Search Results (258)

Background: Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) experience a high burden of human papillomavirus (HPV) infection and related diseases, yet data on HPV vaccination among this group in Brazil remain limited. Aims: The aims of this study were to estimate the prevalence of complete HPV vaccination and to identify factors associated with vaccination completion among MSM using PrEP in Brazil. Methods: We conducted a cross-sectional online survey between May and September 2025 among MSM aged ≥18 years, residing in Brazil and currently using oral PrEP. Participants were recruited through virtual snowball sampling and targeted advertisements on social media and a gay geosocial networking application. Data were collected using a structured, self-administered questionnaire hosted on REDCap^®. Complete HPV vaccination was defined as self-reported receipt of all doses recommended according to the participant’s age and clinical condition. Sociodemographic characteristics, relationship patterns, sexual behaviors, lubricant use during sexual activity, and history of sexually transmitted infections (STIs) were assessed. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (95% CIs) were estimated using Poisson regression with robust (sandwich) variance. Results: A total of 872 MSM using PrEP were included, of whom 59.4% reported complete HPV vaccination. In adjusted analyses, complete vaccination was more frequent among participants reporting both steady and casual partners (aPR = 1.90; 95% CI: 1.36–2.65) or only casual partners (aPR = 1.72; 95% CI: 1.24–2.39), those reporting lubricant use during sexual activity (aPR = 1.41; 95% CI: 1.23–1.61), and those with a diagnosis of chlamydia and/or gonorrhea in the previous 12 months (aPR = 1.22; 95% CI: 1.08–1.36). Conclusions: Although HPV vaccination coverage among MSM using PrEP in Brazil is higher than that reported for MSM in general, it remains incomplete in a population with regular contact with specialized health services. Integrating systematic assessment and delivery of HPV vaccination into PrEP care may help increase vaccination completion and reduce missed opportunities for prevention. Full article

Background: Cervical cancer remains the fourth most common malignancy among women worldwide. Despite vaccination and regular screening, new molecular biomarkers are needed for improved early detection and risk assessment. MicroRNAs (miRNAs) play crucial roles in post-transcriptional regulation, and their dysregulation may contribute to cervical carcinogenesis. This study evaluated the expression of selected miRNAs in cervical swab samples and corresponding biopsies from women with various grades of cervical lesions and assessed their relationship with human papillomavirus (HPV) infection. Methods: A total of 72 cervical swab samples were included in this study, divided according to cytological severity: negative for intraepithelial lesion or malignancy (NILM, n = 15), atypical squamous cells of undetermined significance (ASC-US, n = 12), low-grade squamous intraepithelial lesion (LSIL, n = 19), and high-grade squamous intraepithelial lesion (HSIL, n = 26). In a subset of patients, corresponding biopsy specimens were analysed for comparison. The association of miRNA expression with HPV infection status was also examined. miRNA expression was quantified by real-time PCR using commercially available assays. Results: To assess the relationship between miRNA expression, lesion severity, and HPV infection, fold change values were compared to the control group (NILM). No significant differences were observed in the ASC-US group (p > 0.05). In contrast, several miRNAs were significantly upregulated in the LSIL and/or HSIL groups, as well as in HPV-positive samples, indicating their association with both lesion progression and viral infection. Specifically, miR-17-5p, miR-26b-5p, miR-29a-3p, miR-103a-3p, miR-106a-5p, miR-146a-5p, miR-155-5p, and miR-191-5p showed increased expression (p < 0.05) compared with controls. The observed upregulation of miR-26b-5p, miR-106a-5p, and miR-146a-5p highlights their potential role in HPV-associated cervical carcinogenesis. Dysregulated miRNAs were enriched in pathways related to infectious diseases, various types of cancer, and cell adhesion processes. Conclusions: The gradual increase in specific miRNAs with lesion severity and HPV infection suggests their role in cervical carcinogenesis. The identified miRNAs may serve as promising non-invasive biomarkers for early detection and monitoring of HPV-associated cervical lesions. Full article

Background: Cervical cancer remains a major global health challenge, ranking fourth among malignancies in women, with an estimated 660,000 new cases and 350,000 deaths in 2022. Despite advances in vaccination and screening, incidence and mortality remain disproportionately high in low- and middle-income countries. The disease is strongly linked to persistent infection with high-risk human papillomavirus (HPV) types, predominantly HPV 16 and 18, whose E6 and E7 oncoproteins drive cervical intraepithelial neoplasia (CIN) and invasive cancer. This review summarizes current evidence on clinically relevant biomarkers in HPV-associated CIN and cervical cancer, emphasizing their role in screening, risk stratification, and disease management. Methods: We analyzed the recent literature focusing on validated and emerging biomarkers with potential clinical applications in HPV-related cervical disease. Results: Biomarkers are essential tools for improving early detection, assessment of progression risk, and personalized management. Established markers such as p16 immunostaining, p16/Ki-67 dual staining, and HPV E6/E7 mRNA assays increase diagnostic accuracy and reduce overtreatment. Prognostic indicators, including squamous cell carcinoma antigen (SCC-Ag) and telomerase activity, provide information on tumor burden and recurrence risk. Novel approaches—such as DNA methylation panels, HPV viral load quantification, ncRNAs, and cervico-vaginal microbiota profiling—show promise in refining risk assessment and supporting non-invasive follow-up strategies. Conclusions: The integration of validated biomarkers into clinical practice facilitates more effective triage, individualized treatment decisions, and optimal use of healthcare resources. Emerging biomarkers, once validated, could further improve precision in predicting lesion outcomes, ultimately reducing the global burden of cervical cancer and improving survival. Full article

Background/Objectives: Women carry two-thirds of the global anal cancer burden. Persistent genital (vulval, vaginal and cervical) high-risk Human Papillomavirus (hrHPV) infection and the resultant genital high-grade squamous intraepithelial lesions (HSILs) and genital cancers are now acknowledged as independent risk factor for anal dysplasia in women. Patients with both genital and anal hrHPV-related diseases, however, are poorly researched. Methods: National Cancer Registration and Analysis Service (NCRAS) data was requested via the NHS Digital data access request service (DARS). Women in England over the age of 25 years diagnosed with anal HSIL/cancer between 2001 and 2020 who also had a vulval and/or vaginal and/or cervical cancer HSIL/cancer diagnosis within the 20-year period before or 1-year period after their anal cancer/HSIL were studied. The burden of genital disease in women with anal cancer, their sociodemographic risk factors and timelines between acquisition of genital and anal pathology were assessed. Results: A total of 8% (n = 1297/16,301) of all women with anal HSIL/cancer also had metachronous or synchronous genital HSIL/cancer diagnoses. Women who were first diagnosed with cervical HSIL had a lower burden of recurrent anogenital lesions over time (p = 0.04) but a significantly higher risk of presenting with late-stage anal cancer than women first presenting with vulval pathology (p = 0.02). Women who had disease in more than one anatomical site developed disease features 10–20 years earlier compared to other published datasets on women with single site disease. Conclusions: These findings support the current IANS screening recommendation guidelines and suggest that the current anal cancer risk for women with cervical dysplasia may be underestimated. Full article

HPV vaccines are among the most effective vaccines available, offering safe administration and high cost-effectiveness. The composition of the vaccines has been changed, involving enrichment with pathogenic strains and extending the possibility of prevention to other HPV-related cancers and diseases. The efficacy of the vaccine extends beyond primary prevention due to documented reductions in the relapse of cervical lesions. The objective of the present study was to evaluate whether there were differences in the frequency of high-grade squamous intraepithelial lesions (H-SILs) and cervical carcinoma between vaccinated and unvaccinated women. This retrospective study included all incident cases of cervical cancer or H-SIL diagnosed between 1 January 2003 and 31 December 2020, in Catania, Italy. We analyzed 2722 cases: 751 cervical cancers and 1901 H-SILs. A total of 88% of patients had never been vaccinated. Among women with H-SILs, 85% had never received a vaccination against HPV. Among the few women with H-SILs who were vaccinated, 3.5% of them received at least one dose of the HPV vaccine before diagnosis, while 96.5% started the HPV vaccine cycle after diagnosis of cervical lesions. The mean age at diagnosis for our population was 43.4 years (52 years for cervical cancer; 39.8 years for H-SIL). Statistically significant differences were found between vaccinated and unvaccinated women. The HPV vaccine is an underutilized intervention that has the potential to eradicate cervical cancer and reduce the occurrence of other HPV-related cancers. Implementing new communication strategies can increase the number of vaccinated subjects. Full article

Background: Human papillomavirus (HPV) is a serious disease caused by a viral infection that can lead to various types of cancers in both women and men. Nearly all cases of cervical cancer (99.7%) develop as a result of an HPV infection, ranging from low to high grade, with a 5-year mortality rate ranging from 8 to 81% depending on the timeliness of diagnosis. Recent studies have further shown that HPV significantly increases the risk of cardiovascular disease, including coronary artery disease (CAD). However, the mechanism and impact of HPV on CVD from a proteomics and transcriptomics perspective are not well understood. Objectives: The purpose of this work is to provide the evidence framework for using machine learning to further advance knowledge on the interplay of HPV and CVD in relation to proteomic and transcriptomic changes. Key findings: In addition to existing known relationships between HPV and atherosclerosis and CAD, dilated cardiomyopathy (DCM) is identified as an important cardiovascular disease modified by HPV infections. A more comprehensive understanding of the cholesterol-modifying mechanisms underpinning HPV’s influence on CVD has been identified. Downstream ML has been used to selectively identify key proteins for subsequent bioinformatic mining across a range of public and in-house curated databases. Implications: By further understanding the mechanisms underlying HPV-induced cardiovascular pathogenesis, machine learning models can be developed in a more targeted manner, stratifying patients that will have an optimal response to emerging probiotic-based therapies. Full article

Cervical cancer remains a major global burden largely caused by persistent infection with high risk human papillomavirus (HPV). Biological differences between HPV clade A7 and HPV clade A9 may influence tumor programs and clinical outcomes. To propose pharmacological candidates for repositioning, we applied an expression-based drug repurposing approach using the OCTAD (Open Cancer Therapeutic Discovery) framework. Disease transcriptional signatures were constructed for both HPV clades and compared with drug perturbation profiles to identify compounds showing inverse associations with the tumor related expression patterns, restricting the analysis to Food and Drug Administration (FDA) approved agents. The screening identified 41 and 52 candidates for HPV clade A7 and HPV clade A9, respectively, and stronger transcriptomic reversal was associated with higher drug sensitivity in relevant cell lines. These candidates were enriched for pharmacologic classes such as histone deacetylase inhibitors, estrogen pathway modulators, and statins. Additional enriched categories also emerged, including antimetabolites, protein kinase inhibitors, proteasome inhibitors, antimalarials, and antimicrobial agents, several of which already show experimental activity in cervical cancer models. These findings reveal both shared and clade-associated vulnerabilities in HPV-driven cervical cancer and demonstrate the utility of expression-based repurposing for generating actionable hypotheses. The resulting drug lists provide a concise, biologically grounded resource to guide preclinical validation and rational exploration in cervical cancer HPV positive models. Full article

Genome editing technologies, including CRISPR/Cas9, TALENs, and ZFNs, offer promising approaches to disrupt HPV oncogenes E6 and E7, thereby restoring tumor-suppressor pathways. In this review, we summarize recent preclinical findings demonstrating selective apoptosis and tumor regression in HPV-positive cell and animal models, as well as early-phase clinical studies exploring local CRISPR-based therapies. We also compare the relative strengths and limitations of major editing platforms, discuss delivery strategies, and highlight their potential integration with immunotherapy and conventional treatments. While preclinical studies show encouraging efficacy (e.g., up to 60% tumor regression in xenograft models and marked reactivation of p53/pRb pathways), translation into routine practice remains limited by challenges such as efficient delivery, minimizing off-target effects, long-term safety, cost, and ethical considerations. Continued optimization of high-fidelity nucleases, tissue-specific delivery systems, and genotype-tailored guide RNAs will be essential. Genome editing therefore represents a potential future addition to the therapeutic landscape of HPV-related diseases, but substantial barriers must be addressed before clinical implementation. Full article

Background/Objectives: With declining vaccine coverage and rising concerns regarding vaccines, vaccine-preventable diseases are rising. Many research studies have examined approaches to enhance the acceptance of vaccines, but the integration of these approaches into practice has been limited. Thus, the objective was to identify recent evidence surrounding provider–patient communication tools and approaches related to vaccination confidence. Methods: A systematic review following PRISMA methodology was conducted. Using a pre-specified search strategy aligned with the research objective and performed in PubMed, CINAHL, and Web of Science, articles were evaluated by two researchers independently, with a third resolving discrepancies, at the title and abstract screening, full-text review, quality assessment, and data extraction phases. Extraction data were descriptively analyzed, including the impact on vaccine acceptance, and synthesized thematically. Results: From the 2291 studies which underwent screening, a total of, 143 articles were included. Most studies were conducted in the United States, in the outpatient setting, and utilized physicians and nurses to deliver the intervention. Many vaccines were covered, with the greatest number of studies focusing on influenza, HPV, and pneumococcal vaccines. The three predominant communication approaches and tools utilized were provider-focused training, direct patient education/materials, and provider–patient communication strategies. These strategies often focused on addressing knowledge gaps, health beliefs, and common concerns. Over two-thirds of studies increased vaccine acceptance following communication interventions. Conclusions: To address vaccine concerns, it is important to ensure providers have the education and training necessary as well as tools to address underlying causes of concerns. When equipped, providers are able to improve vaccine acceptance. Full article

Background: Human papillomavirus (HPV)-associated oral and oropharyngeal squamous cell carcinomas have risen dramatically in incidence over recent decades. Yet, unlike cervical neoplasia, there is no established screening paradigm for HPV-driven oropharyngeal dysplasia, as precursor lesions are often occult and are not easily accessible for examination. This drives an urgent need for non-invasive biomarkers to enable early detection, risk stratification, and timely intervention. Objective of this review is to highlight advances in liquid biopsy modalities, specifically saliva- and blood-based biomarkers—in the context of HPV-driven oral carcinogenesis—and to evaluate their utility in early cancer detection, prognostic, post-treatment surveillance, and recurrence monitoring. Methods: We performed a narrative review of PubMed-indexed studies (2015–2025) focusing on HPV-positive oral and oropharyngeal squamous cell carcinomas. and liquid biopsy analytes. Key sources were high-impact original studies and meta-analyses from 2020–2025 examining circulating tumor DNA (ctDNA), viral nucleic acids, circulating tumor cells (CTCs), extracellular vesicles (EVs), and related biomarkers in saliva and blood. Reported data on assay performance, biases, and validation were reviewed to highlight how oral cancer findings align with trends seen in other solid tumors. Results: In reviewing recent studies (2015–2025), we found consistent evidence that saliva best captures locoregional tumor signals while plasma circulating tumor HPV DNA (ctHPV DNA) reflects systemic disease, and that using both matrices improves detection over either alone. Dual-fluid testing will potentially enable earlier identification of molecular residual disease with clinically meaningful lead time before radiographic recurrence, supporting risk-adapted surveillance. Overall, literature favors standardized pre-analytics and combined saliva plus plasma workflows to enhance early detection and follow-up in HPV-positive oral and oropharyngeal squamous cell carcinomas. Conclusions: Liquid biopsy approaches offer promising tools for the early, non-invasive detection and real-time monitoring of HPV-associated oral cancers. Realizing their full clinical potential will require robust prospective validation and standardization of pre-analytical protocols. Integrating salivary and blood biomarkers into tailored surveillance programs may further support earlier intervention and improved patient outcomes, while potentially reducing reliance on unnecessary invasive procedures. Full article

Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) represent a distinct subgroup of head and neck squamous cell carcinoma (HNSCC) characterized by better prognosis and increased radiosensitivity compared to HPV-negative OPSCC. However, current diagnostic and monitoring methods, including tissue biopsies and imaging, are insufficient for precise risk stratification and early detection of recurrence, leading to challenges in treatment de-escalation and surveillance strategies. Circulating tumor HPV DNA (ctHPV-DNA) has emerged as a promising minimally invasive biomarker that offers tumor-specific detection and monitoring capabilities, potentially transforming the management of HPV-related OPSCC through early disease detection, treatment response assessment, recurrence surveillance stratification, and disease monitoring. Despite encouraging results from early clinical studies, current use is limited to trial settings. Large-scale prospective studies are needed to validate its clinical utility and determine whether early ctHPV-DNA testing can improve patient outcome while reducing treatment related morbidity. This review outlines the biological rationale, technological approaches, and current clinical evidence for ctHPV-DNA in HPV-related OPSCC, emphasizing its potential role in treatment monitoring and surveillance. Full article

Background/Objectives: Human papillomavirus (HPV) is the main causative agent of cervical cancer and contributes to a significant proportion of other anogenital and oropharyngeal malignancies. The need for better biomarkers and therapeutic approaches in HPV-associated cancers has drawn attention to exosomes, small extracellular vesicles known for their stability, biomolecule transport capabilities, and role in cell-to-cell communication. Methods: This review comprehensively evaluates recent literature on the diagnostic, prognostic, and therapeutic applications of small extracellular vesicles, particularly exosomes, in HPV-related cancers. It analyzes findings on exosomal nucleic acids, proteins, and long non-coding RNAs, as well as engineered exosome-based therapies. Results: Exosomal miRNAs (e.g., miR-204-5p, miR-99a-5p, miR-21), proteins (e.g., glycolytic enzymes, HSP90), and lncRNAs (e.g., HOTAIR, DLEU1) have emerged as promising biomarkers for disease detection and monitoring. Exosomal cargo actively participates in HPV-related tumor progression. For example, miRNAs such as miR-21 and miR-146a modulate immune cell polarization and inflammatory signaling, while lncRNAs like HOTAIR promote oncogenic transcriptional programs. Exosomal proteins including HSP90 and ANXA1 facilitate extracellular matrix remodeling and immune evasion, thereby influencing tumor growth and metastasis. In HPV-positive head and neck and cervical cancers, exosomal cargo reflects HPV status, tumor progression, and treatment response. Therapeutic studies demonstrate the utility of exosomes in vaccine delivery, immune modulation, and drug delivery systems, including the use of PROTACs. However, clinical translation faces barriers including isolation protocol standardization, biomarker validation, and scalable production. Conclusions: Exosomes hold great promise for integration into diagnostic and therapeutic workflows for HPV-related cancers. Future research should focus on resolving standardization issues, validating biomarkers in diverse cohorts, and optimizing engineered exosome platforms for targeted therapy. Full article

Background: Migrant populations are commonly under-immunised relative to general populations in host countries. The evidence base on routine vaccination among migrant children suggests that higher priority is given to infants and younger children compared to adolescents. Though migrants are often classified as a homogenous group, different sub-populations of migrants exist, including voluntary migrants who choose to move and involuntary migrants forcibly displaced by humanitarian crises. The human papillomavirus (HPV) vaccine, a relatively recent addition to global routine immunisation schedules for adolescents, is a useful proxy for understanding vaccine equity for this under-prioritised group. This qualitative systematic review explores health system determinants of delivery and uptake of HPV vaccination services among involuntary migrants. Methods: A literature search was conducted across ten electronic databases. An analytical framework tailored to the migrant context aided in capturing the complexity and magnitude of systemic factors that determine vaccine delivery and uptake among involuntary migrants. Of the 676 records retrieved, 27 studies were included in this review. Results: Key determinants of vaccine delivery include adaptation of immunisation policies for migrant inclusiveness, implementation of migrant-targeted interventions, health provider recommendations, electronic health records, and free vaccines. Uptake determinants include access dependent on legal status, awareness-related determinants akin to culturally appropriate health messaging, and acceptance-related determinants associated with sociocultural beliefs, misinformation, and distrust. Conclusions: Prioritising vaccination programmes linked with non-outbreak-related diseases is challenging in the disruptive context of humanitarian crises given fragile health systems, limited resources, loss of health infrastructure and deployment of health personnel to emergency care. We strongly advocate for global actors at all health systems levels to actively reform national HPV vaccination programmes to enhance inclusivity of adolescent girls in crises settings or resettled in host countries. Full article

Infection with oncogenic human papillomavirus (HPV) remains a leading cause of cervical cancer and other HPV-related diseases. This situation persists despite the availability of effective prophylactic vaccines. While global vaccination programs have significantly reduced the incidence of HPV in adolescents and young adults, many women presenting with HPV infection or squamous intraepithelial lesions (SIL) were not covered by primary prevention. This review was performed with the aim of evaluating the impact of administering the 9-valent HPV vaccine in adult women who are HPV-positive or have histologically confirmed cervical precancerous lesions. Following the PRISMA 2020 guidelines, a search was performed in the MEDLINE, Scopus, and Cochrane Library databases. A total of 653 studies were retrieved, of which 7 studies, including 19,414 women, met the inclusion criteria. According to the literature, vaccination was linked to significant reductions in persistent HPV infection, progression of SIL, and recurrence of high-grade lesions after surgical removal. Complete HPV remission was achieved in up to 72.4% of vaccinated women, compared to 45.7% among unvaccinated controls. Vaccination after conization lowered the recurrence risk of CIN2+ lesions by 87%, with benefits seen regardless of timing. The most significant effect was observed when vaccine administration was performed before the surgical procedure. Furthermore, HPV vaccination notably enhanced viral clearance and decreased the likelihood of repeated surgical interventions. Despite differences in study design and follow-up definitions, the overall evidence supports additional vaccination in HPV-positive adult women as an effective measure to reduce recurrence and promote viral remission. These findings emphasize the need for clear guidelines and wider access to HPV vaccination for adult populations. Full article

Background/Objectives: In Japan, the human papillomavirus (HPV) vaccine introduction process is unique, and no HPV knowledge scale with established reliability and validity currently exists. This study aimed to develop a new HPV knowledge scale and evaluate its reliability and validity for practical use. Methods: With permission from the original authors of the HPV Knowledge Scale (Jo Waller et al.), we created a Japanese version incorporating the original two subscales and adding new items. The translation process involved multiple researchers, back-translation by a professional agency, and expert review to ensure linguistic and contextual accuracy. The study was approved by the Clinical Research Ethics Review Board of the researchers’ affiliated universities and conducted between April and August 2024. Results: Reliability and validity were assessed using data from 793 parents of junior high school students, including both boys and girls. Confirmatory factor analysis showed a good model fit (Goodness-of-Fit Index [GFI] = 0.934, Adjusted GFI [AGFI] = 0.907, Comparative Fit Index [CFI] = 0.928, Root Mean Square Error of Approximation [RMSEA] = 0.063). Cronbach’s alpha ranged from 0.688 to 0.845 and item-total correlations ranged from 0.393 to 0.584. Test–retest reliability, assessed with Spearman’s rank correlation, was r = 0.791 (p < 0.001). The final scale, named the Japan HPV Knowledge Scale (J-HPV-KS), includes 17 items across five factors. Conclusions: The J-HPV-KS covers HPV-related diseases, transmission routes, natural history, and vaccines. It demonstrated sufficient reliability and validity for use in Japan and is a useful tool for assessing HPV-related knowledge among Japanese parents and guardians. Full article