Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium.
AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium.
Sci Rep. 2023 Oct 15;13(1):17492. doi: 10.1038/s41598-023-44154-y.
Cutaneous warts are benign skin lesions caused by the human papillomavirus (HPV). Even though they are considered benign, they can have a considerable impact on the quality of life and cause serious illness in certain immunocompromised populations. Studies have shown that the efficacy of wart treatment is dependent on the causative HPV type. Therefore, in this article, we aim to determine the HPV genotype-specific prevalence in cutaneous warts of a Flemish population as part of the Omnivirol-Salycilic acid randomized controlled trial. Swab samples of cutaneous warts (n = 269) were collected during enrollment. The DNA extraction was performed on the automated NucliSENS® easyMAG® system (bioMérieux). The samples were analyzed with two separate in-house PCR assays capable of detecting the most prevalent cutaneous HPV types (i.e. wart-associated HPV qPCR) as well as the most relevant mucosal types (i.e. RIATOL qPCR assay). In total, the type-specific prevalence of 30 distinct HPV genotypes was determined. The beta-globin gene was used as a cellularity control and for viral load quantification. Data concerning wart persistence, previous treatment, wart type, and other relevant wart and patient characteristics was collected through a baseline questionnaire. The study population consisted mostly of persistent warts considering that 98% (n = 263) of the sampled skin lesions were older than six months and 92% (n = 247) had undergone previous treatment. The most prominent wart type was the mosaic verruca plantaris (42%, n = 113). The most prevalent HPV types were cutaneous HPV types 27 (73%, n = 195), 57 (63%, n = 169), and 2 (42%, n = 113). Only 2% (n = 6) of the lesions was HPV negative. The highest median viral loads were observed with HPV27 and 57 (i.e. 6.29E+04 and 7.47E+01 viral copies per cell respectively). The multivariate analysis found significant associations between wart persistence and certain wart types, the number of warts, and HPV genotypes. Based on these findings, persistent warts are more likely to: (1) be verruca vulgaris, verruca plantaris simple or mosaic, (2) to manifest as multiple warts, (3) and to be negative for HPV type 2 or 4. These characteristics can be useful in the clinical setting for future risk stratification when considering treatment triage and management. Trial registration: NCT05862441, 17/05/2023 (retrospectively registered).
皮肤疣是由人乳头瘤病毒（HPV）引起的良性皮肤病变。尽管它们被认为是良性的，但它们会对生活质量产生重大影响，并导致某些免疫功能低下人群出现严重疾病。研究表明，疣的治疗效果取决于致病 HPV 类型。因此，在本文中，我们旨在作为 Omnivirol-Salycilic acid 随机对照试验的一部分，确定弗拉芒人群皮肤疣中 HPV 基因型的特定流行率。在招募期间采集了 269 例皮肤疣的拭子样本。DNA 提取是在自动化 NucliSENS® easyMAG®系统（生物梅里埃）上进行的。使用两种独立的内部 PCR 检测方法对样本进行分析，这些检测方法能够检测到最常见的皮肤 HPV 类型（即疣相关 HPV qPCR）以及最相关的黏膜类型（即 RIATOL qPCR 检测）。总共确定了 30 种不同 HPV 基因型的特定流行率。β-珠蛋白基因被用作细胞密度控制和病毒载量定量。通过基线问卷收集了有关疣持续时间、先前治疗、疣类型以及其他相关疣和患者特征的数据。研究人群主要由持续性疣组成，因为采样的皮肤病变中有 98%（n=263）超过 6 个月，92%（n=247）接受过先前的治疗。最突出的疣类型是镶嵌性足底疣（42%，n=113）。最常见的 HPV 类型是皮肤 HPV 类型 27（73%，n=195）、57（63%，n=169）和 2（42%，n=113）。只有 2%（n=6）的病变 HPV 阴性。HPV27 和 57 的中位病毒载量最高（即分别为 6.29E+04 和 7.47E+01 个细胞的病毒拷贝）。多变量分析发现疣持续存在与某些疣类型、疣数量和 HPV 基因型之间存在显著关联。基于这些发现，持续性疣更有可能：(1) 是寻常疣、足底单纯性或镶嵌性疣，(2) 表现为多发性疣，(3) HPV 类型 2 或 4 阴性。这些特征在临床环境中可用于治疗分诊和管理时进行未来的风险分层。试验注册：NCT05862441，2023 年 5 月 17 日（回顾性注册）。
