Division of Infectious Diseases, University of California at San Francisco, San Francisco, California.
Division of Infectious Diseases, Loyola University Medical Center, Maywood, Illinois.
Clin Transplant. 2019 Sep;33(9):e13590. doi: 10.1111/ctr.13590. Epub 2019 Jun 20.
These guidelines from the American Society of Transplantation Infectious Diseases Community of Practice update the epidemiology and management of human papillomavirus (HPV) infections in organ transplant recipients. HPV is one of the most common sexually transmitted infections and is associated with cancers of the anogenital region. Increasing evidence suggests an association with head and neck cancers as well. Solid organ transplant recipients have a higher risk of HPV infection than the general population. Infection manifests as premalignant lesions, warts, or cancer of the cervix, penis, vulva, scrotum, and anal canal. Most are asymptomatic initially, so diagnosis can be difficult without screening. A vaccine is available though not effective in preventing all cancer-causing strains. Organ transplant recipients should be screened for HPV-associated cancers and appropriate therapy initiated in a timely manner. Further studies are warranted to delineate the most effective screening methods and therapeutic modalities, including whether changes in immunosuppression are effective in attenuating disease.
这些由美国移植传染病学会实践社区制定的指南更新了器官移植受者人乳头瘤病毒(HPV)感染的流行病学和管理。HPV 是最常见的性传播感染之一,与肛门生殖器区域的癌症有关。越来越多的证据表明,它也与头颈部癌症有关。实体器官移植受者感染 HPV 的风险高于一般人群。感染表现为癌前病变、疣或宫颈癌、阴茎癌、外阴癌、睾丸癌和肛门癌。大多数人最初没有症状,因此如果不进行筛查,诊断可能很困难。目前有一种疫苗,但不能有效预防所有致癌株。应筛查器官移植受者是否存在 HPV 相关癌症,并及时开始适当的治疗。需要进一步的研究来描述最有效的筛查方法和治疗方式,包括免疫抑制的改变是否能有效减轻疾病。