal microbiota and have been increasingly recognized for their protective effects against high-risk human papillomavirus (HR-HPV) infection and the progression of cervical intraepithelial neoplasia (CIN). These beneficial bacteria contribute to host defense through multiple mechanisms, including the production of lactic acid that sustains a low vaginal pH, enhancement of epithelial barrier integrity via E-cadherin regulation, and modulation of immune signaling pathways such as interferon responses and NF-κB activity. Lactobacillus strains exert anti-inflammatory effects by downregulating pro-inflammatory cytokines and interfering with oncogenic pathways including Wnt/β-catenin and the expression of HPV E6 and E7 proteins. Additionally, they may regulate tumor-suppressor microRNAs and modulate dendritic cell and macrophage activity, supporting antiviral immunity. Recent studies have explored their potential influence on CIN regression and HR-HPV clearance, particularly the strains Lactobacillus crispatus and L. gasseri, which are associated with favorable microbial community states. This review explores the potential mechanisms through which Lactobacillus species contribute to HR-HPV clearance and the regression of cervical dysplasia, integrating evidence from molecular studies, in vivo models, and clinical trials. The emerging role of probiotic interventions as adjunctive strategies in HPV management is also discussed, highlighting their possible synergy with conventional treatments and prophylactic vaccination. Full article
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15 pages, 1983 KiB  
Article
Screening for Cervical Cancer and Early Treatment (SCCET) Project—The Programmatic Data of Romanian Experience in Primary Screening for High-Risk HPV DNA
by Gabriel Marian Saveliev, Adriana Irina Ciuvică, Dragos Cretoiu, Valentin Nicolae Varlas, Cristian Balalau, Irina Balescu, Nicolae Bacalbasa, Laurentiu Camil Bohiltea and Nicolae Suciu
Diagnostics 2025, 15(16), 2066; https://doi.org/10.3390/diagnostics15162066 - 18 Aug 2025
Viewed by 315
Abstract
Background/Objectives: Cervical cancer (CC), caused mainly by high-risk human papillomavirus (hrHPV), remains a global health challenge despite being preventable. The disease’s incidence and mortality rates significantly vary across regions, highlighting the need for effective screening programs. The World Health Organization prioritizes CC screening [...] Read more.
Background/Objectives: Cervical cancer (CC), caused mainly by high-risk human papillomavirus (hrHPV), remains a global health challenge despite being preventable. The disease’s incidence and mortality rates significantly vary across regions, highlighting the need for effective screening programs. The World Health Organization prioritizes CC screening to monitor and eliminate the disease. The Screening for Cervical Cancer and Early Treatment (SCCET) project aligns with this goal by adhering to the 2012 National Program for Cervical Cancer Screening and implementing the European Guidelines of Quality Assurance. Methods: The SCCET initiative facilitates access to equitable and high-quality preventive medical services for Romanian women, incorporating the Babeș–Papanicolaou smear (Pap test) and/or hrHPV DNA screening. Focused on the Muntenia Region of South Romania, the project leverages a methodical approach to gather substantial medical data on hrHPV infection rates and cervical lesions, thereby improving health management for women in the screening program. Results: Through public information and educational campaigns about HPV and its link to CC, the SCCET project has significantly enhanced participation in the screening program. In the study conducted between September 2022 and March 2023, 14,385 women aged 30 to 64 years voluntarily participated; of these, 11,996 (83.4%) underwent primary hrHPV DNA screening and were tested using the PowerGene 9600 Plus Real-Time polymerase chain reaction (PCR) system and the commercial Atila BioSystems AmpFire® HPV Screening 16/18/HR test, version 4.1. This substantial participation indicates a positive shift in public attitudes towards CC prevention and highlights the success of the project’s outreach efforts. The study revealed an overall prevalence of hrHPV infection of 12.24%; of these, the most common genotype was other hrHPV types (9.84%), followed by HPV 16 (2.3%) and HPV 18 (0.71%). Conclusions: The SCCET project’s recent data on primary hrHPV DNA screening showcases its pivotal role in advancing the management and prevention of CC in Romania. By providing accessible, high-quality screening services and fostering public education on HPV, the initiative has made significant strides toward reducing the burden of CC. This effort aligns with global public health goals, and providing updated information on the prevalence of hrHPV types will allow the development of personalized national screening and vaccination programs to eradicate CC. Full article
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14 pages, 265 KiB  
Article
Exploring Vulnerable, Ethnic Minority, and Low Socioeconomic Children’s Knowledge, Beliefs, and Attitudes Regarding HPV Vaccination in Romania
by Teodora Achimaș-Cadariu, Andrei Pașca, Delia Nicoară and Dan Lucian Dumitrașcu
Healthcare 2025, 13(16), 2010; https://doi.org/10.3390/healthcare13162010 - 15 Aug 2025
Viewed by 242
Abstract
Background/Objective: To assess vulnerable Romanian children’s knowledge, attitudes, and beliefs regarding the HPV vaccination. Methods: Vulnerable children (ethnic minorities, high social vulnerability index, or low socioeconomic status) from three schools in Cluj County, Romania, were enrolled in a short educational presentation regarding HPV [...] Read more.
Background/Objective: To assess vulnerable Romanian children’s knowledge, attitudes, and beliefs regarding the HPV vaccination. Methods: Vulnerable children (ethnic minorities, high social vulnerability index, or low socioeconomic status) from three schools in Cluj County, Romania, were enrolled in a short educational presentation regarding HPV and were delivered a physical questionnaire consisting of 26 items. Results: 199 vulnerable school students concluded the questionnaire with a mean age of 14.62. Most participants were unaware of the HPV infection or the HPV vaccine. Following the educational program, most participants exhibited a reasonably elevated level of knowledge, which positively correlated with the intention to vaccinate. Fifty-three per cent of respondents would vaccinate in school if the vaccine were available, fifty-four per cent would vaccinate if the product were free of charge or at minimal cost, and over sixty-four per cent would vaccinate at their doctor’s recommendation. Several knowledge items, beliefs, and attitudes towards vaccination were disclosed to influence children’s preference to participate in vaccination campaigns. Conclusions: This analysis unveiled the pivotal role of knowledge about HPV in the immunization uptake within underserved, vulnerable populations of Romanian children. An intricate interplay between vulnerability, knowledge, accessibility, and the willingness to vaccinate was impacted by several beliefs and attitudes towards HPV vaccination. Most children were willing to participate in HPV immunization campaigns, whether school-based, reimbursed, or at the doctor’s recommendation. These findings act as pillars for assembling future educational campaigns in vulnerable Romanian communities of children, aiming to enhance awareness and coverage of HPV vaccination and ensure inclusive health policies. Full article
(This article belongs to the Special Issue HPV Vaccine and Cervical Cancer Prevention)
21 pages, 691 KiB  
Article
The High Prevalence of Oncogenic HPV Genotypes Targeted by the Nonavalent HPV Vaccine in HIV-Infected Women Urgently Reinforces the Need for Prophylactic Vaccination in Key Female Populations Living in Gabon
by Marcelle Mboumba-Mboumba, Augustin Mouinga-Ondeme, Pamela Moussavou-Boundzanga, Jeordy Dimitri Engone-Ondo, Roseanne Mounanga Mourimarodi, Abdoulaye Diane, Christ Ognari Ayoumi, Laurent Bélec, Ralph-Sydney Mboumba Bouassa and Ivan Mfouo-Tynga
Diseases 2025, 13(8), 260; https://doi.org/10.3390/diseases13080260 - 14 Aug 2025
Viewed by 277
Abstract
Background/Objectives. Women living with human immunodeficiency virus (WLWH) have a six-fold higher risk of developing cervical cancer associated with high-risk human Papillomavirus (HR-HPV) than HIV-negative women. We herein assessed HR-HPV genotype distribution and plasma levels of the cancer antigen 125 (CA-125) in WLWH [...] Read more.
Background/Objectives. Women living with human immunodeficiency virus (WLWH) have a six-fold higher risk of developing cervical cancer associated with high-risk human Papillomavirus (HR-HPV) than HIV-negative women. We herein assessed HR-HPV genotype distribution and plasma levels of the cancer antigen 125 (CA-125) in WLWH in a rural town in Gabon, in Central Africa. Methods. Adult WLWH attending the local HIV outpatient center were prospectively enrolled and underwent cervical visual inspection and cervicovaginal and blood sampling. HIV RNA load and CA-125 levels were measured from plasma using the Cepheid® Xpert® HIV-1 Viral Load kit and BioMérieux VIDAS® CA-125 II assay, respectively. HPV detection and genotyping were performed via a nested polymerase chain reaction (MY09/11 and GP5+/6+), followed by sequencing. Results. Fifty-eight WLWH (median age: 52 years) were enrolled. Median CD4 count was 547 cells/µL (IQR: 412.5–737.5) and HIV RNA load 4.88 Log10 copies/mL (IQR: 3.79–5.49). HPV prevalence was 68.96%, with HR-HPV detected in 41.37% of women. Among HR-HPV-positive samples, 87.5% (21/24) were genotypes targeted by the Gardasil vaccine, while 12.5% (3/24) were non-vaccine types. Predominant HR-HPV types included HPV-16 (13.8%), HPV-33 (10.34%), HPV-35 (5.17%), HPV-31, and HPV-58 (3.45%). Most participants had normal cervical cytology (62.07%), and a minority (14.29%) had elevated CA-125 levels, with no correlation to cytological abnormalities. Conclusions. In the hinterland of Gabon, WLWH are facing an unsuspected yet substantial burden of cervical HR-HPV infection and a neglected risk for cervical cancer. Strengthening cervical cancer prevention through targeted HPV vaccination, sexual education, and accessible screening strategies will help in mitigating associated risk. Full article
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13 pages, 425 KiB  
Review
Narrative Review of the Use of Genomic-Adjusted Radiation Dose (GARD) in Radiotherapy
by Jun Yin
Cancers 2025, 17(16), 2650; https://doi.org/10.3390/cancers17162650 - 14 Aug 2025
Viewed by 321
Abstract
This narrative review examines the genomic-adjusted radiation dose (GARD), a biologically informed framework developed to personalize radiotherapy by integrating tumor-specific genomic data. GARD combines the radiosensitivity index (RSI), based on gene expression, with the linear quadratic model to estimate patient-specific radiation effect. Since [...] Read more.
This narrative review examines the genomic-adjusted radiation dose (GARD), a biologically informed framework developed to personalize radiotherapy by integrating tumor-specific genomic data. GARD combines the radiosensitivity index (RSI), based on gene expression, with the linear quadratic model to estimate patient-specific radiation effect. Since its introduction in 2017, GARD has demonstrated prognostic value across multiple cancer types in retrospective studies. This review summarizes key studies evaluating GARD across various tumor types and clinical contexts. Emerging trials, including a Phase II trial in HPV-positive oropharyngeal cancer, aim to validate GARD-guided dosing in precision radiotherapy. Future efforts may focus on refining RSI, addressing tumor heterogeneity, and validating GARD-guided dosing in prospective settings. Full article
(This article belongs to the Special Issue Understanding the Complexities of Anticancer Drugs Resistance)
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