Immunosuppression and the occurrence of HPV in kidney transplant patients verified by urinary cytology

• Autor(a) principal: Leon,Rogéria M.
• Data de Publicação: 2016
• Outros Autores: Ranzi,Alana D., Fardin,Graziele S., Keitel,Elizete, Brackmann,Rosicler Luzia, Prolla,João Carlos, Bica,Claudia G.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Jornal Brasileiro de Patologia e Medicina Laboratorial (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442016000100025
• topic: immunosuppression; risk factors; kidney transplantation; papillomavirus infections

ABSTRACT Introduction: Human papillomavirus (HPV) is the main cause of cervical cancer, and immunosuppression is recognized as a risk factor for HPV infection and its persistence. After renal transplantation, immunosuppressive agents are used to prevent rejection, but predispose recipients to chronic infections and malignancies. Objective: This study aimed to verify, based on urinary cytology (UC), the prevalence of HPV in immunosuppressed kidney transplant patients. Material and method: In this cross-sectional study, the population was composed of kidney transplant patients that had undergone routine UC from August 2012 to August 2014. Results: There were 2,305 urine cytopathological tests. Thirteen patients with presence of koilocytes in such examination were observed. Therefore, the relative frequency of patients with HPV detected in urine was 0.56%. In the interval until the first post-transplant year, 10 (76.92%) patients presented koilocytes (p < 0.0001) in the UC. The dosages of immunosuppressive agents until the first post-transplant consultation, which showed correlation with the period between transplantation and the first UC test with the presence of koilocytes (p < 0.0001), were prednisone 10.5-20 mg/day, mycophenolate sodium 901-1,440 mg/day, and tacrolimus 4.5-12 mg/day. Conclusion: This study showed immunosuppression as an important risk factor for infection by HPV or its reactivation. Screening UC tests after transplantation may evidence HPV infection.