Abstract：
OBJECTIVE: This systematic review and meta-analysis aims to investigate the prevalence of cervical high-risk human papillomavirus (hrHPV) among kidney transplant recipients (KTRs) and, furthermore to compare it to that in immunocompetent controls.
METHODS: A systematic literature search was conducted in PubMed, EMBASE, and Cochrane Library databases from January 2000 to February 2023, to identify studies investigating the prevalence of cervical hrHPV in KTRs. Pooled cervical hrHPV prevalences, odds ratios (ORs) comparing KTRs to controls and corresponding confidence intervals (CIs) were estimated using random effects logistic regression models. Heterogeneity between studies was assessed through the I2 statistic, and the significance was evaluated by the Cochrane\'s Q test.
RESULTS: Altogether, 16 studies covering >1200 KTRs were included. The prevalence of cervical hrHPV in KTRs was 27.7% (95% CI 21.3-35.1) with substantial interstudy heterogeneity. Stratification indicated a higher prevalence in recent years (2019-2023) and in Asia (39% (95% CI 11.2-61.4)). The prevalence of HPV16 and HPV18 in KTRs was 8.0% (95% CI 3.9-15.9) and 1.7% (95% CI 0.8-3.7), respectively. Comparing hrHPV prevalence in KTRs and controls based on six studies including >500 KTRs and 1000 controls, the OR for hrHPV was 2.0 (95% CI 1.1-3.6).
CONCLUSIONS: This meta-analysis establishes an increased cervical hrHPV prevalence in KTRs compared to controls. The increased risk may be associated with immunosuppressive therapy post-transplantation. Further research is needed to explore the potential benefits of HPV vaccination, including potential revaccination strategies in KTRs.
METHODS: A systematic literature search was conducted in PubMed, EMBASE, and Cochrane Library databases from January 2000 to February 2023, to identify studies investigating the prevalence of cervical hrHPV in KTRs. Pooled cervical hrHPV prevalences, odds ratios (ORs) comparing KTRs to controls and corresponding confidence intervals (CIs) were estimated using random effects logistic regression models. Heterogeneity between studies was assessed through the I2 statistic, and the significance was evaluated by the Cochrane\'s Q test.
RESULTS: Altogether, 16 studies covering >1200 KTRs were included. The prevalence of cervical hrHPV in KTRs was 27.7% (95% CI 21.3-35.1) with substantial interstudy heterogeneity. Stratification indicated a higher prevalence in recent years (2019-2023) and in Asia (39% (95% CI 11.2-61.4)). The prevalence of HPV16 and HPV18 in KTRs was 8.0% (95% CI 3.9-15.9) and 1.7% (95% CI 0.8-3.7), respectively. Comparing hrHPV prevalence in KTRs and controls based on six studies including >500 KTRs and 1000 controls, the OR for hrHPV was 2.0 (95% CI 1.1-3.6).
CONCLUSIONS: This meta-analysis establishes an increased cervical hrHPV prevalence in KTRs compared to controls. The increased risk may be associated with immunosuppressive therapy post-transplantation. Further research is needed to explore the potential benefits of HPV vaccination, including potential revaccination strategies in KTRs.
摘要：
目的：本系统综述和荟萃分析旨在调查肾移植受者(KTRs)中宫颈高危型人乳头瘤病毒(hrHPV)的患病率,此外，将其与免疫活性对照进行比较。
方法：在PubMed，EMBASE,以及2000年1月至2023年2月的Cochrane图书馆数据库，以确定调查KTRs中宫颈hrHPV患病率的研究。汇集宫颈hrHPV流行率，使用随机效应逻辑回归模型估计比较KTRs与对照组的比值比(ORs)和相应的置信区间(CIs).通过I2统计量评估研究之间的异质性，并通过Cochrane的Q检验评估其显著性。
结果：总之，包括16项研究，涵盖>1200KTRs。KTRs中宫颈hrHPV的患病率为27.7％（95％CI21.3-35.1），具有实质性的研究间异质性。分层显示近年来（2019-2023年）和亚洲（39%（95%CI11.2-61.4））的患病率较高。KTRs中HPV16和HPV18的患病率分别为8.0%（95%CI3.9-15.9）和1.7%（95%CI0.8-3.7），分别。基于六项研究，包括>500KTRs和1000个对照，比较KTRs和对照中的hrHPV患病率。hrHPV的OR为2.0(95%CI1.1-3.6).
结论：这项荟萃分析确定，与对照组相比，KTRs中的宫颈hrHPV患病率增加。风险增加可能与移植后的免疫抑制治疗有关。需要进一步的研究来探索HPV疫苗接种的潜在益处。包括KTRs中潜在的再接种策略。
方法：在PubMed，EMBASE,以及2000年1月至2023年2月的Cochrane图书馆数据库，以确定调查KTRs中宫颈hrHPV患病率的研究。汇集宫颈hrHPV流行率，使用随机效应逻辑回归模型估计比较KTRs与对照组的比值比(ORs)和相应的置信区间(CIs).通过I2统计量评估研究之间的异质性，并通过Cochrane的Q检验评估其显著性。
结果：总之，包括16项研究，涵盖>1200KTRs。KTRs中宫颈hrHPV的患病率为27.7％（95％CI21.3-35.1），具有实质性的研究间异质性。分层显示近年来（2019-2023年）和亚洲（39%（95%CI11.2-61.4））的患病率较高。KTRs中HPV16和HPV18的患病率分别为8.0%（95%CI3.9-15.9）和1.7%（95%CI0.8-3.7），分别。基于六项研究，包括>500KTRs和1000个对照，比较KTRs和对照中的hrHPV患病率。hrHPV的OR为2.0(95%CI1.1-3.6).
结论：这项荟萃分析确定，与对照组相比，KTRs中的宫颈hrHPV患病率增加。风险增加可能与移植后的免疫抑制治疗有关。需要进一步的研究来探索HPV疫苗接种的潜在益处。包括KTRs中潜在的再接种策略。
