Coinfection of High-Risk and Low-Risk Human Papillomavirus in Urethra Condylomata Accuminata
Downloads
Background: Condylomata accuminata (CA) is a sexually transmitted infection caused by the Human Papillomavirus (HPV), which has more than 40 subtypes classified into high and low risks. The incidence of coinfection involving HPVs in genitalia varies between 2%–71%. Coinfection events increase in immunosuppressed patients. Purpose: To know the types of HPV in CA lesions and the risk factors of a high and low-risk HPV coinfection. Case: A 45-year-old woman presented with genital warts appeared three weeks before. The patient had a breast cancer history and undergone chemotherapy. The examination revealed multiple papules with verrucous surface, firm borders, with whitish color around the urethra and on the vaginal wall. Acetowhite test was positive. The biopsy examination showed squamous epithelium arranged to form papils and foci suspected as koilocytes suggesting CA. The Human Immunodeficiency Virus (HIV) rapid test, VDRL (Venereal Disease Research Laboratory) and TPHA (Treponema Pallidum Haemagglutination) examinations showed non-reactive results. The HPV deoxyribonucleic acid (DNA) genotyping test showed positive results for HPV type 56 (High-Risk Genotypes) and HPV type 6 (Low-Risk Genotypes). She was treated with electrosurgery and consulted to the urology department. Discussion: Coinfection of HPVs might cause a persistent HPV infection for a longer duration, as well as the risk of developing into cancerous lesion. The mechanism of high-risk and low-risk HPV coinfection in immunosuppressed individuals might be due to faster replication of the virus or reactivation of a latent infection. Conclusion: Coinfection of 2 types of HPV could happen in immunosuppression condition such as in patient undergone chemotherapy.
Baseman JG, Koutsky LA. The epidemiology of human papillomavirus infections. J Clin Virol 2005; (32): 16-24.
Chae JY, Bae JH, Yoon CY, Park HS, Moon DG,
Lee JG, Oh MM. Female urethral condyloma causing bladder outlet obstruction. Int Neurourol J 2014; 18(1): 42.
Bruni L, Diaz M, Castellsagué M, Ferrer E, Bosch FX, de Sanjosé S. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect 2010 Dec 15; 202(12): 1789-99.
Tota JE, Chevarie-Davis M, Richardson LA, Devries M, Franco EL. Epidemiology and burden of HPV infection and related diseases: implications for prevention strategies. Prev Med 2011 Oct 1; (53): 12-21.
Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J, Bruni L, Vignat J, Ferlay J, Bray F, Plummer M, Franceschi S. Global burden of human papilloma virus and related diseases. Vaccine 2012 Nov 20; (30): 12-23.
Guan P, Howell"Jones R, Li N, Bruni L, de Sanjosé S, Franceschi S, Clifford GM. Human papillomavirus types in 115,789 HPV"positive women: a meta"analysis from cervical infection to cancer. Int J Cancer 2012 Nov 15; 131(10): 2349-59.
Aswar A. Karakteristik pasien kutil kelamin di RSUP Haji Adam Malik Medan Periode 2008-2011. Repository USU. 2012.
Spinillo A, Dal Bello B, Gardella B, Roccio M, Dacco MD, Silini EM. Multiple human papillomavirus infection and high grade cervical intraepithelial neoplasia among women with cytological diagnosis of atypical squamous cells of undetermined significance or low grade squamous intraepithelial lesions. Gynecol Oncol 2009 Apr 1; 113(1): 115-9.
Xie J, Ao C, Li J, Jiang L, Liu H, Zeng K. 5-aminolevulinic acid photodynamic therapy for condyloma acuminatum of urethral meatus. J Dermatol Treat 2018:1-4.
Quint W, Jenkins D, Molijn A, Struijk L, van de Sandt M, Doorbar J, Mols J, Van Hoof C, Hardt K, Struyf F, Colau B. One virus, one lesion”individual components of CIN lesions contain a specific HPV type. J Pathol 2012 May; 227(1): 62-71.
Brown DR, Schroeder JM, Bryan JT, Stoler MH, Fife KH. Detection of multiple human papillomavirus types in Condylomata acuminata lesions from otherwise healthy and immunosuppressed patients. J Clin Microbiol 1999; 37(10): 3316-22.
Nielson CM, Harris RB, Flores R, Abrahamsen M, Papenfuss MR, Dunne EF, Markowitz LE, Giuliano AR. Multiple-type human papillomavirus infection in male anogenital sites: prevalence and associated factors. Cancer Epidemiol Biomarkers Prev 2009; 18(4): 1077-83.
Erman-Vlahovic M, Vlahovic J, Mrcela M, Hrgovic Z. Coexistence of condylomata acuminata with warty squamous cell carcinoma and squamous cell carcinoma. Med Arch 2017; 71(1): 72-5.
Murtiastutik, D. Buku Ajar Infeksi Menular Seksual. Surabaya: Airlangga University Press; 2008.
Elliot J. Androphy, MD & Reinhard Kirnbauer, MD. Human Papilloma Virus Infections. In Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpartick's Dermatology in General Medicine. 8th Edition. New York: The McGraw-Hill Companies, Inc; 2012. p. 2421-33.
Doorbar J, Egawa N, Griffin H, Kranjec C, Murakami I. Human papillomavirus molecular biology and disease association. Reviews in medical virology. 2015; 25:2-3.
Song D, Li H, Li H, Dai J. Effect of human papillomavirus infection on the immune system and its role in the course of cervical cancer. Oncology letters. 2015;10(2):600-6.
Lacey CJ, Woodhall SC, Wikstrom A, Ross J. 2012 European guideline for the management of anogenital warts. J Eur Acad Dermatol 2013 Mar; 27(3): 263-70.
Prado JC, Calleja-Macias IE, Bernard HU, Kalantari M, Macay SA, Allan B, Williamson AL, Chung LP, Collins RJ, Zuna RE, Dunn ST. Worldwide genomic diversity of the human papillomaviruses-53, 56, and 66, a group of high-risk HPVs unrelated to HPV-16 and HPV-18. Virology 2005; 340(1): 95-1.
- Copyright of the article is transferred to the journal, by the knowledge of the author, whilst the moral right of the publication belongs to the author.
- The legal formal aspect of journal publication accessibility refers to Creative Commons Atribusi-Non Commercial-Share alike (CC BY-NC-SA), (https://creativecommons.org/licenses/by-nc-sa/4.0/)
- The articles published in the journal are open access and can be used for non-commercial purposes. Other than the aims mentioned above, the editorial board is not responsible for copyright violation
The manuscript authentic and copyright statement submission can be downloaded ON THIS FORM.
