背景:宫颈癌(CC)是一个重要的全球公共卫生问题,特别是在哥伦比亚等发展中国家。主要危险因素涉及高危型HPV(HR-HPV)感染,再加上特定于人口的变量。哥伦比亚的加勒比地区缺乏关于HR-HPV型频率的研究。因此,本研究旨在确定接受宫颈细胞学筛查的女性中类型特异性HR-HPV的患病率及其与社会人口统计学因素的关系.
方法:一项涉及自愿妇女的横断面研究,这些妇女提供了知情同意,并完成了一份社会人口统计学调查问卷,临床,并进行了性行为信息。所有参与者都接受了宫颈细胞学和分子分析。通用HPV检测采用三个同时的PCR(GP5+/6+,MY09/11和PU1R/2M),阳性样品使用OptiplexHPV基因分型试剂盒进行基因分型。该分析包括12种高危型HPV(HR-HPV-16、-18、-31、-33、-35、-39、-45、-51、-52、-56、-58和-59)。根据科尔多瓦省的地理分区域报告了频率,单感染和多感染之间存在差异。社会人口统计学和临床变量进行有序逻辑回归,在p值<0.05时具有统计学意义。统计分析使用STATA14®和R-Core团队软件。
结果:我们包括450名女性,平均年龄40岁(SD±11.44)。PCR分析显示43%的HPV阳性(n=192)。GP5+/6+检测到的阳性最多,为26%(n=119),其次是22%的PU1R/2M(n=100)和15%的MY09/11(n=69)。多重感染发生率为87.3%(n=142),主要为2至4种类型(47.37%,n=90)。优势类型为HPV-18(15.6%,n=61),HPV-16(14.9%,n=58),HPV-31(13.0%,n=51),和HPV-45(11.5%,n=45)。Logistic回归将60岁以上的年龄确定为并发多种类型的风险(OR=6.10;95%CI1.18-31.63)。更年期是保护性的(OR=0.31;95%CI0.11-0.89)。
结论:我们的研究表明,在参与CC检测计划的成年女性中,多重(2-4)高危HPV感染的患病率明显。主要是,α7物种构成了流行的HR病毒类型,MedioSinú次区域的患病率升高。更年期状态赋予对多种HR-HPV感染的保护。然而,年龄增长,尤其是60年以后,与多种HPV类型同时感染的易感性增加有关。
BACKGROUND: Cervical cancer (CC) is a significant global public health concern, particularly in developing countries such as Colombia. The main risk factor involves high-risk HPV types (HR-HPV) infection, coupled with population-specific variables. The Caribbean region in Colombia lacks research on HR-HPV-type frequencies. Therefore, this study aims to establish the prevalence of type-specific HR-HPV and its association with sociodemographic factors among women undergoing cervical cytology screening.
METHODS: A cross-sectional study involving voluntary women who provided informed consent and completed a questionnaire capturing sociodemographic, clinical, and sexual behavior information was conducted. All participants underwent cervical cytology and molecular analysis. Generic HPV detection employed three simultaneous PCRs (GP5+/6+, MY09/11, and PU1R/2 M), and positive samples were genotyped using the Optiplex HPV Genotyping kit. The analysis encompassed the 12 types of high-risk HPV (HR-HPV-16,-18,-31,-33,-35,-39,-45,-51,-52,-56,-58, and - 59). Frequencies were reported based on geographic subregions within the Córdoba department, and disparities were made between single and multiple infections. Sociodemographic and clinical variables were subjected to ordinal logistic regression, with statistical significance at a p-value < 0.05. The statistical analyses utilized STATA 14® and R-Core Team-software.
RESULTS: We included 450 women, mean age 40 (SD±11.44). PCR analysis revealed 43% HPV-positive (n=192). GP5+/6+ detected the most positives at 26% (n=119), followed by PU1R/2 M at 22% (n = 100) and MY09/11 at 15% (n=69). Multiple infections occurred in 87.3% (n=142), primarily 2 to 4 types (47.37%, n=90). Dominant types were HPV-18 (15.6%, n=61), HPV-16 (14.9%, n=58), HPV-31 (13.0%, n = 51), and HPV-45 (11.5%, n=45). Logistic regression identified age above 60 as a risk for concurrent multiple types (OR=6.10; 95% CI 1.18-31.63). Menopause was protective (OR=0.31; 95% CI 0.11-0.89).
CONCLUSIONS: Our study reveals a notable prevalence of multiple (2-4) high-risk HPV infections among adult women engaged in CC detection initiatives. Predominantly, α7 species constitute the prevalent HR-viral types, with the Medio Sinú subregion showing elevated prevalence. Menopausal status confers protection against diverse HR-HPV infections. Nevertheless, advancing age, particularly beyond 60 years, is linked to an increased susceptibility to simultaneous infections by multiple HPV-types.