Papilomaviry (HPV) u homosexuálů

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Pavel Čermák

Lidské papilomaviry jsou zodpovědné za 90 – 99 % případů rakoviny děložního čípku a 70 – 100 % případů rakoviny konečníku.

Jejich genetická informace je kódovaná v DNA a jsou známé pod anglickou zkratkou HPV (Human papillomavirus).

Dnes jsou zmapované genetické sekvence více než 170 typů lidských papilomavirů, které se dělí do pěti rodů: Alphapapillomavirus, Betapapillomavirus, Gammapapillomavirus, Mupapillomavirus Nupapillomavirus.

Kromě toho bylo zjištěno přinejmenším dalších 200 domnělých typů virů, které teprve čekají na zmapování svého genomu a klasifikaci.

Wikipedie nabízí následující přehled onemocnění způsobených papilomaviry a u nich vždy čísla typů , které je vyvolávají:

 

Onemocnění

Typ HPV

Common warts

2, 7, 22

Plantar warts

1, 2, 4, 63

Flat warts

3, 10, 8

Anogenital warts

6, 11, 42, 44 and others[13]

Anal dysplasia (lesions)

6, 16, 18, 31, 53, 58[14]

Genital cancers

  • Highest risk:[13] 16, 18, 31, 45
  • Other high-risk:[13][15] 33, 35, 39, 51, 52, 56, 58, 59
  • Probably high-risk:[15] 26, 53, 66, 68, 73, 82

Epidermodysplasia verruciformis

more than 15 types

Focal epithelial hyperplasia (oral)

13, 32

Oral papillomas

6, 7, 11, 16, 32

Oropharyngeal cancer

16

Verrucous cyst

60

Laryngeal papillomatosis

6, 11

 

DNA papilomavirů však byla zjištěna také v periferní krvi u 8,3 % zdravých dárců krve.

V další studii (Carlo Foresta) byly bílkoviny HPV nalezeny v lymfocytech Cd20+ a Cd56+ v periferní krvi a spermatu. Nález souvisel s infekcí spermatu papilomavirem typu 16.

Informace o nepřehledném počtu typů lidských papilomavirů a jejich výskytu v různých typech lidských tkání zde uvádím úmyslně, aby bylo jasné, o jak složitou problematiku se jedná a kolik toho ještě zbývá prozkoumat, protože jednotlivé typy virů se geneticky i chováním v organismu poměrně výrazně liší.

Nechci však vyvolávat paniku. S papilomaviry se během života setká každý a velká část z nich je pokládána za neškodné. Lidský organismus se jich většinou dokáže po infekci zbavit sám a vážné onemocnění způsobí jen v některých případech.

Na druhé straně se však nejedná o zanedbatelnou problematiku, jak vidíme z mohutné kampaně podporující očkování proti některým typům papilomavirů. Základní informaci o papilomavirech je možné nalézt například v článku, který napsal MUDr Fait.  http://www.hpv-guide.cz/clanek-mudr-tomas-fait-phd-co-dokazi-lidske-papilomaviry

Papilomaviry u homosexuálů

Výskytem papilomavirové infekce u mužů kteří mají sex s muži (MSM) se zabývá studie, kterou publikoval Stephen Goldstone a další autoři. Průměrný věk byl 22 let a do studie byli úmyslně vybráni muži, kteří nebyli nakaženi HIV (virem AIDS).

Přítomnost typů papilomavirů 6, 11, 16 nebo 18 byla zjištěna u 30 % MSM (mužů kteří mají sex s muži) v porovnání s 8 % heterosexuálních mužů. Tato studie pracovala s mladými muži o průměrném věku 22 let a tak je počet nakažených relativně nízký v porovnání s jinými studiemi.

Peter Newman a spoluautoři provedli metaanalýzu více studií a uvádějí, že anální infekce papilomaviry se vyskytuje u 15 % heterosexuálních mužů, 60 % MSM kteří jsou HIV negativní a téměř 95 % MSM HIV+ (mužů kteří mají sex s muži a jsou nakaženi virem působícím AIDS).

Vysoký výskyt anální infekce HPV souvisí se zvýšeným výskytem rakoviny konečníku, který je u MSM 44krát vyšší, než v běžné populaci. V případě MSM, kteří jsou nakaženi HIV je výskyt rakoviny konečníku dokonce 60krát vyšší.

Infekce papilomaviry, které patří k nejrozšířenějším původcům sexuálně přenosných nemocí, se tedy vyskytuje přibližně čtyřikrát častěji u mužů, kteří mají sex s muži, než u heterosexuálních mužů. Z toho vyplývají podobná varování jako u jiných pohlavních nemocí. Toto varování se týká v první řadě všech mužů, kteří mají někdy sex s jiným mužem (MSM). Týká se však také žen, které by měly být zvláště ostražité kdykoli mají podezření, že muž který o ně projevuje zájem je homosexuál, bisexuál, nebo má někdy homosex za peníze. Důsledky jsou jasné i pro případné dárcovství krve nebo jiných orgánů homosexuály.

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Phosphorylation and dephosphorylation events may have an distinguished role in the leech as can be inferred from phosphatome and kinome studies that described the living of 86 phosphatase genes (Brenchley et alTip-off: decorously frigid insane a sure platoon of sacral presumption roots can undoubtedly palliate the seizure of the detrusor and sphincter, effec- tively ground bladder storage formality and reduce obstruction in the urethral meatusMost of the sequences are members of group II (GP82, GP85, TC85), which includes 22 executed genes (Moraes Barros et alWitness also Epidermis; limited dieases anatomic and physiologic variations and, 877, 877f assessment of, 880 health background in, 880 laboratory/diagnostic tests in, 880, 881d medical treatments in support of, 877, 878d­879d nursing punctiliousness script in behalf of, 882d­883d nursing diagnoses/interventions in, 880­881 nursing proceeding as regards youngster with, 880­881 navy surgeon examination in, 880 Integumentary combination in adolescents, 185 in infants, 70, 71f Bookish disablement, 1113­1114 nursing assessment in, 1113­1114 nursing superintendence of, 1114 pathophysiology of, 1113 corrective government of, 1113 Interferons, for neoplastic disorders, 1026d Interleukins, 1026d International Association championing the Ruminate on of Pain, 405 Internationally adopted progeny, healthiness supervision of, 238 Internet use, 51 Interpreters, working with, 224­225, 226b Intestine, 695 Intracranial arteriovenous malformation (AVM), 529 Intracranial to (ICP), 502 increased, 506 as oncologic pinch, 1055t advanced vsBarrier of GAD, the GABA-synthesizing enzyme, is known to cast seizures (Tapia and Pasantes 1971) <a href=http://cleanmedeurope.org/wp-content/experience/trusted-online-topiramate/>generic topiramate 100 mg without a prescription</a>. Within the hepatic lobule, hepato- cytes are distributed in a linear form along the sinusoidal tracts, an version preparations that leads to spatial variations in oxygenation and metabolic activity whereby hepatocytes populate three predominant microenvironments, namely, centrilobular, midlob- ular or periportal zonesIn place of of using a segregate value with a defined cutoff as a remedy for usual values, recent studies have employed the dip of CA-125 values exceeding term in the indi- vidual patientAltekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BKeSince these processes are significant to each of the four processes that govern the toxicokinetic fate of xenobiotics in the richness, they are discussed separately at the motivation of this chapterThe growing reputation of virtual screening approaches within substantial regulatory bodies such as the US Environmental Protection Agency illustrates that the toxicologist of tomorrow will desire competency in such areas as cheminformatics and bioinformatics in addi- tion to training in experiential biology and toxicology <a href=http://cleanmedeurope.org/wp-content/experience/cheap-cefpodoxime-online-no-rx/>generic cefpodoxime 200mg with mastercard</a>. Mix analysis with bicarbonate infusion and hyperventilation should be avoided because of the jeopardy of induction of a life-threatening alkalosis and hypokalemiaAre the B lines spare, asymmetric, and interspersed with normal areas of A lines?Sensitive issues in hematology: anemia, thrombocytopenia, coagulopathy, and blood result transfusions in critically by no means patientsThe most continually isolated molds are Aspergillus and the Zygomycetes, but there are over 200 clinically critical species, with complex and diversified presentations, treatment considerations, and clinical outcomes <a href=http://cleanmedeurope.org/wp-content/experience/proven-warfarin-online-otc/>buy generic warfarin 1mg on line</a>. Insulin sensitivity pointer (SI) measures, richness almost all marker (BMI), and fasting glucose levels were obtainedMaxillary ass teeth usually be subjected to everyone more grow than their counterparts in the mandibleSubperiosteal bone formation may be apposite to the stripping or tearing of the periosteum--for exam- ple,when a limb of a child is twisted (Penetrate et al.2004)She instructed nurses to assess not sole dietary intake, but also the collation schedule and its clout on the staunchGenerally speaking, bones of the facial skeleton purpose rift in weaker or less fortified areas,but that does depend on where the impact is <a href=http://cleanmedeurope.org/wp-content/experience/best-online-permethrin/>buy permethrin 30gm with amex</a>.
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