Prospective and Retrospective Studies of HPV After Organ Transplant
MM Madeleine, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
LG Johnson, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
JR Daling, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
J Hicks, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
JJ Carter, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
K Nelson, Puget Sound Blood Center, Seattle, WA, USA
D Galloway, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
S Schwartz, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Renal and cardiac organ transplant recipients (OTR) experience a high incidence of
squamous cell skin cancer (SCSC), which is thought to develop in part due to infection
with cutaneous HPVs. We are enrolling OTR in two complementary studies to
investigate the putative role of HPV in SCSC after transplant. Within a retrospective
cohort of OTR in the Seattle area, a nested case-control study will assess 1) if there are
high-risk cutaneous HPV types that are associated with an increased risk of SCSC; 2)
whether pre-transplant HPV antibodies are associated with future SCSC risk; and 3) if
patient characteristics (including history of sun exposure, skin type, eye color, medication
use, and other exposures) gathered at in-person interview and integrated with measures of
HPV types together determine the association between HPV, risk factors, and SCSC in
OTR. The second study is designed to explore the natural history of beta HPV infection
in OTR with longitudinal collection of blood and eyebrow samples over a 2-year period.
Samples will be collected pre-transplant and at 1 and 2 years after transplant. In this
longitudinal study we will assess 1) whether the number of HPV DNA types, antibody
response, or viral persistence increases with time since transplant and 2) the effect of
changes in levels of cell-mediated immunity as measured by a CD4 assay on HPV
infection status (as measured by various markers of HPV) over time. Our studies may
contribute to a more complete understanding of the role of HPV in SCSC and the role
immunosuppression plays in HPV activation. We plan to present preliminary data from
this ongoing study.