beta-carotene and Papillomavirus-Infections

Cervix carcinoma is an important health problem world-wide, being the second most common cancer among women, ranking first in many developing countries. A number of important epidemiological risk factors have been identified as contributing to the development of CIN and invasive cervix carcinoma. Of key importance is infection with human papillomavirus (HPV), which is the primary risk factor. There are evolving primary and secondary preventive strategies that could further reduce the burden from cervical carcinoma. The possible primary preventive strategies include risk reduction, diet or dietary supplements, HPV vaccines, and other chemopreventive agents. The possible advances in secondary preventive strategies include new technologies for Pap smears, HPV typing triage, and other adjuvant screening procedures. The impact of these strategies will depend upon evidence to support their use along with the characteristics of the population and environment in which they are used.

Topics: Anticarcinogenic Agents; Antioxidants; Ascorbic Acid; beta Carotene; Carcinoma, Squamous Cell; Clinical Trials as Topic; Colposcopy; Diet; Female; Folic Acid; Humans; Image Processing, Computer-Assisted; Mass Screening; Nutritional Requirements; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Photochemotherapy; Risk Factors; Tumor Virus Infections; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears; Viral Vaccines; Vitamin E; Vitamins

The aim of this paper was to evaluate the factors that predict regression of untreated CIN 2 and 3. A total of 93 patients with colposcopic persistent CIN 2 and 3 lesions after biopsy were followed for 6 months. Human papillomavirus (HPV) types were determined by polymerase chain reaction at enrolment. We analysed the biologic and demographic predictors of natural regression using univariate and multivariate methods. The overall regression rate was 52% (48 out of 93), including 58% (22 out of 38) of CIN 2 and 47% (26 out of 55) of CIN 3 lesions (P=0.31 for difference). Human papillomavirus was detected in 84% (78 out of 93) of patients. In univariate analysis, 80% (12 out of 15) of lesions without HPV regressed compared to 46% (36 out of 78) of lesions with HPV infection (P=0.016). Women without HPV and those who had a resolution of HPV had a four-fold higher chance of regression than those with persistent HPV (relative odds=3.5, 95% CI=1.4-8.6). Women with five or fewer lifetime sexual partners had higher rates of regression than women with more than five partners (P=0.003). In multivariate analysis, HPV status and number of sexual partners remained as significant independent predictors of regression. In conclusion, HPV status and number of lifetime sexual partners were strongly predictive of regression of untreated CIN 2 and 3.

Topics: Adolescent; Adult; beta Carotene; Colposcopy; DNA, Viral; Double-Blind Method; Female; Humans; Incidence; Marital Status; Middle Aged; Papillomaviridae; Papillomavirus Infections; Polymerase Chain Reaction; Prospective Studies; Risk Factors; Sexual Partners; Sexually Transmitted Diseases, Viral; Tumor Virus Infections; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

Women with histopathologically confirmed cervical intraepithelial neoplasia (CIN) were followed at 3-month intervals in a randomized double-blinded trial to evaluate the efficacy of beta-carotene to cause regression of CIN. Questionnaire data, plasma levels of micronutrients, and a cervicovaginal lavage for human papillomavirus (HPV) detection were obtained at each visit, and an endpoint biopsy was performed at 9 months. Sixty-nine subjects had a biopsy endpoint evaluation; 9 of 39 (23%) subjects in the beta-carotene group versus 14 of 30 (47%) in the placebo group had regression of CIN (P = 0.039). Independent risk factors for persistent CIN at 9 months included type-specific persistent HPV infection (OR = 11.38, P = 0.006) and continual HPV infection with a high viral load (OR = 14.25, P = 0.007) at baseline and 9 months, an initial diagnosis of > or =CIN II (OR = 6.74, P = 0.016), and older age (OR for > or =25 years = 4.10, P = 0.072). After controlling for these factors, the beta-carotene and placebo groups did not differ in risk for having CIN at 9 months (OR = 1.53, P = 0.550). Resolution of baseline HPV infection was significantly correlated with non-high-risk HPV types (RR = 2.94, P = 0.015), age <25 years (RR = 2.62, P = 0.014), and douching after sexual intercourse (RR = 3.02, P = 0.012), but not with randomization group. Our data indicate that a large proportion of mild CIN lesions regress; age and HPV infection play an important role in the natural course of CIN; and repeated HPV testing may have a value in distinguishing women who need aggressive treatment for CIN versus those who do not. Supplementation of beta-carotene does not appear to have a detectable benefit in treatment of CIN.

Topics: Adult; beta Carotene; Double-Blind Method; Female; Humans; Logistic Models; Longitudinal Studies; Multivariate Analysis; Odds Ratio; Papillomaviridae; Papillomavirus Infections; Treatment Outcome; Tumor Virus Infections; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

The association between dietary intake and persistence of type-specific human papillomavirus (HPV) infection, during a 12-month period, among 433 women participating in the Ludwig-McGill HPV Natural History Study was evaluated by use of a nested case-control design. Dietary intake was assessed by a food-frequency questionnaire at the month-4 visit. HPV status was assessed at months 0, 4, 8, and 12 by polymerase chain reaction (MY09/11). Only women who ever tested positive for HPV were included in the present study: 248 had transient HPV infections (1 of 4 positive tests or nonconsecutively positive), and 185 had persistent HPV infections (> or =2 consecutive tests positive for the same HPV type). Risk of type-specific, persistent HPV infection was lower among women reporting intake values of beta-cryptoxanthin and lutein/zeaxanthin in the upper 2 quartiles and intake values of vitamin C in the upper quartile, compared with those reporting intake in the lowest quartile. Consumption of papaya > or =1 time/week was inversely associated with persistent HPV infection.

Topics: Adult; Ascorbic Acid; beta Carotene; Brazil; Case-Control Studies; Cohort Studies; Cryptoxanthins; Feeding Behavior; Female; Fruit; Humans; Longitudinal Studies; Lutein; Nutritional Status; Papillomaviridae; Papillomavirus Infections; Poverty; Surveys and Questionnaires; Tumor Virus Infections; Urban Population; Xanthophylls

The studies were carried out in a group of 228 female patients with normal cytological smear and 324 patients with cervical intraepithelial neoplasia (CIN). The applied method of human papillomavirus (HPV) identification, i.e., the HPV digene hybrid capture system, made it possible to select a control group consisting of 168 HPV-negative patients with normal Papanicolaou smears, as well as a group of 228 HPV-positive female patients with CIN. By examining the diet of the patients, it was shown that women with cervical dysplasia associated with high oncogenic risk of HPV infections consumed a smaller quantity of foods containing vitamin C, beta-carotene, and folacin. Our studies indicate a relationship between nutritional habits and the development of CIN associated with HPV infection.

Topics: Animals; Antioxidants; Ascorbic Acid; beta Carotene; Dairy Products; Diet; Dietary Fats; Dietary Fiber; Edible Grain; Female; Folic Acid; Fruit; Humans; Milk; Papillomaviridae; Papillomavirus Infections; Tumor Virus Infections; Uterine Cervical Dysplasia; Vegetables

The presence of HPV, using the Digene Hybrid Capture System, was identified in a group of 324 women with CIN and in 228 women with normal cytological smears. Risk of occurrence of CIN was 40 times higher for high risk HPV types. The serum folic acid level and the level of antioxidant compounds in plasma (retinol, alpha-tocopherol, vitamins C and E) in women of the studied and control group was determined by HPLC (high-performance liquid chromatography-reversed phase). Statistically lower levels of folic acid were found in the women with CIN-HPV (+) (OR: 7.5: 95% CI: 1.2-9.7). Studies have shown that lower levels of antioxidants coexisting with low levels of folic acid increases the risk of CIN development.

Topics: Antioxidants; beta Carotene; Cocarcinogenesis; Female; Folic Acid; Folic Acid Deficiency; Humans; Papillomaviridae; Papillomavirus Infections; Regression Analysis; Risk Factors; Tumor Virus Infections; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vitamin E

Studies were carried out in 528 women hospitalized in the Department of Obstetrics and Gynecology Medical Academy in Lublin. Besides the control group, patients were classified according to the observed histopathological changes in the cervix (CIN) and found infections with human papillomavirus (HPV). In all cases beta-carotene content in blood serum was examined. HPV infection was probably a cause of decrease of beta-carotene content. It was found that with increased advancement of cervical dysplasia the level of beta-carotene in serum decreased.

Topics: Adolescent; Adult; beta Carotene; Female; Humans; Life Style; Middle Aged; Papillomaviridae; Papillomavirus Infections; Poland; Risk Factors; Smoking; Tumor Virus Infections; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms