HPV genotype distribution on oncogene expression in HIV-positive adults and the underlying risk factors for anal, oral, and genital malignancy
Bibliographic record
Abstract
BACKGROUND: Human Papillomavirus (HPV) is the most common sexually-transmitted agent. Infections with oncogenic HPV types 16 & 18 are causally linked to the development of cervical cancer, as well as a proportion of anal, oropharyngeal, vulvar, vaginal and penile cancers and their associated precancerous lesions. Immune suppression increases the likelihood of HPV-related diseases, and people with human immunodeficiency viral (HIV) infection or with HIV-positive partners are at a higher risk of precancerous lesions and cancers, as well as genital warts. OBJECTIVES: Determine the prevalence and distribution of high risk (HR) oncogenic HPV genotypes in HIV-positive adults in Atlantic Canada. Examine association between HR HPV genotypes and premalignant lesions and incident malignancy; Examine association between premalignant lesions and malignancy and patients’ demographics and underlying risk factors. METHODS: This prospective cohort study was designed for four years in Atlantic Canada HIV care clinics. Total 300 were enrolled in the study and of them, 263 were included in the final analysis. Participants were required to complete a confidential questionnaire to obtain demographic and risk factor data. Annual collection of oropharyngeal and anal swab specimens from all participants and an additional cervical specimen from females were obtained. All specimens were tested for cytologic abnormalities, HPV DNA and HPV genotyping. The ASIR of the incident cancers was calculated using the Canadian general population as reference. RESULTS: Of 263 patients 93.2% were males. The mean (SD) age of the study population at the enrollment time was 46.9 (9.4) years and 51.3 (9.1) years at the study’s end. A total of 227 (86.3%) participants were positive for HPV infection. Of these, 88.1% had HPV infection at one body site and 11.9% had HPV genotypes detected at two body sites simultaneously. Up to 50 HPV genotypes were detected, of which 32 (63%) were HR oncogenic types. Eight (16%) HPV types were significantly associated with the confirmed 31 (11.8%) cases of precancerous lesions and 8 (3.3%) incident cases of malignancy. The precancerous lesions significantly associated with patients CD4 cell count < 200 cells/mL (p=0.034), smoking (p=0.007), history of anogenital warts (p=0.002) and genital herpes (p=0.007). CONCLUSIONS: The overall incidence of cancer was 3.3%, all of them diagnosed in males. The ASIR (95%CI) of anal cancer is 535/100,000 (30-970) and ASIR (95%CI) of oral cancer is 533/100,000 (30-970). KEY WORDS: Human papillomavirus infection, anal cancer, cervical cancer, head and neck cancer, squamous cell carcinoma, HPV genotyping, HPV prevalence and incidence, HPV and malignancy, HPV risk factors, HIV-HPV co-infection, prevalence of cancer in MSM.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".