女性人乳头瘤病毒感染的相关因素分析

目的 分析女性人乳头瘤病毒(human papilloma virus,HPV)感染率、HPV亚型分布及影响感染的相关因素,为女性宫颈癌的防治提供科学指导.方法 以2009年3-11月在哈尔滨医科大学附属肿瘤医院接受子宫颈HPV检测的605例女性为观察对象,取其宫颈脱落细胞标本,采用快速导流杂交技术HPV DNA检测法进行HPV的基因型分型,采用单因素和多因素非条件Logistic回归模型分析年龄、婚姻、受教育程度、收入、职业、初次性生活年龄、避孕方式、妊娠次数、分娩方式、吸烟等因素与HPV感染的关系.结果 女性HPV总感染率为21.49%(130/605),其中高危亚型感染率为15.70%(95/605),中国人常见亚型感染率为5.29%(32/605).在单因素分析中,危险因素为初次性生活年龄,HPV感染率随初次性生活年龄增高而减低(X2=4.4618,P<0.05),而年龄、婚姻、受教育程度、收入、职业、避孕方式、妊娠次数、分娩方式、吸烟因素组内比较差异无统计学意义(X2值分别为0.0525、1.8510、1.0348、0.2592、1.1176、1.5664、2.8835、1.4597、2.6161,P均>0.05).在多因素非条件Logistic回归中,危险因素主要有初次性生活年龄、婚姻和妊娠次数(X2值分别为21.6637、8.0574、15.7573,P均<0.05).结论 初次性生活年龄、婚姻及妊娠次数与HPV感染高度相关,应尽量避免高危因素的发生,同时应重视HPV的筛查,尽可能做到早期发现及时进行规范性治疗.     

女性人乳头瘤病毒感染的相关因素分析

目的 分析女性人乳头瘤病毒(human papilloma virus,HPV)感染率、HPV亚型分布及影响感染的相关因素,为女性宫颈癌的防治提供科学指导.方法 以2009年3-11月在哈尔滨医科大学附属肿瘤医院接受子宫颈HPV检测的605例女性为观察对象,取其宫颈脱落细胞标本,采用快速导流杂交技术HPV DNA检测法进行HPV的基因型分型,采用单因素和多因素非条件Logistic回归模型分析年龄、婚姻、受教育程度、收入、职业、初次性生活年龄、避孕方式、妊娠次数、分娩方式、吸烟等因素与HPV感染的关系.结果 女性HPV总感染率为21.49%(130/605),其中高危亚型感染率为15.70%(95/605),中国人常见亚型感染率为5.29%(32/605).在单因素分析中,危险因素为初次性生活年龄,HPV感染率随初次性生活年龄增高而减低(X2=4.4618,P<0.05),而年龄、婚姻、受教育程度、收入、职业、避孕方式、妊娠次数、分娩方式、吸烟因素组内比较差异无统计学意义(X2值分别为0.0525、1.8510、1.0348、0.2592、1.1176、1.5664、2.8835、1.4597、2.6161,P均>0.05).在多因素非条件Logistic回归中,危险因素主要有初次性生活年龄、婚姻和妊娠次数(X2值分别为21.6637、8.0574、15.7573,P均<0.05).结论 初次性生活年龄、婚姻及妊娠次数与HPV感染高度相关,应尽量避免高危因素的发生,同时应重视HPV的筛查,尽可能做到早期发现及时进行规范性治疗.     

承德地区妇女HPV感染影响因素及干预措施分析

目的探讨承德地区人乳头瘤病毒(HPV)感染影响多因素Logistic分析及干预措施。方法采用分层抽样法选取承德市3个区8个县2013年1月至2016年1月4 250名女性作为研究对象,分析HPV感染发生情况。采用单因素分析影响HPV感染相关因素,采用多因素Logistic回归分析影响HPV感染危险因素。结果 4 250名女性中,HPV感染907例,感染率为21.34%。经单因素分析结果显示,两组年龄、孕次、饮酒比较差异无统计学意义(P 0.05);两组居住地、教育情况、初次性生活年龄、产次、流产史、性伴侣、吸烟和避孕方式比较差异有统计学意义(P 0.05)。将上述单因素分析差异具有统计学意义的纳入多因素Logistic回归分析显示,初次性生活年龄20岁、有流产史、多个性伴侣、吸烟和口服避孕药为影响HPV感染危险因素。结论承德地区HPV感染受多因素影响,其中初次性生活年龄、流产史、性伴侣、吸烟和避孕方式为影响HPV感染危险因素,为降低HPV感染需采取针对性干预措施。     

农村地区成年女性高危型人乳头瘤病毒感染情况调查及危险因素分析

目的了解甘肃省张掖市甘州区农村地区成年女性高危型人乳头瘤病毒的感染情况及其危险因素,为减少和控制高危型HPV感染提供依据。方法采用概率比例规模抽样法,抽取甘肃省张掖市甘州区农村地区成年女性920名作为调查对象,进行高危型HPV检测,采用自行设计的统一调查表,对调查对象的年龄、收入等基本情况以及可能影响高危型HPV感染的因素进行问卷调查。结果甘州区成年女性高危型HPV感染率为8.91%;多因素非条件Logistic回归分析结果显示,生殖系统感染、性伴数、职业、吸烟和流产史为高危型HPV感染的危险因素;随机森林模型分析结果显示,绝经、初次怀孕年龄、年龄、初次育儿年龄和初次性行年龄是影响高危型HPV感染的重要因素。结论甘州区农村地区成年女性高危型HPV感染率较高,以16型和58型为主,高危型HPV感染与多种因素有关。为有效降低高危型HPV感染率,必须采用健康教育、健康促进等多种手段进行综合干预。     

1000例妇产科患者HPV筛查结果及相关微生物检测分析

目的检测西安市妇产科患者人乳头瘤病毒(human papillomavirus,HPV)及其它病原体感染情况,并分析HPV感染的危险因素。方法 2015年3月-2018年3月西安医学院第一附属医院妇产科收治的患者共1 000例,采用PCR法检测HPV感染情况并进行分型;采用微生物检验法、胶体金法、革兰染色法及悬滴湿片法检查其它病原体感染情况。对入选病例的民族,文化程度,初次性生活年龄,孕产次数,性伴侣数等因素进行非条件Logistic回归分析,确定HPV感染危险因素。结果 1 000例妇产科患者中HPV检测阳性249例,阳性率为24.90%。其中HPV高危型(HPV16、HPV18、HPV30、HPV31、HPV33)感染占52.21%,HPV低危型(HPV6、HPV32)感染占47.79%。随着年龄增长,患者感染低危型HPV的概率逐渐降低,感染高危型HPV的概率逐渐增加。生殖道内解脲支原体、衣原体、及乳酸杆菌感染率在HPV阴性组分别为2.93%、2.53%和3.06%,HPV阳性组分别为20.48%、27.31%和32.93%,差异均有统计学意义(均P0.05)。非条件Logistic回归分析,初次性生活年龄过早(18岁)、孕产次数过多(≥3次)及多个性伴侣(≥2个)均为HPV感染高危因素(P0.05)。结论西安医学院第一附属医院妇产科患者HPV感染率较高,生殖道微生物感染、性生活过早,孕产次数及多个性伴侣为HPV感染风险因素。因此应加强对相关人群的健康教育,并定期对中老年妇女进行HPV筛查,预防和控制HPV感染。     

1000例妇产科患者HPV筛查结果及相关微生物检测分析北大核心CSCD

目的检测西安市妇产科患者人乳头瘤病毒(human papillomavirus,HPV)及其它病原体感染情况,并分析HPV感染的危险因素。方法 2015年3月-2018年3月西安医学院第一附属医院妇产科收治的患者共1 000例,采用PCR法检测HPV感染情况并进行分型;采用微生物检验法、胶体金法、革兰染色法及悬滴湿片法检查其它病原体感染情况。对入选病例的民族,文化程度,初次性生活年龄,孕产次数,性伴侣数等因素进行非条件Logistic回归分析,确定HPV感染危险因素。结果 1 000例妇产科患者中HPV检测阳性249例,阳性率为24.90%。其中HPV高危型(HPV16、HPV18、HPV30、HPV31、HPV33)感染占52.21%,HPV低危型(HPV6、HPV32)感染占47.79%。随着年龄增长,患者感染低危型HPV的概率逐渐降低,感染高危型HPV的概率逐渐增加。生殖道内解脲支原体、衣原体、及乳酸杆菌感染率在HPV阴性组分别为2.93%、2.53%和3.06%,HPV阳性组分别为20.48%、27.31%和32.93%,差异均有统计学意义(均P<0.05)。非条件Logistic回归分析,初次性生活年龄过早(<18岁)、孕产次数过多(≥3次)及多个性伴侣(≥2个)均为HPV感染高危因素(P<0.05)。结论西安医学院第一附属医院妇产科患者HPV感染率较高,生殖道微生物感染、性生活过早,孕产次数及多个性伴侣为HPV感染风险因素。因此应加强对相关人群的健康教育,并定期对中老年妇女进行HPV筛查,预防和控制HPV感染。     

承德市妊娠晚期妇女感染HPV分型、危险因素及分娩结局的相关性分析

目的检测承德市妊娠晚期妇女感染人类乳头瘤病毒(HPV)类型,调查相关感染因素,分析HPV感染与分娩结局的关系。方法选择2013年1月～2017年12月在本院妇科门诊经治并进行模式液基薄层细胞学技术(TCT)及HPV筛查的患者4225例,确诊为HPV感染妊娠晚期妇女268例,检测HPV类型,比较高危型和低危型HPV感染患者及健康对照组孕妇分娩结局。所有患者随访2年,观察HPV持续感染情况,并通过Logistic回归法分析HPV持续感染发生的独立危险因素。结果268例HPV感染者共检出9种HPV基因型,其中高危型HPV感染229例,以HPV16感染多见(39.18%),HPV18、HPV52感染分别占13.80%和13.06%;低危型HPV感染39例,以HPV6、HPV11多见,分别占6.72%和5.97%。Logistic回归分析显示,年龄20～30岁,患有甲状腺疾病和宫颈炎为HPV持续感染的独立危险因素(P0.05)。高危HPV感染组、低危HPV感染组及健康对照组产妇胎膜早破、早产、新生儿呼吸窘迫综合征、产后出血等的发生率差异无统计学(P0.05)。结论承德市妊娠晚期妇女感染高危型HPV以HPV16为主,持续感染率较高,但HPV感染与妊娠结局无直接关系。年龄20～30岁、患有甲状腺疾病和宫颈炎为妇女妊娠晚期高危型HPV感染危险因素,可为HPV感染的预防提供参考。     

宫颈上皮内瘤变患者宫颈锥切术后发生高危型HPV持续感染的影响因素分析

目的探讨宫颈上皮内瘤变(CIN)患者宫颈锥切术后发生高危型人乳头状瘤病毒(HPV)持续感染的影响因素,为有效预防提供参考。方法选择2019年6月至2020年6月在我院收治的60例CIN患者作为研究对象,对患者进行宫颈锥切术治疗。术后随访6个月,对患者进行2次HPV DNA检测,根据检测结果将患者分为感染组(发生高危型HPV持续感染)和非感染组(未发生高危型HPV持续感染),比较两组患者的年龄、婚姻状况、不良嗜好、不良性行为、妊娠次数、术后用药情况、术后切缘碘试验或醋酸白试验结果;对CIN患者宫颈锥切术后发生高危型HPV持续感染的影响因素进行多因素Logistic回归分析。结果 60例CIN患者宫颈锥切术后发生高危型HPV持续感染11例,感染发生率为18.33%。感染组和非感染组患者的年龄、婚姻状况、不良嗜好、术后用药情况比较,差异无统计学意义(P0.05);感染组患者的不良性行为发生率、术后切缘碘试验或醋酸白试验结果阳性率以及妊娠次数显著高(多)于非感染组患者,差异有统计学意义(P0.05)。多因素Logistic回归分析结果显示,不良性行为、妊娠次数、术后切缘碘试验或醋酸白试验阳性是CIN患者宫颈锥切术后发生高危型HPV持续感染的独立危险因素。结论不良性生活、妊娠次数、术后切缘碘试验或醋酸白试验阳性是CIN患者宫颈锥切术后发生高危型HPV持续感染的独立危险因素,采取针对性措施加以预防,可望降低感染的风险。     

玉林市862例女性宫颈人类乳头状瘤病毒感染状况分析

目的 探讨玉林市妇女宫颈人类乳头状瘤病毒(HPV)感染状况,为预防HPV感染和宫颈癌防治提供理论依据.方法 采用香港凯普生物科技有限公司生产的专用采样刷取宫颈脱落细胞对玉林市862例妇女进行HPV检测,并对HPV-DNA亚型情况进行分析.结果 862份宫颈标本中共检出HPV感染165例,阳性率为19.14%.其中19～30岁组HPV感染率为19.44%;31～45岁组HPV感染率为18.60%;46～70岁组HPV感染率为20.45%,各年龄组的HPV感染差异无统计学意义(P>0.05).HPV的分型状况:18种为亚型(214例次),高危亚型占73.36%.高危亚型检出12个亚型(包括HPV16、18、31、33、35、39、45、51、52、58、59、68)157例次,HPV高危亚型首位是HPV16占高危亚型的27.39%,依次为HPV52占26.11%,HPV58占14.01%,HPV18占10.83%,HPV31占3.18%.低危型HPV检出6种亚型(包括HPV11、43、53、6、66、CP8304)57例次,占26.63%.结论 高危型HPV感染是诱发宫颈癌的病因学因素,筛查、控制HPV感染能有效降低宫颈癌的发病率.     

1730例女性健康体检者高危型和低危型人乳头瘤病毒感染情况调查

目的通过对1730例健康体检女性的人乳头瘤病毒(human papillomavirus,HPV)感染情况进行分析,推测广州地区女性HPV感染状况。方法采用HPV核酸分型流式荧光杂交法,对来我院体检的1730例健康女性宫颈分泌物进行17种高危型HPV和10种低危型HPV核酸检测,并对不同年龄组的感染情况进行比较,总结该人群不同HPV型别及亚型感染率。结果高危型HPV感染率10.17%(176/1730),低危型HPV感染率为5.90%(102/1730)。各年龄段高危型HPV感染率最高的为60岁年龄段,其次为30岁年龄段。HPV感染模式最常见为高危型单一,最少见的感染模式为低危型多重合并高危型单一。高危型HPV感染率前8位依次为HPV53型、58型、52型、39型、16型、18型、51型、56型,低危型HPV感染率前4位依次为HPV43型、61型、81型、42型。结论广州地区女性HPV感染率较高,并且以高危型HPV感染为主。定期进行HPV筛查,有利于预防和早期发现宫颈病变。     

Cervical human papillomavirus infections in commercial sex workers-risk factors and behaviours

We have investigated the prevalence of, and risk factors for, cervical human papillomavirus (HPV) infection in commercial sex workers (CSWs) and controls attending the same sexual health clinics in Sydney. A self-administered 'risk factor' questionnaire was completed and a Pap smear and a specimen for HPV detection and typing were taken. Results from the 288 CSWs and 266 controls were assessed by univariate and multivariate analyses. No significant difference in the rates of cervical HPV infection in CSWs (31.6%) and controls (24.4%) was found but HPV related cytological abnormalities were more common on the CSWs (P <0.05). In both groups, factors independently associated with HPV infection were the use of non-barrier contraception, cytological abnormalities, age under 36 and the number of non-paying sexual partners. A risk factor for CSWs only was sex-work in Japan. A detailed 'work' history from CSWs may be useful to identify unsafe practices or work in countries where safer sex may be less acceptable.     

Determinants of cervical human papillomavirus infection: differences between high- and low-oncogenic risk types.

This cross-sectional survey assessed the determinants of human papillomavirus (HPV) infections among 2080 women who participated in cervical cancer screening. HPVs were typed by restriction and sequencing analyses. The prevalence of HPV was 7.3% (4.2% for high-risk, 1.9% for low-risk, and 2.1% for unknown-risk types). High-risk HPV prevalence decreased with age, whereas low- and unknown-risk HPVs had a second peak in older women. Young age was the only common variable associated with the 3 groups of HPV infections. Lifetime number of sex partners was associated with high- and low-risk types but not with unknown-risk HPVs. Previous Pap smear, treatment for cervical lesions, induced abortion, smoking and having smoker(s) in the family were risk factors for high-risk HPVs. Barrier contraception was protective for low-risk HPVs; current vaginal discharge had a negative association with unknown-risk HPVs. The results indicate that different risk profiles exist for infections with different HPV groups.     

深圳市光明新区孕妇梅毒感染状况及危险因素分析

目的了解深圳市光明新区孕妇梅毒感染状况并分析其危险因素。方法对所有首次到医院进行产前检查的孕妇,采用梅毒甲苯胺红不加热血清试验（TRUST）进行初筛,阳性血清采用梅毒螺旋体明胶颗粒凝集试验（TPPA）进行确认;再采用单因素Logistic和非条件多因素Logistic回归分析。结果 2003年1月至2011年11月,梅毒免费筛查孕妇60 992人,检出梅毒阳性孕妇400人,阳性率0.66%。单因素分析显示,孕妇的户籍、文化程度、性伴文化程度、职业、不良妊娠结局史、泌尿生殖道炎症、近5年性伴数、性伴近5年的性伴数、首诊孕周等,与孕妇梅毒的发生有统计学意义。多因素分析发现,职业、不良妊娠结局史、近5年性伴数、性伴近5年性伴数和首诊孕周,是孕妇梅毒发病的独立危险因素。结论深圳市光明新区孕妇人群梅毒感染率处于较高水平,加强性病健康教育、改善就医条件以及关心育龄人群的业余生活等,有助于降低发病率。     

Risk factors for anogenital human papillomavirus infection in men

BACKGROUND: Human papillomavirus (HPV) is strongly associated with cervical and other anogenital cancers. Identification of risk factors for HPV infection in men may improve our understanding of HPV transmission and prevention. METHODS: HPV testing for 37 types was conducted in 463 men 18-40 years old recruited from 2 US cities. The entire anogenital region and semen were sampled. A self-administered questionnaire was completed. Multivariate logistic regression aided the identification of independent risk factors for any HPV type, oncogenic HPV types, and nononcogenic HPV types. RESULTS: Prevalence was 65.4% for any HPV, 29.2% for oncogenic HPV, and 36.3% for nononcogenic HPV. Factors significantly associated with any HPV were smoking > or =10 cigarettes per day (odds ratio [OR], 2.3 [95% confidence interval {CI}, 1.0-5.3]) and lifetime number of female sex partners (FSPs) (OR for > or =21, 2.5 [95% CI, 1.3-4.6]), and factors significantly associated with oncogenic HPV were lifetime number of FSPs (OR for > or =21, 7.4 [95% CI, 3.4-16.3]) and condom use during the past 3 months (OR for more than half the time, 0.5 [95% CI, 0.3-0.8]). For nononcogenic HPV, a significant association was found for number of FSPs during the past 3 months (OR for > or =2, 2.9 [95% CI, 1.4-6.3]). CONCLUSIONS: Lifetime and recent number of FSPs, condom use, and smoking were modifiable risk factors associated with HPV infection in men.     

Age-Specific prevalence of anal human papillomavirus infection in HIV-negative sexually active men who have sex with men: the EXPLORE study

BACKGROUND: In the United States, anal cancer in men who have sex with men (MSM) is more common than cervical cancer in women. Human papillomavirus (HPV) is causally linked to the development of anal and cervical cancer. In women, cervical HPV infection peaks early and decreases after the age of 30. Little is known about the age-specific prevalence of anal HPV infection in human immunodeficiency virus (HIV)-negative MSM. METHODS: We studied the prevalence and determinants of anal HPV infection in 1218 HIV-negative MSM, 18-89 years old, who were recruited from 4 US cities. We assessed anal HPV infection status by polymerase chain reaction. RESULTS: HPV DNA was found in the anal canal of 57% of study participants. The prevalence of anal HPV infection did not change with age or geographic location. Anal HPV infection was independently associated with receptive anal intercourse (odds ratio [OR], 2.0; P<.0001) during the preceding 6 months and with >5 sex partners during the preceding 6 months (OR, 1.5; P<.0001). CONCLUSIONS: Urban, HIV-negative MSM have a stable, high prevalence of anal HPV infection across all age groups. These results differ substantially from the epidemiologic profile of cervical HPV infection in women. This may reflect differences between these populations with respect to the number of new sex partners after the age of 30 and may explain the high incidence of anal cancer in MSM.     

宜昌地区HPV分型调查

目的:调查2011-01-01-2013-01-24三峡大学人民医院人乳头状瘤病毒(HPV)分型感染状况,分析HPV分型与诊断、年龄分布、单一与多重感染、患者孕产流及外伤等状况。方法:以我院LIS系统和病案室为资料来源,收集患者HPV分型感染、年龄分布、单一与多重感染、患者孕产流及外伤等资料。应用SPSS19.0分析不同年龄组、宫颈病变组间的分布差异。结果:宜昌地区妇女感染以HPV16为主(52.22%)。其次为HPV18、HPV52等;HPV感染总数在CINⅠ、CINⅡ、CINⅢ,宫颈癌Ⅰ、Ⅱ、Ⅲ期中差异有统计学意义(P0.01);40~49岁感染人数最多,为43例(47.78%);HPV感染阳性率在各年龄组间差异有统计学意义(P0.05);单一感染占77.78%,双重感染占18.89%,三重感染占3.33%;感染者中有3次孕史和1次生产史的最常见;43.9%的患者有外伤史,其中以结扎手术为主。结论:宜昌地区妇女HPV感染亚型以HPV16为主;HPV感染在病理程度、年龄中差异有统计学意义;感染者大多有多孕、多产和流产、外伤史。     

Epidemiologic risk profile of human papillomavirus infections in human immunodeficiency virus-positive Chinese women

The aim of this study was to evaluate the prevalence and risk factors of human papillomavirus (HPV) infection among human immunodeficiency virus (HIV)-positive women in China. To this end, we enrolled 200 HIV-positive and 182 HIV-negative women in this cross-sectional cohort study. The following sampling methods were used: (i) structured interview, (ii) CD4 cell counts, and (iii) cervical specimens. HPV genotype (total 23 types) was analyzed using polymerase chain reaction assay. Logistic regression analysis was used to identify independent causative factors for HPV infection. The prevalence of HPV infection was 3-fold higher in the HIV-positive women than in the HIV-negative women. The overall prevalences of HPV infection, high risk (HR)-HPV infection, and multiple HPV infections in the HIV-positive women were 36.5%, 33.5%, and 13.0%, respectively, and the corresponding values in HIV-negative women were 12.1%, 10.4%, and 6.0%, respectively (P < 0.05). The types of HR-HPVs were similar in the HIV-positive and HIV-negative women (HPV-16, -52, -58, and -18), and the prevalences of infections by these viruses were 1.5- to 3-fold higher in the HIV-positive group than in the HIV-negative group. HR-HPV infection among the HIV-positive women was associated with three factors: low CD4 count (OR for 200 ≤ CD4 ≤ 350 and CD4 < 200/μL were 2.11 and 3.13, respectively), HIV infection through sexual contact (OR, 7.90; 95% CI, 2.38-14.60), and having HIV-positive sexual partners (OR, 2.02; 95% CI, 1.03-3.95). We found that the prevalence of HPV infection among the HIV-positive Chinese women was higher than that among the HIV-negative women; moreover, among the HIV-positive women, factors associated with HIV infection were risk factors for HR-HPV infection.     

Cervical cytological abnormalities and factors associated with high-grade squamous intraepithelial lesions among HIV-infected women from Rio de Janeiro, Brazil

Although cervical cancer remains a major public health problem in Brazil, knowledge of cervical cytological abnormalities among HIV-infected women remains scarce. At baseline evaluation of a cohort followed in Rio de Janeiro, Brazil, 703 HIV-infected women underwent cytology-based cervical cancer screening and human papillomavirus (HPV) DNA testing. Poisson regression analysis was used to evaluate the association of factors with the presence of high-grade squamous intraepithelial lesions (HSIL). Cervical cytology was abnormal in 24.3% of the women; 4.1% had HSIL. Beyond HPV infection, factors independently associated with the presence of HSIL was age (≥25 and ≤40 years, prevalence ratio [PR] 2.60, 95% confidence interval [CI] 1.11-6.10), and more than three pregnancies was protective (PR 0.33, 95% CI 0.11-0.94). High coverage of cervical cancer screening is warranted to prevent morbidity and mortality from cervical cancer in this population.