HPV单一与多重型别感染子宫颈病变风险比较

目的 对比HPV单一与多重型别感染者子宫颈病变风险,探索相应的管理模式.方法 回顾性总结2010年至2012年在北京大学第一医院妇产科同时行子宫颈细胞学与HPV检测且高危型HPV阳性妇女7 192例的临床资料,分析HPV高危型单一与多重型别感染者子宫颈癌前病变及浸润癌的相关性.结果 7 192例HPV高危型感染者中单一及多重型别感染率分别占75.88%及24.12%.在单一及多重型别感染者中,最常检出的型别均为16型,其次为58型、52型、53型.单一与多重型别感染者中细胞学高级别异常及以上占比分别7.81%及8.24%,两者无统计学差异(χ2=0.343,P=0.574),Logistic回归分析发现HPV16、31、33型别感染与细胞学高级别及以上异常具有相关性[OR分别为3.700(95%CI:3.048~4.492)、2.038(95%CI:1.568~2.647)、1.563(95%CI:1.110~2.201)].单一与多重型别感染者中CIN2+检出率分别为22.29%及23.04%,CIN3+检出率分别为11.72%及8.73%,两组感染者CIN2+检出无统计学差异(χ2=0.226,P=0.653),CIN3+检出有统计学差异(χ2=0.622,P=0.011),在HPV16、HPV16/18单一与多重型别感染者CIN2+检出均无统计学差异(χ2值分别为2.215、2.680,均P>0.05),CIN3+检出均有统计学差异(χ2值分别为0.622、11.112,均P<0.05),在非HPV16/18型单一及多重型别感染者CIN2+、CIN3+检出均无统计学差异(χ2值分别为2.747、0.199,均P>0.05).Logistic回归分析发现HPV 16型、单一型感染、细胞学异常及高级别异常与子宫颈病变CIN2+具有相关性[OR值分别为2.358(95%CI:1.934~2.874)、1.264(95%CI:1.020~1.566)、2.216(95%CI:1.779~2.761)、9.599(95%CI:7.728~112.575);HPV16、33型别感染、细胞学异常及高级别异常与CIN3+具有相关性[OR值分别为4.192(95%CI:3.102~5.665)、1.806(95%CI:1.183~2.757)、2.919(95%CI:1.360~2.708)、10.357(95%CI:7.545~14.215).结论 HPV多重型感染虽可导致更多的细胞学异常,但尚未导致更多的高级别细胞学异常;HPV单一型别、HPV16型别、16/18型别感染者的CIN3+风险增高,临床上应重视对这一人群的管理.     

女性高危型人乳头瘤病毒无症状感染及影响因素调查

目的掌握女性高危型人乳头瘤病毒(Human papillomavirus,HPV)无症状感染现状及其影响因素。方法采用便利抽样法于2015年1-6月在山西省襄汾县选取女性志愿者,采集宫颈脱落细胞检测高危型HPV,分析感染率及其影响因素。结果调查对象高危型HPV总感染率为8.60%(172/2 000),感染率较高的5个HPV型别为HPV58(1.75%)、HPV16(1.50%)、HPV66(1.20%)、HPV52(1.00%)和HPV39(0.85%)。多重感染率最高的HPV型别为HPV39(0.50%)、HPV52(0.45%)、HPV16(0.45%)。Logistic回归分析显示,口交(OR=2.92,95%CI:1.11-7.63)、近5年性伴≥2名(OR=2.02,95%CI:1.14-3.55)、初次性生活年龄≤20岁(OR=1.51,95%CI:1.08-2.10是高危型HPV感染的影响因素;冲洗外阴间隔时间超过7d(OR=2.21,95%CI:1.07-4.57)是多重感染的危险因素。结论高危型HPV无症状感染以HPV58、HPV16、HPV66、HPV52和HPV39为主,主要与性行为方式和阴道卫生有关。     

深圳地区女性HPV阳性者多重型别感染情况分析

目的了解深圳地区参与子宫颈癌筛查的女性人乳头瘤病毒(human papillomavirus, HPV)多重感染情况。方法通过深圳市妇幼保健管理系统选取2014-2016年参加子宫颈癌筛查HPV阳性且接受HPV基因亚型检测者的信息。采用χ2检验比较不同人口学及筛查特征者HPV多重感染的差异,采用logistic回归模型进行HPV多重感染的相关因素分析。结果 10 624例女性HPV阳性者的年龄为(38.08±9.38)岁,其中多重感染2 319(21.8%)例。多重感染者中,纯高危型1 861(80.4%)例、高危-低危混合型426(18.4%)例、纯低危型29(1.3%)例。相对于其他人群,25岁及以下(χ2=44.73, P0.001)、职业为干部/职员(χ2=27.46, P=0.001)、未婚/离异/丧偶(χ2=9.34, P=0.009)、机会性筛查(χ2=6.45, P=0.04)、筛查年份为2014年者(χ2=18.13, P=0.001)纯高危型多重感染的比例较低,而高危-低危混合型或纯低危型多重感染的比例较高,差异有统计学意义。多因素logistic回归模型显示,发生HPV多重感染的概率较低的相关因素有:大于25岁年龄组(26～30岁:OR=0.68, 95%CI=0.56～0.82, 31～35岁:OR=0.67, 95%CI=0.56～0.81, 36～40岁:OR=0.56, 95%CI=0.46～0.69, 41～45岁:OR=0.61, 95%CI=0.49～0.75, 46～50岁:OR=0.63, 95%CI=0.50～0.79和≥51岁:OR=0.79, 95%CI=0.63～0.99)、拥有商业等其他保险(OR=0.42,95%CI=0.33～0.53)和筛查年份为2016年者(OR=0.75,,95%CI=0.67～0.84);发生HPV多重感染的概率较高的相关因素有:未婚/离异/丧偶(OR=1.47,95%CI=1.18～1.82)和机会性筛查者(OR=1.17,95%CI=1.01～1.34)。多重感染中最常见的5种HPV感染亚型均为高危型,依次是HPV52(25.1%)、HPV16(19.2%)、HPV58(13.3%)、HPV18(9.9%)和HPV51(9.3%)。结论 HPV52和HPV16是深圳地区女性HPV多重感染中最常见的优势型别。HPV多重感染特征与女性的社会人口学和筛查特征相关,应密切关注HPV纯高危型多重感染。     

HPV及阴道微环境对下生殖道多中心上皮内病变的交互作用研究

目的探讨人乳头瘤病毒(HPV)及阴道微环境失衡对下生殖道多中心上皮内病变的影响及交互作用分析。方法选取2021年1月至12月甘肃省妇幼保健院行阴道镜检查的HPV阳性且经病理组织学诊断为下生殖道多中心病变的296人为病例组,选取同期HPV阳性且组织病理学结果为慢性宫颈炎/宫颈息肉患者共343人为对照组。以多因素Logistic回归分析确定HPV及阴道微生态对下生殖道多中心病变的影响;以相乘模型分析细菌性阴道病(BV)与HPV对多中心病变的交互作用。结果HPV16/18型、多重HPV感染、持续HPV感染、BV感染均是发生下生殖道多中心病变的危险因素,其OR值及95%CI分别为1.361(1.132~1.637)、1.556(1.272~1.901)、2.046(1.673~2.503)、2.153(1.031~4.497);交互作用分析显示HPV16/18型阳性且BV阳性患者发生多中心病变风险升高(OR=3.529,95%CI:2.103~5.921),二者具备相乘交互作用(OR=1.755,95%CI:1.322~2.330);多重型别HPV感染且BV阳性者发生多中心病变风险升高(OR=3.767,95%CI:2.126~6.674),二者具备相乘交互作用(OR=1.558,95%CI:1.159~2.095);持续HPV感染且BV阳性者多中心病变风险升高(OR=6.050,95%CI:3.337~10.969),二者具备相乘交互作用(OR=1.885,95%CI:1.389~2.560)。结论HPV与阴道微环境对于下生殖道多中心病变具有交互作用影响,对于HPV阳性者应密切关注阴道微环境变化,对于细菌性阴道病应给予积极治疗。     

上海市虹口区妇女高危型人乳头瘤病毒感染及宫颈癌前病变情况分析

[目的]了解上海市虹口区普查妇女中高危型人乳头瘤病毒(HPV)的感染情况,并探讨其在宫颈癌前病变中的作用。[方法]对318例普查妇女行高危型HPV-DNA检测及病理检测。[结果]病理检查阴性者HPV感染率为10.8%(21/195),低度子宫颈病变者HPV感染率为25.0%(4/16),高度子宫颈病变者HPV感染率为81.8%(9/11)。HPV诊断宫颈癌前病变的灵敏度为48.1%,特异度为89.2%,阳性预测值为38.2%,阴性预测值为92.6%。[结论]HPV感染是宫颈癌及癌前病变的高危因素。HPV-DNA检测具有较高的阴性预测值,在宫颈癌筛查中具有重要作用。     

人乳头状瘤病毒基因分型在宫颈病变中的临床价值

目的了解人乳头状瘤病毒(HPV)分型在宫颈病变患者中的分布情况,分析不同型别的HPV感染与宫颈病变的关系。方法回顾2008年7月至2016年5月间,在乌海市妇幼保健院妇科就诊的符合入组条件的1 825例妇女,根据其宫颈活检组织学诊断结果分成3组:正常子宫颈组909例;低级别鳞状上皮内病变(LSIL)组668例;高级别鳞状上皮内病变(HSIL)及以上病变组248例。比较3组间HPV感染、亚型分布、多重感染的差异,分析HPV基因分型结果在高级别鳞状上皮内病变及以上病变的作用。结果与正常子宫颈组比较,年龄是LSIL、HSIL及以上病变的保护因素,OR值为分别为0.951(P=0.000)、0.981(P=0.014)。与LSIL组比较,年龄是HSIL及以上病变患病的危险因素,OR值为1.033(P=0.000)。HPV感染是HSIL及以上病变患病的危险因素,HSIL及以上病变组与正常子宫颈组比较,HPV感染的OR值52.672(P=0.000),HSIL及以上病变组与LSIL组比较HPV感染的OR值为10.038(P=0.000)。与正常子宫颈组比较,HPV6、HPV11、HPV51是LSIL的危险因素(OR值分别为11.041、7.665、2.590,P<0.05);与LSIL组比较,HPV6、HPV11、HPV51是HSIL及以上病变患病的保护因素(OR值分别为0.083、0.342、0.660,P<0.05)。HPV16、HPV58、HPV31与HSIL及以上病变患病高风险有关(与正常子宫颈组比较,OR值分别为26.990、6.135、3.315,与LSIL组比较,OR值分别为7.937、2.264、2.426,P<0.05);除此外,HPV59、HPV33、HPV18也与HSIL及以上病变患病高风险有关(与正常子宫颈组比较,OR值分别为3.342、3.178、2.634,P<0.05);此6种亚型除HPV31外均与LSIL的患病高风险有关(P<0.05)。结论 HPV基因分型结果可以预测患HSIL及以上病变的风险,有助于宫颈病变患者的分层管理,具有较高的临床应用价值。     

2009年海阳市部分乡镇医院妇科门诊农村妇女高危型人乳头状瘤病毒DNA检测与细胞学联合检查情况调查

目的 探讨2009年山东省海阳市部分妇科门诊农村妇女高危型人乳头状瘤病毒(human papilloma virus,HPV)感染现状及细胞学联合检查的临床意义.方法 选择2009年1月至12月,在山东省海阳市8家乡镇医院妇科门诊接受第二代杂交捕获试验(hybrid captureⅡ,HC-Ⅱ)检测高危型HPVDNA和新柏液基薄层细胞学检查(Thin-prep cytology test,TCT)的4267例农村妇女(受检者)为研究对象.宫颈细胞病理学诊断标准,采用2001年国际癌症协会推m的TBS(the 2001 Bethesda system)分级标准进行细胞学诊断.检查数据经审核后进行统计学分析(本研究遵循的程序符合实施检查医院人体试验委员会所制定的伦理学标准.得到该委员会批准,征得受试对象本人的知情同意,并与之签署临床研究知情同意书).结果 ①总高危型HPV DNA阳性感染率为21.47%(916/4267).患者年龄为19～74岁.其中,20～29岁和30～39岁组的高危型HPV DNA阳性感染率最高,为26.68%和27.22%,分别与本组总高危型HPV DNA阳性率比较.差异有显著意义(x2=27.85,P＜0.01;x2=16.69,P＜0.01).其中,单一高危型HPV DNA亚型感染率为62.82 0A(575/916),高危型HPV DNA多重亚型感染率为37.18%(341/916),两者比较.差异有显著意义(x2=56.53,P＜0.01).高危型HPV DNA多重亚型感染中,一般以2及3种亚型感染多见,分别为29.42%(100/341)和25.22%(86/341).其余为4,5及6种亚型混合感染.本组感染率最高的HPV亚型分别为HPV-16,-58,-33和-18,分别为33.78%(309/916),17.15%(157/916),11.29%(103/916)和10.75%(98/916).②细胞学检测结果:无宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)为2613例(61.24%,2613/4267);未明确诊断意义的不典型鳞状上皮细胞(atypicalsquamous cells of undetermined signIficance/glandular cells,ASCUS)为906例(21.23%,906/4267),低度鳞状上皮细胞内病变(low-grade intraepithelial lesion,LSIL)为494例(11.57%,494/4267),高度鳞状上皮内病变(high-grade intraepithelial lesion,HSIL,HSIL)为237例(5.55%,237/4267),宫颈鳞状细胞癌(squamous cell carcinoma,SCC)为17例(0.41%,17/4267).结论 海阳市8家乡镇医院妇科门诊农村妇女高危型HPV DNA感染率高,未明确诊断意义的不典型鳞状上皮细胞、低度鳞状上皮细胞内病变、高度鳞状上皮内病变等细胞学榆查结果明显高于国内筛查数据.应对高危型人乳头瘤病毒感染者及宫颈细胞学异常者定期随访以了解其动态变化.     

西安市1650例已婚妇女宫颈细胞HPV感染调查分析

目的 调查西安市25～65岁已婚妇女宫颈细胞人乳头瘤病毒(HPV)感染状况以及HPV亚型感染状况与液基细胞学检查结果的关系.方法 收集2009年4月至2011年10月正常体检宫颈脱落细胞标本1 650例,进行宫颈脱落细胞液基细胞学检查及HPV PCR反向斑点杂交基因分型检测.结果 HPV总感染率为8.79%(145/1 650),其中单一感染构成比为38.62%(56/145),双重感染构成比为24.83%(36/145),三重及以上感染构成比为36.55%(53/145).HPV亚型分布中以16型感染最多,占4.48%,其次为58型2.18%、35型1.39%、18型1.09%、6型1.03%.HPV感染阳性患者液基细胞学检查结果异常率高于HPV阴性感染人群,差异具有统计学意义(χ2=295.92,P<0.01).46～55岁年龄组感染率明显高于25～35及36～45年龄组,差异均具有统计学意义(χ2=12.60,P<0.01;χ2=3.67,P<0.05),与56～65年龄组比较差异无统计学差异(χ2=1.30,P>0.05),并且46～55岁年龄组多重感染率高于其他年龄组.结论 本地区HPV感染率为8.79%,以16型、58型、35型、18型、6型为主,46～55岁年龄组感染率高于其他年龄组,并存在以HPV16型为主多重感染的情况.宫颈炎症与HPV感染具有一定的相关性,预防宫颈癌发生的首要任务是控制感染.     

子宫颈卷曲乳酸杆菌相对丰度与HPV感染和子宫颈病变的关联性

目的 探究子宫颈卷曲乳酸杆菌相对丰度与人类乳头瘤病毒(HPV)感染和子宫颈病变的关联性。方法选取2017年1月-2020年1月台州市立医院妇科收治的228例宫颈病变患者作为研究对象,经病理学证实低度鳞状上皮内病变(LSIL)100例,高度鳞状上皮内病变(HSIL)88例,宫颈鳞癌40例,同期健康女性60名作为对照组。对所有研究对象进行取样和HPV检测。绘制受试者工作特征(ROC)曲线分析卷曲乳酸杆菌相对丰度在HPV感染以及宫颈病变中诊断评估价值。结果 各组HPV感染率比较差异有统计学意义(χ²=64.236,P<0.001),宫颈癌组的HPV感染率高于HSIL组(χ²=8.376,P=0.003),LSIL组高于对照组(χ²=38.751,P<0.001);HSIL组与LSIL组比较无统计学差异(χ²=0.040,P=0.527)。139例HR-HPV感染患者中,95例为16型,43例为18型,1例为16型混合18型。ROC曲线结果,卷曲乳酸杆菌相对丰度在预测HPV和子宫颈病变中的灵敏度...     

宫颈病变患者人乳头状瘤病毒感染调查分析

目的对宫颈病变患者人乳头状瘤病毒(HPV)感染调查分析,为预防宫颈病变患者病情进一步恶化提供指导。方法选择在医院妇产科住院的165例宫颈疾病患者,其中包含44例宫颈癌患者、56例宫颈上皮内瘤变和65例宫颈炎/宫颈尖锐湿疣,使用导流杂交基本芯片技术对送检的标本进行HPV亚型分析检测。结果 165例宫颈病变患者中发生HPV感染116例,感染率为70.3%,其中,宫颈炎/尖锐湿疣患者有31例高危型HPV感染,感染率为47.7%,10例低危型HPV感染,感染率为15.4%;宫颈上皮内瘤变患者高危型HPV感染有35例,感染率为62.5%,低危型HPV感染4例,感染率为7.1%;宫颈癌患者中高危型HPV感染有36例,感染率为81.8%,未发现低危型HPV感染;不同宫颈病变患者高危型、低危型HPV感染率差异有统计学意义(P<0.05);宫颈炎/尖锐湿疣患者中有单一感染39例,感染率60.0%,多重感染8例感染率12.3%,宫颈上皮内瘤变患者中单一感染有31例感染率55.4%,多重感染9例感染率16.1%,宫颈癌患者中有单一感染29例感染率65.9%,多重感染7例感染率15.9%。结论宫颈病变与高危型的HPV多重感染密切相关,在治疗时要根据宫颈病变患者HPV感染亚型检测结果,及时防治宫颈癌变。     

Contraceptive and reproductive risk factors for cervical intraepithelial neoplasia in American Indian women

OBJECTIVES: To evaluate contraceptive and reproductive risk factors for cervical intraepithelial neoplasia (CIN) in southwestern American Indian women. METHODS: We conducted a clinic-based case-control study. Cases were American Indian women with biopsy-proven CIN I, CIN II or CIN III. Controls were from the same clinics and had normal cervical epithelium. All subjects underwent structured interviews focused on contraceptive and reproductive factors. Laboratory assays included polymerase chain reaction (PCR)-based tests for cervical human papillomavirus (HPV) infection. RESULTS: We enrolled 628 women in the study. The strongest risk factors for CIN II/III included HPV infection (adjusted odds ratio [OR] = 7.9, 95% CI : 4.7-13.2), and low income (OR = 3.1, 95% CI : 1.7-5.7). The use of an intrauterine device (IUD) ever (OR = 3.0, 95% CI : 1.4-6.1) and currently (OR = 4.1, 95% CI : 1.1-14.6), and > or = 3 vaginal deliveries (OR = 5.2, 95% CI : 2.4-11.1) were associated with CIN II/III. History of infertility was also associated with CIN II/III (OR = 2.1, 95% CI : 1.0-4.2). CONCLUSIONS: The data suggest that history of infertility, IUD use and vaginal deliveries were associated with CIN among American Indian women.     

Serum micronutrients and cervical dysplasia in Southwestern American Indian women

We carried out a clinic-based case-control study to assess serum micronutrients as risk factors for cervical dysplasia among Southwestern American Indian women, a group with high rates of cervical preinvasive lesions. Cases were American Indian women with biopsy-proven cervical intraepithelial neoplasia (CIN I or CIN II/III). Controls were from the same Indian Health Service clinics with normal cervical epithelium. We interviewed women about histories of sexually transmitted diseases, sexual behavior, diet, hygienic practices, cigarette smoking, and reproductive factors. Laboratory assays included serum for retinol (vitamin A), ascorbic acid (vitamin C), alpha-tocopherol (vitamin E), and red blood cell folate levels, DNA for human papillomavirus (HPV) typing, and tests for other sexually transmitted diseases. The strongest risks for cervical dysplasia were associated with cervical HPV infection [odds ratio (OR) = 3.2, 95% confidence interval (CI) = 2.2-4.6 and OR = 7.9, 95% CI = 4.8-13.1 for CIN I and CIN II/III, respectively]. With adjustments made for HPV infection and other relevant confounders, subjects in the lowest serum retinol quartile were at increased risk of CIN I compared with women in the highest quartile (OR = 2.3, 95% CI = 1.3-4.1). The data suggest that low serum alpha-tocopherol was associated with CIN I/III, although the adjusted OR was not statistically significant (OR = 2.0, 95% CI = 0.9-4.8). Low serum ascorbic acid and red blood cell folate were not associated with cervical dysplasia.     

Human papillomavirus type 18/16 infection and prevalence among middle-aged and older Chinese rural women: a cross-sectional survey in Wufeng,Hubei Province

This study aimed to measure the prevalence and potential factors related to HPV 16/18 infection among middle-aged and older Chinese rural women. The study was conducted among women aged 35–65 years in rural villages within Wufeng in Hubei Province. Data were collected using a pretested questionnaire between July and August 2015. Cervical specimens were collected for HPV DNA detection and typing by using careHPV. Pearson’s Chi-square and logistic regression analyses were used to examine associations with HPV positivity. Among 1001 participants, the prevalence of HPV 18/16 positive genotyping was 15.88% (n = 159). Husbands’ extramarital sex (adjusted odds ratio [OR] = 15.85, 95% confidence interval [CI] 5.76–43.59), cervicitis (adjusted OR = 9.27, 95% CI 5.06–16.99), condom usage (adjusted OR = 0.16, 95% CI 0.05–0.53), higher average number of live births (adjusted OR = 1.98, 95% CI 1.32–2.96 for two live births; adjusted OR = 3.29, 95% CI 1.39–7.81 for three or more live births) were associated with HPV infection. The prevalence of HPV infection among participating women from rural areas was higher than that in several other areas in China. Our findings can aid efforts to prevent HPV infection to lower the risk of cervical cancer.     

Human papillomavirus infection among human immunodeficiency virus-infected women in Maharashtra,India

Introduction

Frequency and distribution of HPV types in HIV-infected women with and without cervical neoplasia and their determinants have not been widely studied in India. We report and discuss HPV prevalence and type distribution in HIV-infected women.

Methods

HPV genotyping was done using cervical samples from 1109 HIV-infected women in a cross-sectional study.

Results

Any HPV was detected in 44.8% and high-risk ones in 41.0% women. Frequency of single and multiple high-risk infections were 26.7% and 14.3%, respectively. Frequencies of high-risk HPV infections in women with and without cervical neoplasia were 73.5% and 37.6%, respectively. HPV16 was the most common genotype, present in 11.5%, and 58.5% of women with cervical intraepithelial neoplasia (CIN) 2 and 3. Other most common high-risk HPV types in CIN 2–3 lesions were HPV 31 (22.6%); 56 (13.2%); 18 and 68a (11.3%) and 33, 35 and 51 (9.4%); and 70 (7.5%). Women under 30 or over 44 years, no abortions, and women with diagnosis of HIV infection within the last 5 years were at high risk of multiple oncogenic HPV infection.

Conclusion

We observed a very high frequency of high-risk HPV and multiple infections in HIV-infected women.     

修水地区人乳头瘤病毒感染与宫颈癌的研究

目的:调查妇女生殖道高危型人乳头瘤病毒(Human papillomavirus,HPV)感染状况,研究高危型HPV感染与宫颈癌及癌前病变的关系。方法:应用第二代杂交捕获(hybrid capture,HC-Ⅱ)实验对30~49岁的已婚妇女进行高危型HPV DNA检测,采用多因素的非条件Logistic回归模型分析HPV感染与宫颈癌及宫颈上皮内病变(CIN)的关系。结果:调查人群高危型HPV DNA总检出率为18.7%,与正常组相比检出率随病变程度加重呈趋势性增高(χ2=444.04,P<0.001)。各年龄组宫颈HPV DNA的检出率几乎一样,无显著性差异(χ2=10.25,P>0.001)。非条件Logistic回归分析显示,HPV感染与宫颈上皮内高度病变(CINⅡ)及癌症的发生高度相关(OR=121.1)。结论:生殖道高危型HPV感染是当地宫颈癌及宫颈上皮内瘤变流行的主要危险因素,提示宫颈癌的防治重点应放在防止HPV感染、对HPV感染的筛查和密切监测已感染高危型HPV的对象。     

Cervical papillomavirus infection and cervical dysplasia in Hispanic, Native American, and non-Hispanic white women in New Mexico.

BACKGROUND: Human papillomavirus infections of the cervix are found with varying frequencies in different populations worldwide, and have been associated with cervical cytologic abnormalities. METHODS: We studied 1,603 randomly selected Hispanic, Native American, and non-Hispanic White women in New Mexico to determine the prevalence of cervical HPV infection in these ethnic groups, and its association with Pap smear abnormalities, using a new commercial dot-blot hybridization assay. RESULTS: Nine percent of all women screened had evidence of cervical HPV infection (13.7% of non-Hispanic White women, 9.7% of Hispanics, and 6.6% of Native American women). Prevalence was higher in younger women ages 14-19 years than in older age groups. Over half of women with cervical HPV infection (n = 145) had normal Pap smears. The proportion of infected women increased among those with more advanced cytopathologic abnormalities; 5.6 percent with normal Pap smears had cervical HPV vs 66.7 percent with moderate-severe dysplasia. CONCLUSIONS: Cervical HPV infection is common among New Mexico clinic attendees, varies in prevalence among the three major ethnic groups, and is strongly associated with cervical cytopathologic abnormalities.     

北京社区妇女生殖道人乳头瘤病毒感染及子宫颈上皮内瘤变流行病学调查

目的探讨北京市社区妇女中高危型人乳头瘤病毒（HPV）感染及子宫颈上皮内瘤变（CIN）状况。方法2006年6月至2007年6月对北京市展览路社区的795名20～54岁有性生活妇女进行筛查。筛查对象接受妇科检查时，依次留取超柏氏薄层液基细胞学（LCT）和高危型HPV（he2）检测标本，并对宫颈细胞学异常者行阴道镜检查及活检。结果795名社区妇女中高危型HPV感染阳性112例，占14．1％；阴性683例，占85．9％。高危型HPV感染率随宫颈病变加重，阳性率升高：正常宫颈及慢性宫颈炎人群为0．8％（6／751）；CINl为83．3％（10／12），CIN2及以上为100％（8／8）；宫颈细胞学阳性并行阴道镜活检的40例中，发现11例慢性宫颈炎、14例宫颈湿疣、5例CINl、3例CIN2、4例CIN3及1例早期浸润癌；细胞学阴性的750人中，发现2例宫颈湿疣、5例CINl及1例宫颈低级别腺上皮内病变（CGIN）。750人中HPV阴性为669人，其中发现3例CINl及1例CGIN；HPV阳性为81例，其中2例CINl及2例宫颈湿疣。在细胞学阳性（≥ASCUS）的40例中，HPV阴性为13例，其中发现10例慢性宫颈炎及3例宫颈湿疣；HPV阳性为27例，发现1例慢性宫颈炎、11例宫颈湿疣、7例CINl、3例CIN2、4例CIN3及1例早期浸润癌，对宫颈病变的检出率后两者相比差异有统计学意义（P〈0．001）。结论北京市社区妇女中高危型HPV感染率随子宫颈上皮内瘤变加重，阳性率升高。     

Prevalence and determinants of high-risk human papillomavirus (HPV) infection and cervical cytological abnormalities in imprisoned women

The aim of the study was to estimate the prevalence and risk factors associated with infection by high-risk human papillomavirus (HR-HPV) in cervix and squamous intra-epithelial lesions (SIL) in imprisoned women. This was done by a cross-sectional study of imprisoned women attending the gynaecological clinic in Foncalent prison in Alicante, Spain. The study period was from May 2003 to December 2005. HR-HPV infection was determined through Digene HPV Test, Hybrid Capture II (HC-II). HPV typing was determined by multiplex nested PCR assay combining degenerate E6/E7 consensus primers. Multiple logistic regression modelling was used for the analysis of associations between variables where some were considered possible confounders after checking for interactions. A total of 219 women were studied. HR-HPV prevalence was 27.4% and prevalence of SIL was 13.3%. HIV prevalence was 18%, higher in Spaniards than in migrant women (24.6% vs. 14.3%, P<0.05). In multivariate analyses, risk factors for HPV infection were younger age (P for trend=0.001) and tobacco use (OR 2.62, 95% CI 1.01-6.73). HPV infection (OR 4.8, 95% CI 1.7-13.8) and HIV infection were associated with SIL (OR 4.8, 95% CI 1.6-14.1). The commonest HPV types were HPV16 (29.4%), HPV18 (17.6%), HPV39 (17.6%) and HPV68 (17.6%). The prevalence of both HR-HPV infection and SIL in imprisoned women found in this study is high. Determinants for each of the outcomes studied were different. HPV infection is the most important determinant for SIL. A strong effect of HIV co-infection on the prevalence of SIL has been detected. Our findings reinforce the need to support gynaecological clinics in the prison setting.