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This systematic review and meta-analysis assessed the effects of SARS-Cov-2 and mRNA vaccines on male reproduction. We conducted a comprehensive search using terms such as "COVID-19," "vaccine," and "sperm parameters" on various electronic databases, including MEDLINE (PubMed), BVS (LILACS and others), Embase (Elsevier), and Cochrane Library. We included observational studies, including cohort, case-control, and cross-sectional studies. Of the 2054 records initially identified, we carefully examined 47 full-text articles and excluded 26 articles for specific reasons, ultimately including 21 studies for our analysis. Among these, 16 studies focused on assessing seminal parameters in patients with COVID-19, while five studies investigated the effects of COVID vaccines on seminal parameters. A meta-analysis of seminal parameters in men before and after the COVID-19 pandemic revealed significant differences in seminal concentration, progressive motility, total motility, and normal morphology. These findings indicate a positive impact of the analyzed parameters before the onset of COVID-19. However, the quality of the evidence was considered low. In contrast, a meta-analysis of five studies evaluating seminal parameters before and after the SARS-Cov-2 vaccine did not show any significant differences in total motility. This analysis, involving 256 men from four studies, provided low-quality evidence, suggesting that mRNA vaccines do not affect male reproduction. Overall, our findings suggest that seminal parameters exhibit considerable variability depending on specific outcomes and the study design. However, based on available evidence, it appears that mRNA vaccines do not have detrimental effects on male reproductive function.

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This systematic review and meta-analysis aim to evaluate whether treatment with metformin would reduce Anti-Müllerian Hormone levels in patients with polycystic ovary syndrome. A search was performed in Medline, Embase, Web of Science, and Cochrane Library databases and grey literature (Google Scholar). The following keywords were used in the search strategy: "Polycystic Ovary Syndrome", "Anti-Mullerian Hormone", "Metformin". The search was limited to human studies, with no language restriction. 328 studies were found, 45 studies were selected for full-text reading and 16 of those studies, six randomized controlled trial and 10 non-randomized studies were included. The synthesis of randomized controlled trials, metformin showed a reduction in serum levels of Anti-Müllerian Hormone compared to control groups (SMD - 0.53, 95 %CI - 0.84 to - 0.22, p < 0.001, I2 = 0 %, four studies, 171 participants, high quality of evidence). Six non-randomized studies evaluated data before and after the metformin intervention. The synthesis showed that using metformin reduced serum Anti-Müllerian Hormone values (SMD - 0.79, 95 %CI - 1.03 to - 0.56, p < 0.001, I2 = 0 %, six studies, 299 participants, low quality of evidence). Metformin administration in women with polycystic ovary syndrome is associated significantly with reduced Anti-Müllerian Hormone serum levels.

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The aim of this study was to determine the accuracy of Bayesian networks in supporting breast cancer diagnoses. Systematic review and meta-analysis were carried out, including articles and papers published between January 1990 and March 2013. We included prospective and retrospective cross-sectional studies of the accuracy of diagnoses of breast lesions (target conditions) made using Bayesian networks (index test). Four primary studies that included 1,223 breast lesions were analyzed, 89.52% (444/496) of the breast cancer cases and 6.33% (46/727) of the benign lesions were positive based on the Bayesian network analysis. The area under the curve (AUC) for the summary receiver operating characteristic curve (SROC) was 0.97, with a Q* value of 0.92. Using Bayesian networks to diagnose malignant lesions increased the pretest probability of a true positive from 40.03% to 90.05% and decreased the probability of a false negative to 6.44%. Therefore, our results demonstrated that Bayesian networks provide an accurate and non-invasive method to support breast cancer diagnosis.

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O objetivo deste estudo foi avaliar a acurácia das redes bayesianas no apoio ao diagnóstico de câncer de mama. Foram realizadas revisão sistemática e metanálise, que incluíram artigos e relatórios publicados entre Janeiro de 1990 e Março de 2013. Foram incluídos estudos transversais prospectivos e retrospectivos que avaliaram a acurácia do diagnóstico de lesões de mama (condição alvo) usando as redes bayesianas (teste em avaliação). Quatro estudos primários que incluíram 1.223 lesões de mama foram analisados, 89,52% (444/496) dos casos de câncer de mama e 6,33% (46/727) das lesões benignas foram positivas tendo-se como base a análise das redes bayesianas. A área dentro da curva SROC (característica de operação do receptor sumária) foi 0,97, com um valor Q* de 0,92. O uso de redes bayesianas no diagnóstico de lesões malignas aumentou a probabilidade pré-teste para um verdadeiro positivo de 40,03% para 90,05% e diminuiu a probabilidade de um falso negativo para 6,44%. Portanto, nossos resultados demonstraram que as redes bayesianas oferecem um método acurado e não invasivo no apoio ao diagnóstico de câncer de mama.

The aim of this study was to determine the accuracy of Bayesian networks in supporting breast cancer diagnoses. Systematic review and meta-analysis were carried out, including articles and papers published between January 1990 and March 2013. We included prospective and retrospective cross-sectional studies of the accuracy of diagnoses of breast lesions (target conditions) made using Bayesian networks (index test). Four primary studies that included 1,223 breast lesions were analyzed, 89.52% (444/496) of the breast cancer cases and 6.33% (46/727) of the benign lesions were positive based on the Bayesian network analysis. The area under the curve (AUC) for the summary receiver operating characteristic curve (SROC) was 0.97, with a Q* value of 0.92. Using Bayesian networks to diagnose malignant lesions increased the pretest probability of a true positive from 40.03% to 90.05% and decreased the probability of a false negative to 6.44%. Therefore, our results demonstrated that Bayesian networks provide an accurate and non-invasive method to support breast cancer diagnosis.

El objetivo de este estudio fue evaluar la exactitud de las redes bayesianas para apoyar el diagnóstico de cáncer de mama. Se realizó una revisión sistemática y un metaanálisis, que incluyeron artículos y estudios publicados entre enero de 1990 y marzo de 2013. Se incluyeron estudios transversales prospectivos y retrospectivos, que evaluaron la exactitud del diagnóstico de lesiones mamarias (condición de destino), utilizando redes bayesianas (prueba de evaluación). Se analizaron cuatro estudios que incluyeron 1.223 lesiones de mama primarias, un 89,52% (444/496) de los casos de cáncer de mama, y un 6,33% (46/727) de las lesiones benignas se tomaron como base de análisis de las redes bayesianas. El área bajo la curva SROC (característica operativa del receptor) fue de un 0,97, con un valor de Q* de un 0,92. El uso de las redes bayesianas en el diagnóstico de las lesiones malignas aumentó la probabilidad pre test de un verdadero positivo desde un 40,03% a un 90,05%, y la disminución de la probabilidad de un falso negativo de un 6,44%. Por lo tanto, nuestros resultados demuestran que las redes bayesianas ofrecen un método preciso y no invasivo en el apoyo del diagnóstico del cáncer mamario.

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OBJECTIVE: A systematic review was performed to estimate the accuracy of human epididymis protein 4 (HE4) assay in the diagnosis of ovarian tumors. METHODS: A comprehensive search of the MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google scholar; British Library) from January 1990 to April 2013 was conducted. Studies that evaluated HE4 levels for the diagnosis of ovarian tumors and compared them with paraffin-embedded sections as the diagnostic standard were included. RESULTS: Forty-five studies were analyzed, which included 10,671 women and 3946 ovarian cancer cases. The pooled sensitivity for the diagnosis of borderline tumors or ovarian cancer was 78% (95% confidence interval, 77%-79%), and the specificity was 86% (95% confidence interval, 85%-87%). Summary receiver operating characteristic curves were constructed. For malignant and borderline ovarian tumors versus benign lesions, the area under the curve was 0.916. Besides the overall analysis, stratification was performed in premenopause and postmenopause, early and late stages, and for accuracy by enzyme-linked immunosorbent assay and chemiluminescence microparticle immuno assay. CONCLUSIONS: A HE4 level is a useful preoperative test for predicting the benign or malignant nature of pelvic masses.

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BACKGROUND: Alzheimer's disease (AD) is the most common cause of dementia, accounting for 65-70% of all dementia cases. OBJECTIVE: We performed a systematic review and meta-analysis to estimate the accuracy of cerebrospinal fluid Aß1-42 for the diagnosis of AD. A comprehensive search of the Cochrane Library, MEDLINE, LILACS, Grey literature, and EMBASE was performed for papers published from January 1990 to August 2013. The following Medical Subject Headings (MeSH) terms were searched: "Alzheimer disease" or "AD" and "amyloid-ß" or "Aß1-42". METHODS: We included case-control and cross-sectional studies, prospective or retrospective, that evaluated Aß1-42 levels in AD. Statistical analysis was performed using REVMAN 5.2, Meta Disc, and Stata 11.0. RESULTS: A total of 804 citations were identified by the search strategy and 41 studies were included. Meta-analysis showed a sensitivity of 84.3% (95% CI: 85.6%-81%) and specificity of 79.4% (95% CI: 77.6%-81.1%). The diagnostic odds ratio was 28.9 (95% CI: 21.2-39.5). CONCLUSION: Our study demonstrated that Aß1-42 can discriminate AD from controls with good sensitivity and specificity.

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The scope of this article was to investigate whether intercessory prayer (IP) influences the adverse outcomes of pregnancies. A double-blind, randomized clinical trial was conducted with 564 pregnant women attending a prenatal public health care service. The women were randomly assigned to an IP group or to a control group (n = 289 per group). They were simultaneously and randomly assigned to practice prayer off-site or not. The following parameters were evaluated: Apgar scores, type of delivery and birth weight. The mean age of the women was 25.1 years of age (± 7.4), and the average gestational age was 23.4 weeks (± 8.1). The average number of years of schooling for the women was 8.1 years (± 3.1). The women in the IP and control groups presented a similar number of adverse medical events with non-significant p. No significant differences were detected in the frequency of adverse outcomes in pregnant women who practiced IP and those in the control group.

Este artigo tem por objetivo investigar se a oração intercessória influencia os desfechos adversos das mulheres grávidas. Foi realizado ensaio clínico randomizado duplo-cego com uma população de 564 gestantes que frequentavam Serviço de pré-natal de serviço público de saúde. As gestantes foram aleatoriamente designadas para grupo de intercessão ou grupo controle (n = 289 por grupo). Foram avaliados os seguintes parâmetros: índice de Apgar, tipo de parto, peso ao nascer. A idade média das mulheres foi de 25,1 anos (±7,4) e a idade gestacional média foi de 23,4 semanas (± 8,1). A média de anos de escolaridade foi de 8,1 anos (± 3,1). As mulheres que receberam intervenção (Oração intercessória) e grupo controle exibiram um número similar de eventos adversos, com p não significativo. Não encontramos diferença significativa entre os desfechos adversos na gestação entre os grupos que receberam oração intercessória e no grupo controle.

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The scope of this article was to investigate whether intercessory prayer (IP) influences the adverse outcomes of pregnancies. A double-blind, randomized clinical trial was conducted with 564 pregnant women attending a prenatal public health care service. The women were randomly assigned to an IP group or to a control group (n = 289 per group). They were simultaneously and randomly assigned to practice prayer off-site or not. The following parameters were evaluated: Apgar scores, type of delivery and birth weight. The mean age of the women was 25.1 years of age (± 7.4), and the average gestational age was 23.4 weeks (± 8.1). The average number of years of schooling for the women was 8.1 years (± 3.1). The women in the IP and control groups presented a similar number of adverse medical events with non-significant p. No significant differences were detected in the frequency of adverse outcomes in pregnant women who practiced IP and those in the control group.

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BACKGROUND: The soluble cell adhesion molecules and adipokines are elevated in patients with obesity, hypertension, type 2 diabetes mellitus, breast cancer and atherosclerosis. OBJECTIVE: To investigate the relationship between anthropometric profile, dietary intake, lipid profile and fasting glycemia with serum levels of adipokines (adiponectin and PAI-1) and adhesion molecules (ICAM-1 and VCAM-1) in women without breast cancer undergoing routine mammographic screening. DESIGN: Transversal study. SUBJECTS: One hundred and forty-five women over 40-years old participated in this study. RESULTS: In 39.3% of cases the BMI was above 30 kg/m2; 46.9% had hypertension, 14.5% had type 2 Diabetes Mellitus, 31.7% had dyslipidemia and 88.3% presented a waist-to-hip ratio ≥ 0.8. A linear correlation was found between serum levels of PAI-1 and triglycerides, between serum levels of PAI-1 and WHR and between serum levels of VCAM-1 and BMI. CONCLUSION: We found a high prevalence of obesity and metabolic syndrome. PAI-1 and VCAM-1 levels were correlated with clinical indicators of obesity and overweight.

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The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.

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The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.

Os eventos que levam à prematuridade ainda não são completamente compreendidos. Foi realizada uma revisão sistemática quantitativa para avaliar os efeitos do tratamento de doença periodontal durante a gravidez para prevenir o nascimento prematuro e baixo peso ao nascer. A metanálise incluiu estudos randomizados de grávidas com diagnóstico de doença periodontal antes de 20 semanas de gestação. O risco relativo (RR) com intervalos de 95% de confiança (IC95%) foi calculado. Avaliou-se os desfechos prematuridade e baixo peso ao nascer. Foram incluídos 13 estudos, comparando 3.576 mulheres em grupos de intervenção com 3.412 mulheres que receberam tratamento habitual. A metanálise mostrou uma redução não significativa nos partos prematuros (RR = 0,90; IC95%: 0,68-1,19) e baixo peso ao nascer (RR = 0,92; IC95%: 0,71-1,20). O gráfico de funil revelou clara evidência de viés de publicação. Em resumo, o tratamento periodontal em mulheres grávidas não pode ser considerado uma forma eficiente de reduzir a incidência de parto prematuro ou baixo peso ao nascer.

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Uma revisão sistemática (RS) é um resumo da literaturamédica usando métodos definidos para pesquisaros estudos na literatura, fazendo análise crítica dos artigosindividualmente e, após, usando-se técnica estatísticaadequada, combinar todos esses artigos selecionadospela estratégia de busca. O entendimento de umaRS e como implementar os achados na prática tem grandeimportância para todos profissionais envolvidos nocuidado da saúde.O objetivo desse estudo foi auxiliaraos pesquisadores a um melhor entendimento de umaRS de enfoque diagnóstico e entender como planejar econduzi-la. RS para avaliar testes diagnósticos são realizadaspara estimar a performance dos testes e impactobaseado na evidência dos estudos. Revisões de enfoquediagnóstico envolvem etapas como as de enfoquede tratamento, como: busca da literatura, avaliação daelegibilidade e qualidade dos estudos e extração e síntesedos dados.

A systematic review is a summary of the medical literaturethat uses explicit methods to perform a thoroughliterature search and critical appraisal of individualstudies and that uses appropriate statistical techniquesto combine these valid studies. An understanding andsystematic reviews and how to implement them in practiceis of extraordinary importance for all professionalsinvolved in the delivery of healthcare. The objective thisstudy was to help people reach a good understandingsystematic reviews of diagnostic tests, and to learn howto plan and conduct a systematic review. Systematic reviewsof evaluations of tests are undertaken to produceestimates of test performance and impact based onall available evidence. Reviews of studies of diagnosticaccuracy involve the same key stages as systematicreviews of treatment interventions: defining questions,searching the literature, evaluating studies for eligibilityand quality, and extracting and synthesizing data.

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OBJECTIVE: To identify the role of Interleukin-6, IL-10 and their epidemiological association in women with persistence of DNA-HPV. DESIGN AND METHODS: A nested case-control study within a longitudinal cohort study. Cervical specimens and blood samples were collected at enrolment from asymptomatic women who looked for a service of public health in a district of Porto Alegre, Brazil. A logistic regression analysis was performed with 95% confidence intervals. The outcome was the persistence of DNA-HPV infection. RESULTS: The analysis showed that the age of the first intercourse below 20 years old (OR = 19.65, IC 95% 2.43-68.85), four or more sexual partners during lifetime (OR = 5.67, IC 95% 1.28-24.99), women with a previous altered Pap smear (OR = 10.17, IC 95% 1.80-57.33), marital status (OR = 12.94, IC 95% 2.43-68.85) and IL6 ≤ 3.106 pg/ml were associated with persistence of HPV infection. IL-10 were not associated with the HPV persistence. CONCLUSION: The present study suggests that IL-6 levels may be a marker of HPV DNA persistence, although further investigation is necessary.

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Objetivo: avaliar a mortalidade materna na região Sul do Brasil, do período de 1996 a 2005. Métodos: estudo ecológico descritivo, avaliando-se todas as mortes maternas de mulheres entre 10 e 49 anos no banco de dados do DATASUS. Resultados: a Razão de Mortalidade Materna foi de 59,48/100.000 nascidos vivos. A avaliação do banco de dados fornecido para o estudo evidenciou que 63% dos óbitos maternos ocorreram por causas diretas, sendo as etiologias mais frequentes as doenças hipertensivas, e hemorrágicas O puerpério foi o período menos frequente de mortes maternas sendo que a grande maioria dos casos ocorreram em ambiente hospitalar. Conclusão: esses resultados demonstram a deficiência da saúde pública e a necessidade de desenvolver-se programas que visem melhorar a qualidade da assistência médica durante a gestação, o parto e o puerpério além de criar estratégias eficazes pra se prevenir a morte materna, uma vez que a grande maioria desses óbitos são passíveis de prevenção.

Objective: to assess maternal mortality in Southern Brazil, the period from 1996 to 2005. Methods: an ecological descriptive study, assessing all the maternal deaths of women between 10 and 49 years in the database of DATASUS. Results: the Ratio of Maternal Mortality was 59.48 per 100,000 live births. The evaluation of the database provided for the study showed that 63% of maternal deaths occurred due to direct, and the most frequent etiologies hypertensive diseases, hemorrhagic and infectious period of puerperal respectively. The most common period in which the maternal deaths has occurred during pregnancy, childbirth or abortion and the vast majority of cases occurred in hospitals. Conclusion: these results demonstrate the deficiency of public health and the need to develop programs that improve the quality of medical care during pregnancy, delivery and puerperium and create effective strategies for preventing maternal deaths is because the large most of these deaths are likely to prevention.

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Background. Müllerian duct malformations delineate a miscellaneous group of congenital anomalies that result from arrested development, abnormal formation, or incomplete fusion of the mesonephric ducts. Case. This paper describes the diagnosis and management of a noncommunicating rudimentary horn complicated by severe pelvic pain and associated endometriosis. Conclusion. This condition was diagnosed by laparoscopy and hysteroscopy examination. Operative videolaparoscopy proved to be a successful approach for the treatment of this congenital Müllerian anomaly.

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Dynamic contrast-enhanced breast magnetic resonance (MR) is a promising emerging technique for evaluating breast lesions. A quantitative systematic review was performed to estimate the accuracy of breast MR in the diagnosis of high-risk breast lesions and breast cancer. A comprehensive search of the Cochrane Library, MEDLINE, CANCERLIT, LILACS, and EMBASE databases was performed from January 1985 to August 2010. The medical subjects heading (MeSH) and text words for the terms "breast neoplasm", "breast lesions", "breast cancer" and "magnetic resonance" were combined with the MeSH term diagnosis ("sensitivity and specificity"). Studies that compared breast MR with paraffin-embedded sections parameters for the diagnosis of breast lesions (benign, high-risk borderline, and breast cancer) were included. Sixty-nine studies were analyzed, which included 9,298 women with 9,884 breast lesions. Interrater overall agreement between breast MR and paraffin section diagnosis was 79% (κ = 0.55), indicating moderate agreement. Pooled sensitivity and specificity were 90% [95% CI 88-92%] and 75% [95% CI 70-79%], respectively. The pooled likelihood positive ratio was 3.64 (95% CI 3.0-4.2) and the negative ratio was 0.12 (95% CI 0.09-0.15). For breast cancer or high-risk lesions versus benign lesions, the AUC was 0.91 for breast MR and the point Q* was 0.84. In summary, breast MR is a useful pre-operative test for predicting the diagnosis of breast lesions.

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Human papillomavirus (HPV) types cause approximately 70% of cervical cancer worldwide. Two vaccines have been recently evaluated in randomized controlled trials: the bivalent vaccine for HPV 16 and 18 (Cervarix, GlaxoSmithKline Biologicals, Rixensart, Belgium) and the quadrivalent vaccine for HPV 6, 11, 16, and 18 (Gardasil, Merck and Co, Inc, Whitehouse Station, NJ). We have performed a systematic review of all randomized controlled trials in which vaccines against HPV were compared with placebo regarding efficacy, safety, and immunogenicity. Six studies met the inclusion criteria, which included 47,236 women. The first objective in this systematic review was to assess vaccine efficacy in the prevention of cytologically and/or histologically proven lesions. And the secondary objective was the evaluation of safety and vaccine immunogenicity. Bivalent and quadrivalent HPV vaccines significantly reduced the rate of lesions in the cervix, vulva, vagina, and anogenital region, with efficacy of 93% (95% confidence interval [CI], 87-96) and 62% (95% CI, 27-70), respectively, when compared with the control groups according to intention to treat. Regarding safety, we found more symptoms in the bivalent vaccine group (35%; 95% CI, 5-73) when compared with the control groups. In regard to vaccine immunogenicity, there was seroconversion in the group that received the vaccine when compared with the placebo group in the bivalent and quadrivalent vaccines. Prophylactic vaccination can prevent HPV infection in women aged 9 to 26 years not previously infected with the HPV subtypes covered by the vaccines. To evaluate cervical cancer incidence and mortality, a longer follow-up is necessary.

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A quantitative systematic review was performed to estimate the accuracy ultrasonography with color Doppler in the diagnosis of ovarian tumors. Studies that compared color Doppler ultrasonography with paraffin-embedded sections parameters for the diagnosis of ovarian tumors were included. Twelve studies were analyzed, which included 2398 women. The pooled sensitivity was 0.87 (95% confidence interval [CI] 0.84-0.90); and the specificity was 0.92 (95%CI, 0.87-0.90). The diagnostic odds ratio for ovarian cancer and borderline lesions versus benign lesions was 125 (95%CI, 55-283). Summary receiver operating characteristic curves were constructed because of heterogeneity in the diagnostic odds ratio. For malignant ovarian cancer and borderline versus benign lesions the area under the curve was 0.9577. In conclusion, ultrasonography with color Doppler is a useful preoperative test for predicting the diagnosis of pelvic masses.

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Human papillomavirus (HPV) has been established as an important etiological factor for the development of cervical cancer. This DNA virus primarily infects the epithelium and can induce benign and malignant lesions of the mucous membranes and skin. Some HPVs are considered high risk due to their role in malignant progression of cervical tumors. Genital HPV infections are common and usually transient among young sexually active women. Only a small fraction of infected women develop cervical cancer, implying the involvement of environmental and genetic cofactors in cervical carcinogenesis. Classification, virology, pathology, natural history, epidemiological features of genital HPV infection, and future prospects for cervical cancer prevention with HPV vaccines will be reviewed here.

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Human papillomavirus (HPV) has been established as an important etiological factor for the development of cervical cancer. This DNA virus primarily infects the epithelium and can induce benign and malignant lesions of the mucous membranes and skin. Some HPVs are considered high risk due to their role in malignant progression of cervical tumors. Genital HPV infections are common and usually transient among young sexually active women. Only a small fraction of infected women develop cervical cancer, implying the involvement of environmental and genetic cofactors in cervical carcinogenesis. Classification, virology, pathology, natural history, epidemiological features of genital HPV infection, and future prospects for cervical cancer prevention with HPV vaccines will be reviewed here.

O papilomavírus humano (HPV) é um fator etiológico bem estabelecido para o câncer cervical. Esse vírus de DNA infecta primariamente o epitélio e pode induzir lesões benignas ou malignas na pele e na mucosa. Alguns HPVs são considerados de alto risco, responsáveis pela progressão das lesões precursoras até câncer cervical. A infecção genital pelo HPV é comum em mulheres jovens e geralmente é transitória. Uma pequena proporção de mulheres infectadas desenvolve câncer cervical, implicando o envolvimento de fatores ambientais e fatores genéticos na carcinogênese. Essa revisão aborda a estrutura viral, classificação e patologia do HPV, história natural e fatores de risco para neoplasia cervical e perspectivas futuras com a vacina anti-HPV.

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