坚持使用安全套可减少男性HPV感染

据路透社《健康新闻报》道,一项新的研究发现,男士在每次性生活时使用安全套,其感染人类乳头状瘤病毒（HPV）的机会比不经常使用者要小。HPV是引起人类生殖器疣的祸首。     

甘肃省妇女宫颈HPV感染的流行病学特征

目的:了解甘肃地区健康妇女宫颈人乳头瘤病毒(human papillomavirus,HPV)感染的流行病学特征,探讨人乳头瘤病毒HPV的型别与病理分级的关系。方法:选择2009年5~8月在甘肃省妇幼保健院妇科门诊行宫颈HPV分型检测的576例患者为研究对象,采用核酸分子快速导流杂交基因芯片技术(Hybrimax)对所有患者宫颈脱落细胞进行HPV分型,随后进行阴道镜检查、宫颈多点活检和宫颈管诊刮术,以病理学诊断为金标准。结果:576例患者中,HPV阳性率19.44%,高危型占73.21%。不同宫颈病变中常见的HPV亚型(检出率>10.0%)从高到低依次为HPV16(26.12%)、HPV58(15.67%)、HPV52(10.45%)。不同病理分级中HPV型别不同,宫颈癌中依次为HPV16、18、31;CINⅡ及CINⅢ中依次为HPV16、58、31、33、66;CINⅠ中依次为HPV16、58、52、33、39、6、11、68、cp8304。对于病理诊断≥CINⅡ者,HPV分型检测的敏感度为79.31%,特异度为87.26%,阳性预测值为41.07%,阴性预测值为97.41%。结论:HPV基因分型检测,可1次检测多种亚型,了解HPV型别分布的地域性差异,对于研制适宜甘肃省妇女的特异性HPV疫苗有指导意义,且有利于宫颈病变的分级、分型及指导个体化治疗。     

反向点杂交法测定浙江省4620例男性HPV感染者的流行病学特征

目的调查浙江省男性人乳头瘤病毒(human papilloma virus,HPV)感染的亚型分布及流行病学特点,为男性HPV感染早期筛查、预防、诊断提供依据。 方法回顾性汇总分析2014年1月至2016年12月期间,浙江省17~74岁的4620名男性尖锐湿疣皮损拭子或组织标本;4620例样本中,其中120份因细胞量不足判定采样失败,剩余4500例样本按不同年龄分为6组(17~20岁组268名、21~30岁组1958名、31~40岁组1156名、41~50岁组667名、51~60岁组355名、>60岁组96名)。用聚合酶链反应(polymerase chain reaction, PCR)和反向点杂交法测定23种HPV基因型,并分析其HPV阳性率分布、HPV阳性率差异和高低危型HPV感染特征。 结果4500例样本中有2799例HPV阳性,总阳性率为62.2%,其中：以6型和11型阳性率最高,分别为15.58%(436/2799例)和10.00%(280/2799例)。高危型阳性率最高的为52型,占4.72% (132/2799例)。在2799例HPV DNA阳性者中,有1266例为单一感染;混合感染1533例,占44.26%,单纯低危型最高为三重感染,单纯高危型最高为四重感染,而高低危混合感染达七重,其中七重感染占2.25%(63/2799例)。高低危混合感染数高于单纯高危型和单纯低危型,两者比较有统计学差异(χ²分别为28.1、82.8,P均<0.05)。HPV阳性结果以21~40岁青壮年为主,占总人数的69.2% (3114/4500)。而HPV阳性率以17~20岁组(75.0%)和51~60岁组(79.7%)最高,与其他年龄段[21~30岁(60.7%)、31~40岁(59.1%)、41~50岁(59.6%)和>60岁(46.4%)组]相比χ²分别为20.48、22.51、18.86、26.02和46.03、48.89、40.99、41.84,P均<0.05。 结论浙江地区男性HPV感染者主要以6、11型为主,高发于青壮年,HPV混合感染比例较高,高低危混合感染较常见。     

乌鲁木齐市男男性行为者艾滋病新发感染分析

摘要:目的 了解新疆乌鲁木齐市男男性行为(MSM)人群HIV新发感染率,确定今后艾滋病防治工作重点。方法 将乌鲁木齐市艾滋病哨点监测MSM人群4 403例样本纳入研究,用ELISA方法对所有研究对象样本进行HIV初筛,初筛阳性者用免疫印迹方法进行确认,符合条件的HIV阳性血清还接受HIV-1 BED捕获酶联法(BED方法)检测,估算该人群连续2012-2015年的新发感染率;对不同人口学特征的新发感染率进行分层分析;掌握安全套的使用情况。结果 2012-2015年乌鲁木齐市HIV新发感染率分别为2.20%、2.54%、4.36%、5.43%,平均3.72%(95%CI:3.11%~4.32%);多因素分析显示已婚的、艾滋病知识知晓率低的HIV新发感染率高。安全套的使用率普遍较低。结论 乌鲁木齐市MSM人群艾滋病流行处于上升阶段,安全套使用率低,应采取有效的干预措施加以控制。     

中国HPV感染面临的问题与挑战

人乳头状瘤病毒（HPV）感染已成为全球女性最严重的疾病负担之一,其不仅可以引起常见的性传播疾病,还与生殖道肿瘤密切相关。尤其是高危型HPV,是导致宫颈癌的最主要因素。虽然HPV感染与宫颈癌的临床研究已成为近十余年的研究热点,但我国有关HPV感染的流行病学、高危型HPV检测在我国宫颈癌筛查中的作用和地位、如何阻断高危型HPV的持续性感染以及HPV疫苗在中国的应用等方面还存在诸多问题与挑战。     

广州市初中生家长对HPV疫苗接种的态度及影响因素调查

目的 调查广州市初中生家长对其子女接种人乳头瘤病毒(human papilloma virus,HPV)预防性疫苗的接受情况,探讨其影响因素,发现HPV预防性疫苗广泛应用的潜在障碍并提出解决办法,为提高公众对HPV预防性疫苗的知晓、接受程度和宫颈癌的预防提供参考依据.方法 对广州市542名初一学生家长进行自填式问卷调查,获得家长对其子女HPV预防性疫苗接种的态度,并通过单因素和多因素非条件Logistic回归分析,探索影响接种意愿的因素.结果 在接受调查的家长中,32.1％在本次调查前听说过HPV,22.9％听说过HPV预防性疫苗,26.7％愿意让子女接受疫苗,疫苗的安全性是不愿接种疫苗的主要原因,大多数家长赞成HPV预防性疫苗在国内广泛应用,希望政府能将其纳入国家免疫接种计划,并进行适当的价格调控和补贴.高收入、认为预防比治疗更重要、认识到疫苗的重要性、主动咨询疫苗信息、对HPV疫苗认知程度高和担心得HPV感染相关疾病的家长更愿意让其子女接受疫苗,担心疫苗副作用的家长则反之.结论 广州市初中生家长对于HPV和HPV预防性疫苗的认知度、对其子女接种HPV预防性疫苗的接受度都低.政府需要根据不同人群背景,加大对HPV相关疾病和HPV预防性疫苗的宣传,制定适应我国国情的HPV疫苗接种政策.     

高危型HPV在宫颈癌发生中的作用

本文利用PCR技术检测了44例宫颈癌患者和15例慢性宫颈炎患者病变组织中高危型HPV（16，18，31，33）的感染率，发现44例宫颈癌患者高危型HPV的阳性率高达91％（40／44），其中HPV16型感染率54．55％（24／44），HPV18型感染率18．2％（8／44），HPV31型感染率13．6％（6／44），HPV33型感染率4．55％（2／44）；15例慢性宫颈炎患者有2例感染HPV16型。结果提示HPV16型是宫颈癌发生最常见的基因型，其次为HPV18型和HPV31型，故对育龄妇女定期进行高危型HPV感染的普查，在早期预防宫颈癌的发生具有十分重要的意义；联合采用分子生物学和宫颈脱落细胞学技术进行即定期普查，既能提高阳性率，又能对感染高危型HPV的慢性宫颈炎患者进行早期的有效预防。     

我国女性人乳头瘤病毒(HPV)感染的流行病学现状

宫颈癌给我国乃至全世界都造成了沉重的社会经济负担,人乳头瘤病毒（human papilloma virus,HPV）尤其是高危型HPV与宫颈癌前病变和宫颈癌密切相关,HPV疫苗的出现无疑给广大女性带来了福音。目前多个国家已经开展了HPV的疫苗免疫计划,我国大陆虽然刚刚批准了二价的HPV疫苗在国内使用,但仍缺乏系统的HPV感染的流行数据,因而本文就我国女性HPV感染的流行病学状况作一综述,旨在为HPV疫苗的研发和应用及宫颈癌防治工作提供指导。     

北京市男男性行为人群艾滋病病毒和人乳头瘤病毒感染状况分析

本研究旨在探讨北京市男男性行为人群人类免疫缺陷病毒(HIV)和人乳头瘤病毒(HPV)感染状况,并分析影响因素。2011年6月到2012年8月,通过滚雪球抽样的方法招募男男性行为者(MSM),进行问卷调查,并进行HIV血清学抗体和HPV病原学(DNA分型)检测。本研究共调查302名MSM,HIV感染率为5.30%,HPV感染率为67.88%。HIV感染的主要影响因素是户籍(P=0.0132),HPV感染的主要影响因素有户籍(P=0.0214)、主动肛交安全套使用频率(P=0.0290)、被动肛交安全套使用频率(P=0.0023)。应有针对性地加强对外地务工人员的宣传教育,并通过发放安全套等措施降低HIV和HPV的感染。     

莱姆病的流行病学研究进展

摘要:莱姆病是由伯氏疏螺旋体感染而引起的人畜共患传染病,是最常见的蜱传疾病之一。莱姆病螺旋体分布广泛,全球五大洲70多个国家已有报道。作为一种自然疫源性疾病,其流行受病原、蜱、自然与社会等多种因素影响。目前全球莱姆病防控形势较为严峻,未能实现有效的源头防控。本文将结合国内外莱姆病研究进展对其流行现状、流行影响因素和防控现状加以概述。     

HPV infections among young MSM visiting sexual health centers in the Netherlands: Opportunities for targeted HPV vaccination

IntroductionIn 2009, girls-only HPV16/18 vaccination was introduced in the Netherlands which has achieved 46–61% uptake. Heterosexual men have benefitted from herd protection, but it is unknown whether men who have sex with men (MSM) also benefit from herd effects of the girls-only HPV16/18 vaccination program. Because MSM bear a high HPV-related disease burden, countries might consider targeted vaccination for MSM. To study possible herd effects and prior HPV exposure at a potential moment of vaccination, we assessed trends in the HPV prevalence and proportions (sero)negative for the various vaccine types among young MSM visiting sexual health centers (SHCs).MethodsWe used data from MSM included in PASSYON study years 2009–2017. In this biennial cross-sectional study among visitors of SHCs aged 16–24 years, MSM provided a penile and anal swab for HPV DNA testing (including vaccine types HPV6/11/16/18/31/33/45/52/58) and blood for HPV antibody testing (HPV16/18/31/33/45/52/58).ResultsIn total 575 MSM were included, with a median of 22 years of age and 15 lifetime sex partners and 3.5% HIV positive. Trends in penile or anal HPV prevalence during 2009–2017 were statistically non-significant for all vaccine types. Of the 455 MSM with a penile and anal swab, 360 (79%), 283 (62%) and 242 (53%) were HPV DNA negative at both anatomical sites for HPV16/18, HPV6/11/16/18 and HPV6/11/16/18/31/33/45/52/58 respectively. Among MSM who were HPV16/18 and HPV16/18/31/33/45/52/58 DNA negative and were tested for serology (n = 335 and 279 respectively), 82% and 71% were also seronegative for the respective types.DiscussionThere were no significant declines in the HPV prevalence among MSM up to eight years after introduction of girls-only HPV16/18 vaccination, indicating that MSM are unlikely to benefit largely from herd effects from girls-only vaccination. Most MSM were vaccine-type DNA negative and seronegative, suggesting that vaccination of young MSM visiting SHCs could still be beneficial.     

Completion of the human papillomavirus (HPV) vaccine series among males with private insurance between 2006 and 2009

Little is known about initiation and completion among males who received the HPV vaccine on an off-label basis before 2009. This study utilized administrative claims data from a private insurance company to examine completion of the 3 dose HPV series among 514 males who initiated the vaccine between 2006 and May of 2009. Frequencies of HPV vaccination were examined and multivariate logistic regression estimated the odds of completing the entire series within 365 days of initiation. We found that only 21% of male initiators completed all 3 vaccine doses within 12 months and completion decreased over time. Series completion did not vary significantly by provider type. These findings suggest that difficulties may be encountered in fully vaccinating enough males to achieve adequate herd immunity in the future.     

人乳头瘤病毒感染与男性不育的研究进展

目的 为了分析评价男性人乳头瘤病毒( HPV) 感染与男性生殖健康的关系。 方法 以“HPV和男性”为关键词检索PubMed、Embase、OVID 、中国期刊全文数据库(CNKI) 、万方科技期刊全文数据库、重庆维普(VIP) 中关于我国男性HPV感染与生殖健康相关研究文献,就男性HPV感染的流行病学以及对精液质量、男性不育、胚胎发育等方面进行综述。 结果 研究显示男性HPV感染不仅影响自身的生殖健康,同时也对其女性伴侣增加了疾病隐患;而且男性HPV感染可能对精液质量带来负面的影响,甚至成为影响男性不育和早期胚胎发育的风险因素;近年来研究也发现男性HPV感染可能影响辅助生殖的结局。 结论 目前关于HPV感染对男性生殖健康和男性不育的影响正在越来越受到人们的关注与重视。     

HPV vaccine awareness and the association of trust in cancer information from physicians among males

IntroductionBlack and Hispanic men are diagnosed with more HPV-related cancers and at later stages compared to other racial/ethnic groups. Physician communication with men about HPV vaccination may be beneficial to increasing HPV vaccinations and decreasing HPV transmission. The purpose of this study was to examine HPV and HPV vaccine awareness among men by race, and the association between trust in cancer information from physicians and ever hearing about HPV and the HPV vaccine.MethodsU.S. adult males (age 18+) were identified from the 2014 Health Information National Trends Survey (HINTS) (n = 1203). Binomial logistic regression models assessed the influences of race/ethnicity and trust of cancer information from physicians on men having heard of HPV and the HPV vaccination.ResultsApproximately 50% of the sample had never heard of HPV and 53% had never heard of the vaccine. Black men were less likely to know that HPV is sexually transmitted compared to White and Hispanic men (p < 0.001). Hispanic and Black men were less likely to have heard about the HPV vaccine when compared to White men (p < 0.001). Additionally, Hispanic men were less likely to trust a doctor about cancer information compared to White and Black men (p < 0.001).ConclusionFindings highlight the lack of awareness about HPV among men. Furthermore, statistically significant racial/ethnic differences were found in HPV vaccine knowledge and trust in receiving cancer information from physicians. Future interventions should include community-based approaches and improved physicians’ HPV-related communication to increase knowledge and uptake of the HPV vaccine.     

西安非医学专业女大学生对HPV和HPV疫苗的认知

目的 了解西安市高校非医学专业女大学生对人乳头瘤病毒(HPV)的认知情况及其对接种HPV疫苗的态度,为制定针对非医学专业大学生健康教育模式,推广HPV疫苗的接种提供依据.方法 采用整群随机抽样的方法,在西安市6所非医学类本科高校中抽取16个专业的大学二、三年级女大学生共2 131名,用自行设计的问卷进行调查,获有效问卷2 096份,有效回收率为98.4％.结果 仅11.3％被调查者知晓HPV,有性生活组大学生对HPV知晓率显著高于无性生活组(x2=20.182,P＜0.05),来自单亲或重组家庭的女大学生对HPV知晓率显著高于来自原生家庭组(x2=4.329,P＜0.05).不同年级间(x2=0.921),来自城市或农村(x2=0.891),是否独生子女(x2 =0.330)组间对HPV知晓率差异无统计学意义(P＞0.05).仅9.7％被调查者知晓HPV疫苗.79.9％的被调查者表示愿意接种HPV疫苗;担心会感染HPV (44.1％)或患宫颈癌(19.3％)的被调查者有较强的接种意愿;公众健康教育(42.2％)及医务人员推荐(34.7％)是女大学生们更愿意接受的疫苗推荐方式.超过半数被调查者(50.1％)能够接受的疫苗价格在50～ 100元.结论 西安非医学专业大学生对HPV及HPV疫苗的知晓率低,但接种意愿强.应加强科普健康教育,普及宫颈癌一级预防、HPV及HPV疫苗相关知识.     

Knowledge and attitudes about human papillomavirus (HPV) and HPV vaccines among women living in metropolitan and rural regions of China

Infection with the human papillomavirus (HPV) is one of the most common sexually transmitted infections and causes virtually all cervical cancer globally. The recent development of two safe and clinically effective vaccines against HPV is a promising step towards lowering cervical cancer rates in the future. What Chinese women think about HPV and the vaccines remains unknown. We undertook a population-based survey, which was embedded in a cervical cancer screening project and was designed to assess women's knowledge about HPV and their acceptability to the vaccines. We found that only 15.0% of women in our study reported to have ever heard of HPV, and this knowledge differs by rural (9.3%) and metropolitan areas (21.6%) and also by education. Most (84.6%) participants were willing to be vaccinated if HPV vaccine became available to them. The present study documents ways in which women learn about HPV and indicates the potential barriers and success of introducing HPV vaccine to China.     

广东省流动人口育龄妇女HPV感染状况调查

目的:对广东省流动育龄妇女进行人乳头瘤病毒(HPV)筛查,为宫颈癌的预防提供依据。方法:应用SELDI-TOF-MS技术对人群进行HPV筛查,并检测16种HPV分型以及分析该群体的年龄、职业、教育程度和性生活史与感染率的关联性。结果:筛查26 766例人群中HPV感染率为6.77%。在各不同的分组中≥55岁组感染率最高(13.29%,P<0.05);商业/服务业组的感染率最高(5.72%,P<0.05);本科组的感染率最高(15.70%,P<0.05);性生活年限高于30年的感染率比其他组别都要高(11.90%,P<0.05);混合型别和单型别的感染也均是性生活年限在30年以上的感染率最高(2.84%和9.09%,P<0.05)。感染HPV型别主要为HPV16(1.39%)、HPV52(1.10%)、HPV58(0.83%)、HPV18(0.69%)。结论:广东省流动育龄妇女HPV感染率与全球总体趋势一致,HPV感染与人群年龄、职业、教育程度和性生活史密切相关,对人群进行HPV感染筛查能有效地防治宫颈癌,有良好的社会经济效益。     

Singaporean men's knowledge of cervical cancer and human papillomavirus (HPV) and their attitudes towards HPV vaccination

Little is known of men's knowledge of cervical cancer and its links with human papillomavirus (HPV), or of their attitudes and beliefs about HPV vaccination. This is despite men's sexual behaviour contributing to HPV transmission and their potential role in deciding whether their children are vaccinated against HPV. To address this, a comprehensive survey was conducted in Singapore where plans are underway for an HPV vaccination program. A representative sample of 930 Singaporean men was found to have moderate knowledge of cervical cancer but poor knowledge and awareness of HPV. Although these men showed strong support for HPV vaccination, overall findings highlight the importance of including men in education campaigns that aim to decrease the incidence of cervical and other HPV-related cancers and to increase the uptake of HPV vaccination.     

Impact of human papillomavirus (HPV) vaccination on HPV 16/18-related prevalence in precancerous cervical lesions

Background

Vaccination against human papillomavirus (HPV) types 16 and 18 is recommended for girls aged 11 or 12 years with catch-up vaccination through age 26 in the U.S. Cervical intraepithelial neoplasia (CIN) grade 2 or 3 and adenocarcinoma in situ (CIN2+) are used to monitor HPV vaccine impact on cervical disease. This report describes vaccination status in women diagnosed with CIN2+ and examines HPV vaccine impact on HPV 16/18-related CIN2+.

Methods

As part of a vaccine impact monitoring project (HPV-IMPACT), females 18–31 years with CIN2+ were reported from pathology laboratories in CA, CT, NY, OR, TN from 2008 to 2011. One diagnostic block was selected for HPV DNA typing with Roche Linear Array. Demographic, abnormal Papanicolaou (Pap) test dates and vaccine status information were collected. The abnormal Pap test immediately preceding the CIN2+ diagnosis was defined as the ‘trigger Pap’.

Results

Among 5083 CIN2+ cases reported to date, 3855 had vaccination history investigated; 1900 had vaccine history documented (vaccinated, with trigger Pap dates, or unvaccinated). Among women who initiated vaccination >24 months before their trigger Pap, there was a significantly lower proportion of CIN2+ lesions due to 16/18 compared to women who were not vaccinated (aPR = .67, 95% CI: .48–.94). Among the 1900 with known vaccination status, 20% initiated vaccination on/after their trigger screening. Women aged 21–23 years were more likely to initiate vaccination on/after the trigger Pap compared to 24–26 year olds (29.0% vs. 19.6%, p = .001), as were non-Hispanic blacks compared to non-Hispanic whites (27.3% vs. 19.0%, p = .001) and publicly compared to privately insured women (38.1% vs. 17.4%, p < .0001).

Conclusion

We found a significant reduction in HPV 16/18-related lesions in women with CIN2+ who initiated vaccination at least 24 months prior to their trigger Pap. These preliminary results suggest early impact of the HPV vaccine on vaccine-type disease, but further evaluation is warranted.