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Transcriptionally active human papillomavirus (HPV) has been identified as an important cause of oropharyngeal carcinoma. (1-5) Human papillomavirus-positive oropharyngeal squamous cell carcinoma (OPSCC) has shown a significant increase in incidence [...], * Context.--Human papillomavirus (HPV) is a major cause of oropharyngeal squamous cell carcinomas, and HPV (and/or surrogate marker p16) status has emerged as a prognostic marker that significantly impacts clinical management. There is no current consensus on when to test oropharyngeal squamous cell carcinomas for HPV/p16 or on which tests to choose. Objective.--To develop evidence-based recommendations for the testing, application, interpretation, and reporting of HPV and surrogate marker tests in head and neck carcinomas. Design.--The College of American Pathologists convened a panel of experts in head and neck and molecular pathology, as well as surgical, medical, and radiation oncology, to develop recommendations. A systematic review of the literature was conducted to address 6 key questions. Final recommendations were derived from strength of evidence, open comment period feedback, and expert panel consensus. Results.--The major recommendations include (1) testing newly diagnosed oropharyngeal squamous cell carcinoma patients for high-risk HPV, either from the primary tumor or from cervical nodal metastases, using p16 immunohistochemistry with a 70% nuclear and cytoplasmic staining cutoff, and (2) not routinely testing nonsquamous oropharyngeal carcinomas or nonoropharyngeal carcinomas for HPV. Pathologists are to report tumors as HPV positive or p16 positive. Guidelines are provided for testing cytologic samples and handling of locoregional and distant recurrence specimens. Conclusions.--Based on the systematic review and on expert panel consensus, high-risk HPV testing is recommended for all new oropharyngeal squamous cell carcinoma patients, but not routinely recommended for other head and neck carcinomas. (Arch Pathol Lab Med. 2018;142:559-597; doi: 10.5858/arpa.2017-0286-CP)

INTRODUCTION Human papillomavirus (HPV) is the leading sexually transmitted infection (STI) worldwide. Most sexually active people become infected with HPV at some point in their lives [1?3]. HPV types with [...], : Introduction: As the leading sexually transmitted infection worldwide, human papillomavirus (HPV) may disproportionately affect transwomen. We aimed to estimate anal HPV prevalence, especially focusing on high?risk (hr)?HPV types and evaluate their associated factors among transwomen living in Rio de Janeiro, Brazil. Methods: Transwomen enrolled in a respondent?driven sampling (RDS)?based survey conducted between August 2015 and January 2016 self?collected anal samples, which were promptly stored at minus 80°C. After DNA extraction, HPV detection and genotyping were performed using the PapilloCheck test. We estimated HPV prevalences and evaluated the correlates of anal hr?HPV infection using a regression logistic model. Results: Out of 345 transwomen, 272 (78.8%) were included in this analysis (122 [44.9%] HIV?positive). No participant had ever received HPV vaccination. Among participants enrolled, 212 (77.9%) were positive for any anal HPV type and 165 (60.7%) for hr?HPV. Most common hr?HPV were as follows: HPV16 (17.6%), HPV68 (14.7%), HPV39 (14.3%), HPV56 (12.5%), HPV51 (11.4%) and HPV52 (11.0%). HIV?positive transwomen had three times the odds of having an hr?HPV compared to HIV?negative transwomen. Participants who had a current rectal Neisseria gonorrhoeae infection had 3.7 times the odds of being coinfected with hr?HPV. Among HIV?positive transwomen, neither antiretroviral therapy use, undetectable viral load, current and nadir CD4 counts were associated with anal hr?HPV infection. Conclusions: Brazilian transwomen in our study exhibit some of the highest population?specific rates of HPV and hr?HPV. There is an urgent need to elucidate the burden of HPV infection, prevalence of HPV?related diseases and access to and uptake of HPV vaccination among transwomen, especially from low? and middle?income settings.

Human Papilloma Virus (HPV) History * Most common sexually transmitted disease ** Rarely transmitted from mother to infant * Commonly associated with genital warts ** Although warts can also appear [...]

P072 A 10-year case series of HHV8-related diseases in an ethnically diverse HIV cohort: is human herpesvirus 8 level a clue to the underlying pathology? A Oliveira (1); N Patel [...]

Introduction Epidermodysplasia verruciformis (EV) is a rare, lifelong disorder characterized by disseminated and persistent flat warts or pityriasis versicolor-like (PV-like) lesions due to an abnormal and selective susceptibility to a [...], Epidermodysplasia verruciformis (EV) is a rare genetic disorder characterized by increased susceptibility to specific human papillomaviruses, the betapapillomaviruses. These EV-HPVs cause warts and increase the risk of skin carcinomas in otherwise healthy individuals. Inactivating mutations in epidermodysplasia verruciformis 1 (EVER1) or EVER2 have been identified in most, but not all, patients with autosomal recessive EV. We found that 2 young adult siblings presenting with T cell deficiency and various infectious diseases, including persistent EV-HPV infections, were homozygous for a mutation creating a stop codon in the ras homolog gene family member H (RHOH) gene. RHOH encodes an atypical Rho GTPase expressed predominantly in hematopoietic cells. Patients' circulating T cells contained predominantly effector memory T cells, which displayed impaired TCR signaling. Additionally, very few circulating T cells expressed the β7 integrin subunit, which homes T cells to specific tissues. Similarly, Rhoh-null mice exhibited a severe overall T cell defect and abnormally small numbers of circulating β7-positive cells. Expression of the WT, but not of the mutated RHOH, allele in Rhoh-/- hematopoietic stem cells corrected the T cell lymphopenia in mice after bone marrow transplantation. We conclude that RHOH deficiency leads to T cell defects and persistent EV-HPV infections, suggesting that T cells play a role in the pathogenesis of chronic EV-HPV infections.

RECURRENT RESPIRATORY PAPILLOMATOSIS (RRP) is the most common benign neoplasm to affect the larynx in children. (1) It is estimated that ~6000 active cases of RRP were present in 1995 [...], BACKGROUND. Recurrent respiratory papillomatosis in children is an uncommon but potentially life-threatening benign tumor of the respiratory tract with laryngeal predilection. The diagnosis of recurrent respiratory papillomatosis may be challenging unless there is a high index of suspicion and awareness of the variable presentations. METHODS. We reviewed the medical charts of children with recurrent respiratory papillomatosis treated at a tertiary children's hospital. The presentation of recurrent respiratory papillomatosis is illustrated by a series of case reports. We provide a paradigm to assist in the early diagnosis of children with recurrent respiratory papillomatosis. RESULTS. Five patients, aged 2 to 6 years, were erroneously diagnosed with recurrent croup, asthma, laryngeal hemangioma, and tracheomalacia after presenting with variable degrees of chronic dyspnea, cough, stridor, dysphonia, weak cry, and syncope. Once the diagnosis of recurrent respiratory papillomatosis was made, recurring surgical ablation of papillomata was initiated. CONCLUSIONS. Any child presenting with a voice disturbance with or without stridor is recommended to have diagnostic flexible fiber-optic laryngoscopy. Recurrent respiratory papillomatosis should be considered in children when other common pediatric airway diseases either do not follow the natural history or do not respond to treatment of the common disorder. Key Words pediatric, recurrent respiratory papillomatosis, human papilloma virus, asthma, croup, stridor, hoarseness Abbreviations RRP--recurrent respiratory papillomatosis HPV--human papillomavirus ED--emergency department URI--upper respiratory infection FFL--flexible fiberoptic laryngoscopy

Visual inspection of the cervix following application of acetic acid is an effective method of reducing the incidence of and mortality from cervical cancer in developing countries, according to findings [...]