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  1. Survivin expression in uterine cervical exfoliative cells as diagnostic test of cervical malignancy process
    Zulham, Jusuf AA, Indarti J, Lisnawati
    Sains Malaysiana, 2011;40.
    Papanicolaou test is a diagnostic test for uterine cervical cancer screening and routinely examined. It has limitations. A better technique is needed to identify true cervical malignancy process. Molecular cancer marker detection may have high the sensitivity and specificity in detecting cancer. Survivin, a marker candidate, is upregulated in many malignancy processes. Ninety women have joined in this cross sectional study by consecutive sampling. Survivin expression was examined by indirect immunoperoxidase method. It was predominantly found in metaplastic cells. Correlation between survivin expression and Papanicolaou test results was calculated by Fischer’s-exact test. Using Papanicolaou test result as an indicator for the presence of uterine cervical abnormalities, the performance indicators were calculated. Fischer’s-exact test showed that survivin expression was not significantly useful as cervical cancer molecular marker. Survivin expression of the uterine cervical exfoliative cells cannot be used as a diagnostic test for uterine cervical malignancy process.
  2. Fulltext Incidence, clearance, persistence and factors related with high-risk anal HPV persistence in South-East Asian MSM and transgender women
    Yunihastuti E, Teeratakulpisarn N, Jeo WS, Nilasari H, Rachmadi L, Somia IKA, et al.
    AIDS, 2020 11 01;34(13):1933-1941.
    PMID: 32773478 DOI: 10.1097/QAD.0000000000002654
    OBJECTIVES: Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence.

    DESIGN: Prospective cohort study.

    METHODS: MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence.

    RESULTS: Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1-0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47-5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22-11.19) and Bali (aOR 3.39; 95% CI 1.07-10.75), being employed/freelance (aOR 3.99; 95% CI 1.48-10.77), and not being circumcised (aOR 2.29; 95% CI 1.07-4.88) were independently associated with anal HR-HPV persistence.

    CONCLUSION: HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.

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