背景:女性中的人乳头瘤病毒(HPV)感染是宫颈癌和生殖器疣的原因。在中国,女性HPV疫苗接种率和目标人群筛查率较低,本研究旨在对HPV感染的基因型分布和患病率进行研究,为宫颈癌及HPV相关疾病的防治提供更有针对性的策略。
方法:采用聚合酶链反应-反向斑点印迹(PCR-RDB)进行HPV基因分型。分析了2013-2020年成都市181,705例女性HPV感染的患病率和23种基因型分布。
结果:181,705例HPV感染总患病率为23.28%,HR-HPV在<20岁年龄组的患病率,60-69岁和≥70岁高于总体患病率。HPV的患病率随年龄呈双峰U形曲线;第一和第二高峰常见于<20岁的女性(42.97%)和60-69岁的女性(37.56%)。分别。成都地区女性HPV感染前5位基因型为HPV52/16/58/81/53。单一感染(73.26%)是主要的HPV感染模式,其次是双重感染(19.17%)和多重感染(7.57%),随着HPV合并感染模式的增加,HPV的感染率逐渐下降,低危和高危合并感染在低危HPV感染中更高(43.68%),在高危HPV感染中更低(13.59%).基因型-6型和-81型感染的患病率分别在20岁和40-59岁年龄组位居第二,而在181,705名女性中,23个基因型中70岁以上年龄组的HPV16患病率最高.
结论:成都女性HPV感染率高于国内某些发达城市,在可用的五种疫苗中,无价疫苗更适合成都女性。对于年轻女性来说,在当前情况下优先接种疫苗至关重要。HPVDNA的双重筛查在中年妇女(30-49岁)中很重要,老年女性(>65岁)不应缺乏筛查。此外,对于生殖器疣患者,有必要筛查高危HPV感染,并提供适当的管理和治疗。鉴于本研究的局限性,未来的HPV研究应旨在实现目标人群的全面覆盖,我们的研究还应包括HPV阳性病例的细胞或病理数据,疫苗接种率,和各种生活方式的细节。
Human papilloma virus (HPV) infection among female is the cause of cervical cancer and genital warts. In China, the HPV vaccination rate and the target population screening rate among females are low, and the aims of this study on the genotype distribution and prevalence of HPV infection were to provide more targeted strategies for the prevention and treatment of cervical cancer and HPV-related diseases.
Polymerase chain reaction-reverse dot blot (PCR-RDB) was adopted for HPV genotyping test, the prevalence and 23 genotypes distribution of HPV infections among 181,705 women in Chengdu from 2013 to 2020 were analysed.
The overall prevalence rate of HPV infection among 181,705 cases was 23.28%, the prevalence of HR-HPV at the age group < 20 years, 60-69 years and ≥ 70 years were higher than the overall prevalence.The prevalence of HPV showed a bimodal U-shaped curve with age; the first and second peak common occurred among females < 20 years old (42.97%) and 60-69 years old (37.56%), respectively.The top five genotypes of HPV infection among females in Chengdu were HPV52/16/58/81/53. Single infection (73.26%) was the main HPV infection pattern, followed by double infection (19.17%) and multiple infection (7.57%), the infection rate of HPV showed a gradual declined as the patterns of HPV coinfections increased, low-risk and high-risk coinfection was higher in low-risk HPV infection (43.68%) and lower in high-risk HPV infection (13.59%). The prevalence of genotypes - 6 and - 81 infection was the second highest at the age group of 20 and 40-59, respectively, while the prevalence of HPV16 was the highest at the age group of ≥ 70 among 23 genotypes among the 181,705 women.
The prevalence of HPV infections among women in Chengdu is higher than domestic certain developed citys, among the five vaccines available, nonavalent vaccine is more suitable for Chengdu females. For young females prioritizing vaccination is essential in the current context.Double screening for HPV DNA is important in middle-aged women (30-49 years), and screening should not be lacking in older women (> 65 years). Additionally,for patients with genital warts, it is necessary to screen for high-risk HPV infection and provide appropriate management and treatment. Given the limitations of this study, future HPV research should aim to achieve full coverage of the target population, and our studies should also include cellular or pathological data of HPV-positive cases, vaccination rates, and various lifestyle details.