1.HPV infection of the external genitalia in men whose female partners have cervical HPV infection.
Lian-Jun PAN ; Jie-Hua MA ; Feng-Lei ZHANG ; Feng PAN ; Dan ZHAO ; Xing-Yuan ZHANG
National Journal of Andrology 2018;24(6):516-519
ObjectiveHuman papilloma virus (HPV) is a necessary cause of cervical cancer and is also closely related to penile cancer, oropharyngeal cancer, and anal cancer in males. However, few studies are reported on male HPV. This study aimed to investigate HPV infection of the external genitalia in men whose female partners have cervical HPV infection.
METHODSWe collected the relevant data on the male outpatients whose partners had cervical HPV infection in our Department of Urology and Andrology from August to December 2016. We obtained samples with nylon swabs from the glans penis, corona, inner layer of the prepuce and penile body and detected different types of HPV infection using the Hybribio HPV typing kit, PCR and membrane hybridization.
RESULTSValid data were collected from 140 males, which showed 83.5% of HPV infection of the external genitalia, including 60 cases of HPV6 (43.2%), 27 cases of HPV16 (19.4%), 14 cases of HPV39 (10.1%), 13 cases of HPV18 (9.4%), 13 cases of HPV58 (9.4%), and 13 cases of HPV52 (9.4%). Redundant prepuce was found in 75.5% of the males, but there was no statistically significant difference in the incidence rate of HPV infection between the normal and redundant prepuce groups (P > 0.05).
CONCLUSIONSMen who have the female partners with positive cervical HPV are at high risk of HPV infection and therefore need to be screened and treated so as to reduce HPV infection in both sexes.
Female ; Foreskin ; virology ; Genital Diseases, Female ; virology ; Genital Diseases, Male ; virology ; Human papillomavirus 16 ; isolation & purification ; Humans ; Male ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; diagnosis ; Penile Neoplasms ; virology ; Penis ; abnormalities ; virology ; Phimosis ; virology ; Polymerase Chain Reaction ; Sexual Partners ; Specimen Handling ; Uterine Cervical Neoplasms ; virology
2.Interaction between vaginal micro-environment alterations and HPV16 infection in cervical intraepithelial neoplasia.
L LI ; L DING ; Y J LYU ; M WANG ; C L LIU ; Y HAN ; J T WANG
Chinese Journal of Epidemiology 2018;39(11):1486-1490
		                        		
		                        			
		                        			Objective: To explore the effect of vaginal micro-environment alterations and HPV16 infection and their interaction in the progression of cervical intraepithelial neoplasia. Methods: The participants of this study came from the cervical lesions study cohort in Shanxi province, including 623 women with normal cervical (NC), 303 patients with pathogenically diagnosed low-grade cervical intraepithelial neoplasia (CINⅠ) and 93 patients with pathogenically diagnosed high-grade cervical intraepithelial neoplasia (CINⅡ/Ⅲ). The data of the demographic characteristics of the study subjects and factors related to cervical intraepithelial neoplasia were collected, and HPV16 infection were detected by using flow-through hybridization technology and H(2)O(2), β-glucuronidase, clotting enzyme, neuraminidase and leucocyte esterase in vaginal secretions were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis. pH value and vaginal cleanliness were also detected at the same time. The database was established and analyzed by SPSS statistical software (version 22.0). Results: The HPV16 infection rate (trend χ(2)=55.45, P<0.001) and the abnormal rates of H(2)O(2) (trend χ(2)=26.19, P<0.001), pH (trend χ(2)=5.06, P=0.024), vaginal cleanliness (trend χ(2)=19.55, P<0.001), β-glucuronidase (trend χ(2)=17.52, P<0.001) and neuraminidase (trend χ(2)=14.90, P<0.001) increased gradually along with the severity of cervical intraepithelial neoplasia, but the abnormal rates of clotting enzyme and leucocyte esterase showed no same trend. The results of GMDR model analysis showed that there was interaction between HPV16 infection and abnormalities of H(2)O(2), β-glucuronidase, clotting enzyme and neuraminidase in CINⅠ group, and the interaction between HPV16 infection and the abnormalities of vaginal cleanliness, H(2)O(2), β-glucuronidase and neuraminidase in CIN Ⅱ/Ⅲ group. Conclusion: Our findings indicated that the vaginal micro-environment alterations and HPV16 infection could increase the risk of cervical intraepithelial neoplasia, and they might have an important synergistic effect in the progression of cervical intraepithelial neoplasia.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Human papillomavirus 16/isolation & purification*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrogen Peroxide
		                        			;
		                        		
		                        			Papillomavirus Infections/virology*
		                        			;
		                        		
		                        			Uterine Cervical Neoplasms/virology*
		                        			;
		                        		
		                        			Uterine Cervical Dysplasia/virology*
		                        			
		                        		
		                        	
3.A human papillomavirus (HPV)-16 or HPV-18 genotype is a reliable predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure for cervical intraepithelial neoplasia 3.
Woo Dae KANG ; U Chul JU ; Seok Mo KIM
Journal of Gynecologic Oncology 2016;27(1):e2-
		                        		
		                        			
		                        			OBJECTIVE: This study was conducted using the human papillomavirus (HPV) DNA chip test (HDC), in order to determine whether the HPV genotype is a predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 3. METHODS: Between January 2002 and February 2015, a total of 189 patients who underwent a hysterectomy within 6 months of LEEP caused by CIN 3 were included in this study. We analyzed their epidemiological data, pathological parameters, high-risk HPV (HR-HPV) load as measured by the hybrid capture II assay, and HR-HPV genotype as measured by the HDC. A logistic regression model was used to analyze the relationship between covariates and the probability of residual disease in subsequent hysterectomy specimens. RESULTS: Of the 189 patients, 92 (48.7%) had residual disease in the hysterectomy specimen, CIN 2 in seven patients, CIN 3 in 79 patients, IA1 cancer in five patients, and IA2 cancer in one patient. Using multivariate analysis, the results were as follows: cone margin positivity (odds ratio [OR], 2.43; 95% CI, 1.18 to 5.29; p<0.05), HPV viral load > or =220 relative light unit (OR, 2.98; 95% CI, 1.38 to 6.43; p<0.01), positive endocervical cytology (OR, 8.97; 95% CI, 3.81 to 21.13; p<0.001), and HPV-16 or HPV-18 positivity (OR, 9.07; 95% CI, 3.86 to 21.30; p<0.001). CONCLUSION: The HPV-16 or HPV-18 genotype is a reliable predictive factor of residual disease in a subsequent hysterectomy following a LEEP for CIN 3.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Cervical Intraepithelial Neoplasia/*surgery/virology
		                        			;
		                        		
		                        			Electrosurgery/methods
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Genotyping Techniques/methods
		                        			;
		                        		
		                        			Human papillomavirus 16/genetics/*isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 18/genetics/*isolation & purification
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hysterectomy
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Neoplasm, Residual
		                        			;
		                        		
		                        			Papillomavirus Infections/*virology
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Uterine Cervical Neoplasms/*surgery/virology
		                        			;
		                        		
		                        			Viral Load
		                        			
		                        		
		                        	
4.Detection of neutralizing antibodies and DNA of human papillomavirus 16, 18 in women aged 18-45 years in Funing, Jiangsu province.
Wenyu LIU ; Feixue WEI ; Jie TANG ; Shangbo YANG ; Yachun GAO ; Ting WANG ; Yunfei JIANG ; Mei LI ; Ying HONG ; Kai CHU ; Wen CHEN ; Yuemei HU ; Fengcai ZHU
Chinese Journal of Epidemiology 2016;37(3):406-409
OBJECTIVETo understand the distributions of DNA and neutralizing antibodies of human papillomavirus (HPV)16, 18 in 18-45 year-old women.
METHODSTotally, 1494 women were enrolled through multistage random sampling in Funing, Jiangsu province. Cervical exfoliated cells were collected from them for HPV DNA testing, and serum samples were taken from them for the detection of HPV16, 18 neutralizing antibodies by using pseudovirion-based neutralization assay(PBNA).
RESULTSAmong the 1494 women, 28(1.9%) and 188(12.6%) were positive for DNA and neutralizing antibody of HPV16 respectively, and 15(1.0%) and 60(4.0%) were positive for DNA and neutralizing antibody of HPV18, respectively. There were no significant differences in the detection rates of DNA and neutralizing antibody of HPV16, 18 among different age groups. About 16.7% of the women were infected with HPV16, 18, or both.
CONCLUSIONIn Funing county of Jiangsu province, most women aged 18-45 years has no immunity to HPV16 and 18, indicating that they are appropriate targets for HPV 16/18 vaccination.
Adolescent ; Adult ; Antibodies, Neutralizing ; isolation & purification ; Antibodies, Viral ; isolation & purification ; China ; DNA, Viral ; isolation & purification ; Female ; Human papillomavirus 16 ; immunology ; Human papillomavirus 18 ; immunology ; Humans ; Middle Aged ; Papillomavirus Infections ; prevention & control ; Papillomavirus Vaccines ; Young Adult
5.Multiple Human Papillomavirus Infection Is Associated with High-Risk Infection in Male Genital Warts in Ulsan, Korea.
Taekmin KWON ; Kyung Hyun MOON ; Sung Hak YANG ; Min Cheol ROH ; Sang Hoon LEE ; Je Won KIM ; In Kyu KIM ; Kyoung Ho ROH ; Sungchan PARK
Journal of Korean Medical Science 2016;31(3):371-375
		                        		
		                        			
		                        			Further understanding of male human papillomavirus (HPV) infection is necessary to prevent infection in men, as well as transmission to women. In our current study, we investigated patterns of HPV infection and genotype distributions in male genital warts using the Anyplex II HPV28 Detection kit. We reviewed the medical records of 80 male patients who presented to 5 neighborhood clinics in Ulsan, Korea, for the treatment of genital warts between April 2014 and January 2015. All patients underwent HPV genotyping. The prevalence and characteristics of HPV infection were analyzed, and the patterns of HPV infection according to age were assessed. Among the study patients, 13 (16.3%) were negative for HPV infection, 46 (57.3%) were infected with low-risk HPV, and 21 (26.3%) were infected with high-risk HPV. Patients with multiple HPV infection were more likely to have high-risk HPV infection (P = 0.001). The prevalence of HPV infection was much higher in samples obtained by tissue excision due to a definite lesion (P = 0.001). There were no differences in high-risk HPV infection (P = 0.459), multiple HPV infection (P = 0.185), and recurrence at diagnosis (P = 0.178) according to age. HPV-6 and HPV-11 were the most common type overall (39.7% and 13.8%, respectively). HPV-16 and HPV-18 were the most common high-risk infections (both 3.4%). HPV infection is not only commonly encountered in male genital warts, but is also accompanied by high-risk HPV and multiple infections.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Condylomata Acuminata/epidemiology/*pathology/virology
		                        			;
		                        		
		                        			DNA, Viral/genetics/metabolism
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Human papillomavirus 11/*genetics/isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 16/genetics/isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 18/genetics/isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 6/*genetics/isolation & purification
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Real-Time Polymerase Chain Reaction
		                        			;
		                        		
		                        			Republic of Korea/epidemiology
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
6.Screening and functional analysis of microRNA expression in HPV16-positive squamous carcinoma of the cervix in the Uygur of southern Xinjiang.
Min YUAN ; Jingxin CHENG ; Yaxin LIU ; Wei SU ; Yu ZHANG ; Yi ZHANG
Journal of Central South University(Medical Sciences) 2015;40(7):701-709
		                        		
		                        			OBJECTIVE:
		                        			To explore the differential expression of microRNA (miRNA) in HPV16-positive squamous carcinoma of the cervix in the Uygur of southern Xinjiang and to predict the target genes of the miRNAs.
		                        		
		                        			METHODS:
		                        			Samples of HPV16-positive squamous carcinoma of the cervix from 5 Uygurs were collected for miRNA microarray assay. The differentially expressed miRNAs were selected for further verification by real-time quantitative RT-PCR. The software, including targetscan, miRwalk, miRanda and pictar, were used to predict the target genes of the verified miRNAs.
		                        		
		                        			RESULTS:
		                        			Eighteen differentially expressed miRNAs were identified by miRNA microarray assay. The significantly differentially expressed miRNA-138 and miRNA-720 were verified by real-time quantitative RT-PCR. According to the prediction, the target genes for miRNA-138 were EZH2, LYPLA1, ARHGEF3, CLNS1A, EIF4EBP1, GNAI2, LIMK1, RHOC, ROCK2, SLC20A1, TERT, and H2AFX, while for miRNA-720 were EZH2, AGAP2, SPOCK2, FGF14, HNRNPA2B1, QKI, FOXG1, ACVR1B, DNMT3A, EPHB2, LATS2, KRAS, CCND2, NBN, ENAM, AMELX, PRNP, and CALB1.
		                        		
		                        			CONCLUSION
		                        			miR-138 and miR-720 are the down-regulated target miRNAs in HPV16-positive squamous carcinoma of the cervix in the Uygur of southern Xinjiang. The common target gene for miR-138 and miR-720 is EZH2, which might be related to cervical squamous carcinoma invasion and metastasis.
		                        		
		                        		
		                        		
		                        			Carcinoma, Squamous Cell
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Down-Regulation
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Human papillomavirus 16
		                        			;
		                        		
		                        			isolation & purification
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			MicroRNAs
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Papillomavirus Infections
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Real-Time Polymerase Chain Reaction
		                        			;
		                        		
		                        			Uterine Cervical Neoplasms
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			virology
		                        			
		                        		
		                        	
7.p16 and PR immunoreactivity and human papillomavirus infection in endocervical adenocarcinoma.
Xiaoyang LIU ; Qing LI ; Wen CHEN ; Ling LI ; Guihua SHEN ; Xun ZHANG
Chinese Journal of Oncology 2014;36(4):263-267
OBJECTIVEThe aim of this study was to investigate the characteristics of p16 and PR immunoreactivity and HPV infection in endocervical adenocarcinoma.
METHODSParaffin blocks of 62 patients with endocervical adnocarcinoma treated in the Cancer Institute and Hospital, Chinese Academy of Medical Sciences from year 2005 to year 2010 were collected. p16 and PR immunostaining and HPV detecting by SPF-10 PCR were conducted on all cases.
RESULTSHPV infection rate of the 62 endocervical adnocarcinoma cases was 74.2% with four cases combined with CIN3. Among the 46 HPV-positive cases, there were 22 cases of HPV18 infection (47.8%), 14 cases of HPV16 infection (30.4%), one case of HPV59 infection (2.2%). and nine multiple HPV infection cases (19.6%). The mean age of the 16 HPV-negative cases was (49.6 ± 10.5)year, while the mean age of the 46 HPV-positive cases was (42.8 ± 9.7)year, showing a significant difference between the two subgroups (P = 0.022). The positive rate of p16 infection was 80.6%. Association analysis showed that the results of p16 and HPV test were independent to each other (P = 0.077). The positive rate of PR was 3.2%. Among the 62 cases, there were 24 cases containing normal cervical glands, with 19 cases PR-positive in the normal cervical glands and the positive rate was 79.2%. The difference of PR positivity between neoplastic glands and normal glands was statistically significant by Chi-square test (P < 0.01) .
CONCLUSIONSThe HPV infection rate of endocervical adnocarcinoma is 74.2%, and the major subtypes were HPV16 and HPV18 infection. p16 immunoreactivity in endocervical adenocarcinoma maybe not the proof of high-risk HPV-related neoplasm. PR staining can be used as a reference designator to differentiate between neoplastic and normal cervical glands.
Adenocarcinoma ; metabolism ; pathology ; virology ; Adult ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; virology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Female ; Human papillomavirus 16 ; isolation & purification ; Human papillomavirus 18 ; isolation & purification ; Humans ; Immunohistochemistry ; Middle Aged ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; virology ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Uterine Cervical Neoplasms ; metabolism ; pathology ; virology
8.Human Papillomavirus Prevalence and Genotype Distribution among HIV-Infected Women in Korea.
Eun Kyoung PARK ; Heerim CHO ; Sun Hee LEE ; Seung Geun LEE ; Sang Yeup LEE ; Ki Hyung KIM ; Chang Hun LEE ; Joo Seop CHUNG ; Ihm Soo KWAK
Journal of Korean Medical Science 2014;29(1):32-37
		                        		
		                        			
		                        			The epidemiology on human papillomavirus (HPV) among human immunodeficiency virus (HIV)-infected women in Korea is not well established. A retrospective study was conducted to determine the prevalence and genotype distribution of HPV infection among HIV-infected women in Korea. HPV DNA genotype and cervical cytology were examined in 60 HIV-positive women and 1,938 HIV-negative women. HPV genotypes were analyzed by using a HPV DNA chip. HIV-infected women had higher prevalence of high-risk HPV (hr-HPV) infection (30% vs 4.9%, adjusted odds ratio [AOR], 6.96; 95% confidence interval [CI], 3.63-13.34, P<0.001) and abnormal cervical cytology (18.3% vs 1.8%, AOR, 10.94; 95% CI, 5.18-23.1, P<0.001) compared with controls. The most common hr-HPV genotype detected in HIV-infected women was HPV 16 (10%), followed by 18 (6.7%) and 52 (5%). Prevalence of quadrivalent vaccine-preventable types (HPV 6, 11, 16, and 18) was 21.7% and 2.3% in HIV-positive women and HIV-negative women, respectively. Age was a significant risk factor for hr-HPV infection in HIV-infected women (P=0.039). The presence of hr-HPV was significantly associated with abnormal cervical cytology (P<0.001). These findings suggest that HPV testing for cervical cancer screening in HIV-infected women would be necessary, particularly among young age group.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Age Factors
		                        			;
		                        		
		                        			Cervix Uteri/virology
		                        			;
		                        		
		                        			DNA Probes, HPV/diagnostic use
		                        			;
		                        		
		                        			DNA, Viral/genetics
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			HIV Infections/complications/*epidemiology/genetics
		                        			;
		                        		
		                        			HIV-1/genetics
		                        			;
		                        		
		                        			Human papillomavirus 11/genetics/isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 16/genetics/isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 18/genetics/isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 6/genetics/isolation & purification
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Papillomavirus Infections/complications/*epidemiology/*genetics
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Republic of Korea/epidemiology
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Uterine Cervical Neoplasms/epidemiology/genetics/virology
		                        			
		                        		
		                        	
9.Role of HPV16/18/45 DNA testing of cervical specimens as a triage testing in cervical cancer screening.
Jing LI ; Wen CHEN ; Le-ni KANG ; Feng CHEN ; Dong-ping GUO ; Ba-yi LI ; You-lin QIAO
Acta Academiae Medicinae Sinicae 2013;35(3):254-259
OBJECTIVETo evaluate the clinical performance of careHPV16/18/45 DNA testing of cervical specimens as a triage testing for women with positive findings during the cervical cancer screening.
METHODSEligible women aged 25-65 years were enrolled from two high-risk communities in Yangcheng County,Shanxi Province.After providing written informed consent on a voluntary base,women underwent questionnaire-based interview,gynecological examination,and sample collection.Hybrid capture 2 technology(HC2),careHPV,Avantage HPV E6 test,and visual inspection with acetic acid(VIA)were conducted as the primary screening tests at the enrollment visit.Women with any positive finding were invited to receive a second VIA and colposcopy.careHPV16/18/45 was performed as a triage testing.Any visible lesion under colposcopy was directly biopsied.Women with pathology confirmed cervical intraepithelial neoplasia grade 2 and worse(CIN2+)were treated with standard procedures.
RESULTSFor the self-collected and doctor-collected samples,the application of careHPV16/18/45 as a triage testing decreased the colposcopy referral to 3.2% and 3.1%,respectively.Meanwhile,the sensitivity,specificity,and positive predictive value(PPV)for CIN2+were 50.0%,97.6%,and 26.7% for women with positive self-sampling careHPV results and 63.0%,97.9%,and 34.0% for women with positive doctor-sampling careHPV results.
CONCLUSIONcareHPV16/18/45 is promising as a triage testing among women with positive screening findings in low-resource settings.
Adult ; Aged ; Colposcopy ; DNA, Viral ; analysis ; Early Detection of Cancer ; methods ; Female ; Human papillomavirus 16 ; genetics ; isolation & purification ; Human papillomavirus 18 ; genetics ; isolation & purification ; Humans ; Mass Screening ; methods ; Middle Aged ; Uterine Cervical Neoplasms ; diagnosis ; virology ; Vaginal Smears
10.Relationship between HPVtype16/18 status and the development of cervical intraepithelial neoplasia.
Ming-tang XU ; Chun-nian HE ; Chang-tian XU ; Huan-fen ZHAO ; Shu-song WANG ; Xiu-zhi ZHANG ; Chen CHEN ; Zhi-bin HAO
Chinese Journal of Pathology 2013;42(6):400-401
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Carcinoma
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			Cervical Intraepithelial Neoplasia
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Human papillomavirus 16
		                        			;
		                        		
		                        			isolation & purification
		                        			;
		                        		
		                        			Human papillomavirus 18
		                        			;
		                        		
		                        			isolation & purification
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			In Situ Hybridization
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Papillomavirus Infections
		                        			;
		                        		
		                        			Uterine Cervical Neoplasms
		                        			;
		                        		
		                        			virology
		                        			
		                        		
		                        	
            
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