The Role of HPV & EBV in the Detection of Biopsy-Proven Cervical Dysplasia in HIV+ Patients

Publication Date

July 2019

Location

LSU Health Medical Education Building

Document Type

Abstract

Start Date

26-7-2019 9:00 AM

End Date

26-7-2019 12:00 PM

Description

Human Papillomavirus (HPV) is a virus contracted from skin-to-skin contact. Though HPV can find a host throughout the body, the most concerning form of HPV is found in genitalia. As the most commonly found sexually-transmitted infection, HPV plays a defining role in the development of several cancers, including but not limited to: anal, oral, penile, vulvar and, most frequently, cervical cancers. Additionally, the Epstein Barr Virus (EBV) is transmitted through saliva and previous data has been proven to increase the risk of abnormal cervical pap smears by 30%. The combination of these two viruses in patients can lead to early detection of cervical dysplasia. As cervical cancer is the second highest cancer found in women worldwide, early detection is a necessity and can be done through biopsies of possible pre-cancerous lesions in individuals with HPV and/or EBV. Through this process, the lab aims to detect cervical dysplasia (CIN), which is an abnormal mass of cells in the cervix that has a high chance of developing into cervical cancer as soon as a patient is diagnosed with HPV in hopes of detecting and treating cervical cancers early. In a joint clinical and laboratory research cohort, the Hagensee lab sampled 125 HIV+ women in the Infectious Disease Clinic at University Medical Center over the course of 10 years. The participants ranged in age from 22 to 65 and the majority of participants (88%) were African- American, followed by Caucasians (11%) and Hispanics (0.8%). The lab collected CD4 counts and HIV viral loads as a marker of the severity of the HIV disease. Additionally, patients would receive a cervical pap smear, cervical swabs to test for HPV and EBV and biopsies of infected areas were taken. The results from these procedures were analyzed to determine any patterns between the presence of the HPV and/or EBV viruses and the development of cervical dysplasia. Of 110 patients with documented HPV/EBV lab results: 46% tested positive for both EBV and HPV, 38% tested positive for HPV but negative for EBV, 8% tested positive for EBV but negative for HPV, and 7% tested negative for both. Patients were also grouped by the severity of their cervical pap smears on a scale of 1 to 4, where 1=negative results and 4=high-grade lesions. Of 118 patients with documented cervical pap smear lab results, a significant number of patients (52) progressed to low or high-grade lesions at some point in the study. Lastly, patients were grouped on the severity of their cervical biopsies on a scale of 1 to 3, where 1=little to no dysplasia and 3=severe dysplasia. Out of 125 patients, 61 had biopsies taken over the course of their involvement in the study. Of those 61, a significant number had moderate to severe results, demonstrating the importance of early detection to possibly pre-diagnose cervical cancer. Though the results show an upward trend in HIV+ patients who also have HPV and/or EBV developing cervical dysplasia, there is insufficient data to present definitive results. Only 54 of the 125 study participants were not missing any of the lab results analyzed in this study (HPV, EBV, biopsies and pap smears). Obtaining all of these results in future studies in essential to confirm the role of HPV and EBV in detecting dysplasia. The Hagensee lab also plans to evaluate biopsies taken before study dates to determine any patterns in the development of dysplasia.

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Mentor: Dr. Michael Hagensee, M.D, PhD, Department of Medicine

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Jul 26th, 9:00 AM Jul 26th, 12:00 PM

The Role of HPV & EBV in the Detection of Biopsy-Proven Cervical Dysplasia in HIV+ Patients

LSU Health Medical Education Building

Human Papillomavirus (HPV) is a virus contracted from skin-to-skin contact. Though HPV can find a host throughout the body, the most concerning form of HPV is found in genitalia. As the most commonly found sexually-transmitted infection, HPV plays a defining role in the development of several cancers, including but not limited to: anal, oral, penile, vulvar and, most frequently, cervical cancers. Additionally, the Epstein Barr Virus (EBV) is transmitted through saliva and previous data has been proven to increase the risk of abnormal cervical pap smears by 30%. The combination of these two viruses in patients can lead to early detection of cervical dysplasia. As cervical cancer is the second highest cancer found in women worldwide, early detection is a necessity and can be done through biopsies of possible pre-cancerous lesions in individuals with HPV and/or EBV. Through this process, the lab aims to detect cervical dysplasia (CIN), which is an abnormal mass of cells in the cervix that has a high chance of developing into cervical cancer as soon as a patient is diagnosed with HPV in hopes of detecting and treating cervical cancers early. In a joint clinical and laboratory research cohort, the Hagensee lab sampled 125 HIV+ women in the Infectious Disease Clinic at University Medical Center over the course of 10 years. The participants ranged in age from 22 to 65 and the majority of participants (88%) were African- American, followed by Caucasians (11%) and Hispanics (0.8%). The lab collected CD4 counts and HIV viral loads as a marker of the severity of the HIV disease. Additionally, patients would receive a cervical pap smear, cervical swabs to test for HPV and EBV and biopsies of infected areas were taken. The results from these procedures were analyzed to determine any patterns between the presence of the HPV and/or EBV viruses and the development of cervical dysplasia. Of 110 patients with documented HPV/EBV lab results: 46% tested positive for both EBV and HPV, 38% tested positive for HPV but negative for EBV, 8% tested positive for EBV but negative for HPV, and 7% tested negative for both. Patients were also grouped by the severity of their cervical pap smears on a scale of 1 to 4, where 1=negative results and 4=high-grade lesions. Of 118 patients with documented cervical pap smear lab results, a significant number of patients (52) progressed to low or high-grade lesions at some point in the study. Lastly, patients were grouped on the severity of their cervical biopsies on a scale of 1 to 3, where 1=little to no dysplasia and 3=severe dysplasia. Out of 125 patients, 61 had biopsies taken over the course of their involvement in the study. Of those 61, a significant number had moderate to severe results, demonstrating the importance of early detection to possibly pre-diagnose cervical cancer. Though the results show an upward trend in HIV+ patients who also have HPV and/or EBV developing cervical dysplasia, there is insufficient data to present definitive results. Only 54 of the 125 study participants were not missing any of the lab results analyzed in this study (HPV, EBV, biopsies and pap smears). Obtaining all of these results in future studies in essential to confirm the role of HPV and EBV in detecting dysplasia. The Hagensee lab also plans to evaluate biopsies taken before study dates to determine any patterns in the development of dysplasia.