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21 May 2009

Human papillomavirus as a risk factor for development of cancer in allograft recipients

P Fiedor, Z Wierzbicki, K Pawelec, T Łazowski, A Gardyszewska, P Jurkowski, D Szubińska, K Szymańska, J Wojciula, A Wydrzyńska, M Socha, G Kowalska-Korczak, A Górski, M Durlik, L Pączek, S Majewski

Ann Transplant 2009; 14(1): 24-24 :: ID: 880286

Abstract

Background: Human papillomavirus (HPV) infection is the most common person-to-person transmitted viral infection and has a steadily increasing prevalence. The goal of this study was to evaluate the incidence of oncogenic type 16 HPV infections and development of cancer in patients after organ allotransplantation.
Material/Methods: 650 organ allograft recipients [kidney, kidney-pancreas, liver] transplanted between 1989 and 2003, receiving standard immunosuppressive treatment (CS, CsA, Tac and Aza), were followed for 2-15 years. Activity of specific receptors and mononuclear cells from peripheral blood was assessed and correlated with level of immunosuppression regiments. All patients were examined for the presence of HPV infection (confirmed by PCR).
Results: In 136 patients HPV16 oncogenic infection was found. Out of this number, in 22 patients (16.6%) skin and/or mucosal changes in anogenital area were found. Those patients were surgically treated and the diagnosis of cancer was confirmed by histopathology. The same type 16 of HPV was detected in the oral cavities. All recipients with clinical manifestation of HPV infection including patients with cancer showed abnormality and particularly lower activity of NK, CD4 and CD25 cell receptors. Immunosuppressive treatment was modified in these patients. Recurrence of cancer was observed in three patients 2-5 years after surgical treatment.
Conclusions: Long-term surviving organ allograft recipients with decreased
immune response and HPV infection have a high risk of neoplastic process
development in lower genital tract. Such patients should be carefully monitored and when such complication occurs surgical treatment is necessary with modification of immunosuppressive treatment.

Keywords: viral infections

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358