Andressa Kelly Ferreira e Silva

Human papillomavirus infection is the cause of several diseases in men and women. More than 100 types of HPV are known and about 30 are related to anogenital infection, with the most prevalent sexually transmitted viral infection worldwide. Given the proposal, the work aims to conduct a systematic review on the diagnosis of HPV in men. The study is a systematic review with the research question 'How is HPV diagnosed in men?' To answer this question, the descriptors “HPV OR papillomavirus” AND “diagnostic” and “man OR men” were used, in the PubMed, ScienceDirect and SciELO databases. After extracting the articles from the three databases and applying the inclusion and exclusion criteria, a total of 26 articles was reached at the end. Within the review, the most used methods for screening male HPV were seen, such as: peniscopy, cytological and histological evaluation, serological tests, p16 immunohistochemistry and molecular tests that are of great importance in the conclusive diagnosis, being reported in 14 articles. The genotype most found in the articles was HPV 16, a high-risk type of HPV, being mentioned in 11 studies. In addition, ten diseases were associated with HPV infection such as: cancer or anal dysplasia, head and neck cancer, penile cancer, co-infections with more than one HPV genotype and with HIV virus. This study was limited due to the lack of methodological standardization of the papers used. Although the prevalence of HPV infection in men is high, there is no consensus on which tests should be used to establish a diagnosis. The different methodologies have different sensitivity and specificity values, thus, the diagnosis of male HPV infection tends to associate the available methods.

BACKGROUND: Statins are used as cholesterol-lowering drugs and may also have direct antimicrobial effects. OBJECTIVE: To evaluate synergic interactions between simvastatin and both amphotericin B and fluconazole, against environmental strains of Cryptococcus neoformans isolated from captive birds’ droppings. DESIGNAND SETTING: Experimental study conducted at Federal University of Piauí, Parnaíba, in collaboration with Federal University of Triângulo Mineiro, Uberaba, Brazil. METHODS: Statin susceptibility tests of Cryptococcus neoformans samples were performed as prescribed in standards. Interactions of simvastatin with amphotericin and fluconazole were evaluated using the checkerboard microdilution method. Presence of these interactions was quantitatively detected through determining the fractional inhibitory concentration index (FICI). RESULTS: Isolates of Cryptococcus neoformans were obtained from 30 of the 206 samples of dry bird excreta (14.5%) that were collected from pet shops and houses. Ten isolates were selected for susceptibility tests. All of them were susceptible to amphotericin and fluconazole. All presented minimum inhibitory concentration (MIC) > 128 µg/ml and, thus, were resistant in vitro to simvastatin. An in vitro synergic effect was shown through combined testing of amphotericin B and simvastatin, such that six isolates (60%) presented FICI < 0.500. Two isolates showed considerable reductions in MIC, from 1 µg/ml to 0.250 µg/ml. No synergic effect was observed through combining fluconazole and simvastatin. CONCLUSION: These results demonstrate that simvastatin should be considered to be a therapeutic alternative, capable of potentiating the action of amphotericin B. However, further studies are necessary to clarify the real effect of simvastatin as an antifungal agent.