Michael E. Hagensee (United States of America)

LSUHSC Medicine

Presenter of 2 Presentations

 Conference Calendar
Clinical Research / Diagnosis and Management of Cervical Cancer and Its’ Precursors ePoster

DETECTION OF BOTH HIGH-RISK HPV & EPSTEIN-BARR VIRUS PREDICTS FUTURE ABNORMAL CERVICAL CYTOLOGY IN HIV+ PATIENTS (ID 593)

Session Date
07/21/2020
Session Time
10:00 - 17:00
Room
ePoster
Session Type
Poster Viewing - 20-24 July
Session Name
Clinical Research / Diagnosis and Management of Cervical Cancer and Its’ Precursors
Lecture Time
10:07 - 10:08
Presenter
Authors

Abstract

Introduction

Human Papillomavirus (HPV) plays a defining role in the development of cervical cancer. High-risk types of HPV are necessary but not sufficient to develop cervical disease. Previous data has shown a potential role of Epstein-Barr Virus (EBV) as a co-factor to HPV in the development of cervical disease. This study focuses on the predictive ability of detection of both hr-HPV and EBV in the development of disease in a cohort of HIV+ women

Methods

Cervical samples were collected from a cohort of 125 HIV+ women and tested for the presence of high-risk HPV, EBV and Pap smear testing. Cervical biopsies were collected as per clinical guidelines. Demographic characteristics, laboratory data including CD4 cell counts and HIV viral load, and social/behavioral risk factor questionnaires were collected. These women were followed prospectively via electronic medical record

Results

The cohort’s average age was 42.3, mostly (88%) African-American with a mean CD4 cell count of 476 cells/ml and median HIV viral load of 124 copies/ml. High risk HPV was detected in 84% and EBV in 54%. Abnormal Pap smears developed in 46% and 48% had a subsequent cervical biopsy. The presence of EBV and hr-HPV increased the development of future abnormal Pap smears (46% vs 30%, p=.03) as compared to those with hr-HPV only. However, there was no difference in the development of an abnormal cervical biopsy in those shedding both EBV and HPV (59% vs 61%).

Conclusions

The presence of EBV in conjunction with hr-HPV does increase the risk of development of abnormal cervical cytology but not histological lesions. EBV may still be useful as a biomarker for those who will develop early cervical disease prior to histological changes. Future studies will focus on better defining the role of EBV utilizing cervical biopsy tissue.

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Clinical Research / Diagnosis and Management of Anal Cancer and Its’ Precursors ePoster

BASELINE DETECTION OF EPSTEIN-BARR VIRUS AND HPV IN ANAL SECRETIONS PREDICTS FUTURE HPV PERSISTENCE AND ANAL DYSPLASIA (ID 488)

Session Date
07/21/2020
Session Time
10:00 - 17:00
Room
ePoster
Session Type
Poster Viewing - 20-24 July
Session Name
Clinical Research / Diagnosis and Management of Anal Cancer and Its’ Precursors
Lecture Time
10:03 - 10:04
Presenter
Authors

Abstract

Introduction

In a number of recent studies, detection of Epstein-Barr virus (EBV) in anal or cervical secretions along with high-risk HPV (hr-HPV) predicts concurrent anal or cervical dysplasia in HIV+ individuals. To further examine the role of EBV in dysplasia, HIV+ men and women were followed prospectively. The goal of this study is to examine the future development of HPV-related lesions and HPV persistence in those with detectable anal EBV.

Methods

Participants were men and women with stable HIV infection (mean CD4 T-cell count, 523 cells/ml; median HIV viral load, 39 copies/ml) who completed a sociodemographic survey and provided anal swabs for cytology, HPV and Epstein-Barr virus (EBV) testing. Anal biopsies were taken if clinically indicated. These individuals were followed at 6-month intervals for an average of 2 years.

Results

The population (n=188) was 88% male, 54% black, with a mean age of 49.1 years. High risk HPV (hrHPV) was detected in 68%, and EBV in 29%. Persistent high-risk HPV was seen in 32%, 48% had dysplastic anal Pap smear and 15% had high-grade anal biopsies. Those individuals who were shedding EBV were more likely to have high-risk HPV persistence (p=.04), a dysplastic Pap smear (p=.03), and an abnormal anal biopsy. There was no association with development of a high-grade anal biopsy.

Conclusions

High rates of hr-HPV infection and anal dysplasia were found in this HIV infected population. The presence of EBV in anal samples may assist in determining those with persistent hr-HPV infection and the development of a dysplastic anal Pap smear. Ongoing studies are investigating the role of EBV in the pathogenesis of dysplasia, particularly in view of the lack of association with high grade lesions.

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Moderator of 1 Session

 Conference Calendar
Public Health Oral Session

01080 - Oral Session 18: VACCINATION AND SCREENING. Impact of HPV vaccination on cervical cancer screening (ID 57)

Session Type
Public Health Oral Session
Session Date
07/24/2020
Session Time
16:00 - 17:40
Room
Hall D
Chair(s)

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