3014例人乳头瘤病毒分型检测结果分析

目的:了解常居广州地区的性病高发人群最近一年人乳头瘤病毒(HPV)的感染情况及其型别分布,为防治HPV感染提供最新的理论依据。方法:回顾性分析我院2018年1月至12月3 014例性病高发人群HPV的检测结果,并初步探讨HPV与性别、年龄及人类免疫缺陷病毒(HIV)的相关性。结果:3 014例样本中男730例(24.22%),女2 284例(75.78%),型别以HPV6、11、16、52、58为主,检出率依次为8.36%(252/3014)、7.83%(236/3014)、6.74%(203/3014)、5.97%(180/3014)、4.64%(140/3014)。男性任一型HPV、低危型HPV、高危型HPV、单纯低危型HPV感染检出率依次为67.81%(495/730)、53.29%(389/730)、45.75%(334/730)、22.05%(161/730),均明显高于女性(P值均0.001),但男性单纯高危型HPV感染检出率和女性比较则无统计学差异(P0.05)。HPV感染在15～24岁和65～74岁这两个年龄段检出率最高,大致成"U"形分布。3 014例中有345例为HIV感染者,HIV感染者任一型HPV、低危型HPV、高危型HPV、单纯低危型HPV感染检出率依次为84.06%(290/345)、64.35%(222/345)、66.96%(231/345)、17.10%(59/345),均明显高于总人群(P值均0.001),但HIV感染者单纯高危型HPV感染检出率和总人群比较则无明显差异(χ~2=2.00,P0.05)。结论:常居广州地区性病高发人群最近一年流行的HPV型别为HPV6、11、16、52、58,表现出与性别、年龄、HIV感染相关的特点,加强HIV感染者的防治工作对降低本地区HPV感染率有重要意义。     

男男性接触者肛周及肛管内尖锐湿疣患者HPV分型与复发的关系

目的 探讨上海男男性接触者肛周及肛管内尖锐湿疣患者人类乳头瘤病毒（HPV）感染基因分型情况及不同基因型别与临床复发的关系。方法 导流杂交基因芯片技术对57例MSM尖锐湿疣患者肛周及肛管内皮损进行HPV基因分型研究,并随访高危型组,低危型组经CO2激光治疗后尖锐湿疣的复发率。结果 57例MSM尖锐湿疣患者肛周及肛管内皮损检测出56例HPV阳性,占98.2%,共检出11种HPV基因亚型,以HPV11（42例,占75%）和HPV6（30例,占53.6%）为主,检出病例数从高到低依次为HPV11 > HPV6 > HPV16 > HPV18 > HPV33、59、cp8304 > HPV31、35。56例HPV阳性患者中低危型感染36例,占64.3%,均为HPV11和（或）HPV6;高危型感染20例,占35.7%,其中17例为低危型与高危型混合感染,占高危型感染的85%。56例患者经CO2激光治疗后随访6个月,高危型组复发率为95%,低危型组复发率为66.7%,两者差异有统计学意义（P < 0.05）。结论 上海男男性接触者尖锐湿疣HPV基因型主要以低危型HPV11、6为主,高危型感染大多合并低危型感染,高危型组复发率明显高于低危型组。     

男性尖锐湿疣皮损HPV基因芯片型别分析

目的探讨本地区男性尖锐湿疣患者皮损中的HPV型别感染情况及其临床意义。方法采用基因芯片微阵列技术对200例男性尖锐湿疣皮损进行26种HPV基因型别检测。结果男性尖锐湿疣患者皮损中HPV检出率为99.00%(198/200),检出的198例阳性患者中单一型别感染42.42%(84/198),以HPV6/11为主(94.00%);多重HPV混合感染以高低危HPV混合感染为主(P<0.05),18～35岁组较>35岁组高危HPV感染率偏多(P<0.05),皮损部位间存在HPV型别差异(P<0.05)。皮损中检测出HPV7型感染4例和HPV67型感染1例。结论男性尖锐湿疣皮损以HPV6/11型感染为主,并多伴有其他HPV型别感染;年龄、皮损部位和感染重数影响HPV型别分布。     

尖锐湿疣患者皮损中HPV基因芯片型别分析

目的探讨本地区尖锐湿疣患者皮损中人乳头瘤病毒(HPV)感染型别及其临床意义。方法采用PCR-反向点杂交法检测172例尖锐湿疣患者皮损中23种HPV基因型别感染率。结果尖锐湿疣患者皮损中HPV检出率为97.67%(168/172),所有检出的阳性患者中单一型别感染率为38.10%(64/168),以HPV6/1l为主(70.31%,25.00%);多重HPV混合感染率为61.90%(104/168),以高低危HPV混合感染为主(P0.05),18~35岁组较35岁组高危HPV感染率偏多,差异有统计学意义(P0.05),女性的多重感染率及高危型感染率均高于男性,差异有统计学意义(P0.05)。结论本地区尖锐湿疣皮损以HPV6/1l型感染为主,并多伴有其他HPV型别感染;年龄、性别和感染重数与HPV型别分布相关。     

深圳市女性尖锐湿疣组织HPV感染的基因型分析

目的:检测女性尖锐湿疣(CA)皮损中人乳头瘤病毒(HPV)的基因型.方法:采用HybriMax技术,对116例女性尖锐湿疣患者皮损组织进行HPV感染分型检测.结果:HPV阳性107例,共发现20种HPV亚型;单一型别阳性率是51%(59/116),以低危型HPV11,6为主.多重基因型别阳性率是41.2%(48/116).高危型HPV检出率为47%(55/116),多重感染率达到87%(48/55);高危型与低危型HPV感染在皮损类型、病变部位无差异.结论:深圳市女性尖锐湿疣以低危型HPV11、6型感染为主;高危型感染多以混合感染形式存在.     

尖锐湿疣67例HPV分型分析

目的：了解尖锐湿疣患者中HPV分型情况,指导临床治疗。方法：对2011年6月～2011年12月于我科门诊就诊并查HPV分型患者的临床资料进行回顾性分析,总结分布特征。结果：本组尖锐湿疣患者67例,HPV检出阳性43例（64.18%）,其中高危型23例（34.33%）：女性18例（78.26%）,男性5例（21.74%）;单纯低危型20例（29.85%）;高危＋低危的混合感染16例（23.88%）,其中感染型别最多2例为4个基因型,阴性24例（35.82%）。结论：本组病例尖锐湿疣患者67例,HPV阳性检出率高（43/67,64.18%）;高危型检出率高（23/67,34.33%）。本组病例提示,加强对尖锐湿疣患者HPV分型检测,更有利于指导患者的治疗和预后。     

尖锐湿疣复发患者HPV基因分型的分布情况及关系分析

目的:研究尖锐湿疣复发患者人乳头瘤病毒(HPV)基因分型的分布情况及关系。方法:选取中国石油天然气集团公司中心医院2014年10月至2016年10月285例尖锐湿疣复发患者为研究对象,采集尖锐湿疣组织样本,进行HPV基因分型检测。结果:271例HPV阳性尖锐湿疣复发患者低危型HPV感染率为37.6%,高危型HPV感染率为84.5%,单一型HPV感染率为53.9%,复合型HPV感染率为46.1%。HPV16与HPV18感染率分别为36.9%、32.1%。尖锐湿疣复发患者低危型HPV感染比例显著高于高危型HPV感染(P0.05)。结论:高危型HPV基因是尖锐湿疣复发患者HPV感染主要类型,其中HPV16与HPV18为尖锐湿疣复发患者最常见HPV基因亚型。     

上海地区女性外阴尖锐湿疣患者宫颈HPV感染及分型研究

目的 探讨上海地区女性外阴尖锐湿疣患者的宫颈HPV感染情况.方法 采用美国FDA批准的捕获杂交试验和基因芯片技术对194例女性外阴尖锐湿疣患者皮损和宫颈脱落细胞进行HPV基因型别研究.结果 194例女性尖锐湿疣患者外阴皮损HPV检出率为100%,其中低危型HPV 144例占74.2%,高危型HPV 50例占25.8%.低危型中136例为单一型别感染,占94.4%,均为HPV6或HPV11;高危型中43例为低危与高危型HPV混合感染,占86%.194例患者中,166例(85.6%)合并宫颈HPV感染,其中低危型感染者119例,感染率为61.4%,高危型感染46例,感染率为23.7%.外阴和宫颈皮损HPV型别的一致性达到95.8%(159/166),低危型HPV感染率从高到低依次为HPV11＞HPV6＞HPV53,高危型依次为HPV16＞HPV18＞HPV52＞HPV31＞HPV45、HPV58.结论 上海地区女性外阴尖锐湿疣患者中高危型HPV感染率较高,且近1/4患者合并宫颈高危型HPV感染.     

广州市男男性接触者肛肠尖锐湿疣HPV感染型别分析

目的:分析2012~2014年我院门诊就诊的患有肛肠尖锐湿疣的男男性接触者(MSM)的人口学资料及肛肠部HPV感染型别分布,为进一步的预防干预提供理论依据。方法:对已确诊的MSM患者进行人口学资料、性行为方式等调查,同时采集调查对象血液及肛肠拭子标本进行HIV检测及HPV的免疫印迹杂交法分型。结果:55例MSM患者中有20例感染HIV,感染率为36.3%。低危型合并高危型HPV的混合感染占69.1%;高危型HPV感染占前4位的依次分别是16型、52型、66型和58型。结论:患尖锐湿疣的MSM人群中HIV的感染率较高;HPV混合型感染在HIV感染的MSM患者中更为常见。     

347例尖锐湿疣患者人乳头瘤病毒基因型检测及分析

目的:分析尖锐湿疣(CA)患者人乳头瘤病毒(HPV)基因型的感染情况,为制定HPV感染的预防策略提供理论依据。方法:采用核酸分子快速导流杂交基因芯片技术,对347例尖锐湿疣患者皮损组织进行HPV感染21种基因亚型检测。结果:347份CA组织标本中HPV阳性330例,检出率95.10%,21种HPV亚型均能检测出。排名位于前6位的亚型检出率由高到低依次是HPV6(36.31%,126/347)、HPV11(29.39%,102/347)、HPV16(13.83%,48/347)、HPV52(11.24%,39/347)、HPV58(8.07%,28/347)、HPV39(8.07%,28/347)。单一低危型感染占31.82%(105/330),单一高危型感染占27.88%(92/330),多重感染占40.30%(133/330)。不同性别中,单一高危型和多重感染率存在明显差异(P0.05),而单一低危型感染率无明显差异(P0.05)。结论:本研究中尖锐湿疣以HPV6、HPV11、HPV16、HPV52、HPV58、HPV39为主,对今后研发针对本地区的预防性疫苗具有重要指导意义。     

Human papillomavirus infection in men who have sex with men participating in a Dutch gay-cohort study

BACKGROUND: To develop strategies for prevention and early treatment of human papillomavirus (HPV) anal and penile cancer, a better understanding of related sexual behavior risk factors is needed. GOAL: The goal of this study was to establish the prevalence of anal and coronal sulcus HPV in a group of men who have sex with men participating in a Dutch gay-cohort study, to identify risk factors associated with HPV infection in this group, and to investigate the presence of identical HPV types in couples with stable relationships. STUDY DESIGN: A cross-sectional study of 241 HIV-negative and 17 HIV-positive men who have sex with men visiting the sexually transmitted disease clinic of the Erasmus MC for a regular and scheduled examination. Participants underwent a routine venereological examination including HIV serologic analysis, and swabs were taken from the coronal sulcus and anus for HPV DNA testing. All subjects were asked to complete a questionnaire on sexual risk behavior. RESULTS: HPV DNA was detected at the coronal sulcus in 23.5% of the HIV-positive men and in 15.8% of the HIV-negative men (P=0.492). In anal specimens, HPV DNA was detected in 64.7% of the HIV-positive men and 32.8% of the HIV-negative men (P=0.015). High-risk HPV types (P=0.007) and 2 or more different HPV genotypes (P=0.006) were seen more often in anal specimens of HIV-positive persons than in specimens of HIV-negative persons. A factor possibly associated with the presence of anal HPV infection was a concomitant anal infection with Chlamydia trachomatis, gonococci, or herpes simplex virus (P=0.059). In only 16.7% of HPV-positive steady couples, both companions showed the presence of one or more identical HPV genotypes. CONCLUSION: In this study, anal HPV DNA was detected more often than HPV DNA at the coronal sulcus. HIV positivity was associated with a higher prevalence of high-risk, but not with low-risk HPV types, at the anus. No association was found between HIV positivity and presence of high-risk HPV at the coronal sulcus. No sexual behavioral determinants for the presence of HPV could be identified. Concomitant anal infection with C trachomatis, gonococci, or herpes simplex virus may be associated with HPV infection. In the majority of steady couples, partners were infected with different HPV types.     

浙江丽水地区男性肛门生殖器疣患者人乳头瘤病毒基因型研究

【摘要】 目的 了解浙江丽水地区男性肛门生殖器疣患者感染人乳头瘤病毒（HPV）基因型的分布状况。方法 PCR-反向斑点杂交技术对150例男性肛门生殖器疣患者标本进行HPV基因分型,包括3种低危型HPV-6、11、43和16种中高危型HPV-16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、CP8304。 结果 150例男性肛门生殖器疣患者中91例（60.67%）检出HPV,其中有74例（81.32%）为低危型HPV-6、11、43的单一或多重感染,另有17例（18.68%）为中高危型的单一或多重感染。31例（34.07%）为多重感染（包括2 ～ 5种基因型混合感染）,其中低危型合并中高危型的多重感染20例占64.52%,低危型之间的二重感染6例占19.35%;HPV-6、11合并中高危型感染分别为13例（41.94%）和6例（19.35%）。各HPV基因型感染136例,感染率从高到低依次为：HPV-6（39例,28.68%）、11（36例,26.47%）、16（11例,8.09%）、52（7例,5.15%）、53（7例,5.15%）、51（6例,4.41%）、58（6例,4.41%）和43（6例,4.41%）。 结论 男性生殖器疣患者HPV基因型感染中,低危型HPV感染占绝对优势,多重感染及各基因型的分布状况差异较大。     

巨大尖锐湿疣患者人乳头瘤病毒型别检测

目的 探讨巨大尖锐湿疣患者皮损人乳头瘤病毒（HPV）-DNA型别。方法 收集门诊2007年1月至2010年1月巨大尖锐湿疣患者67例,凯普导流杂交基因芯片技术对疣体行HPV-DNA分型检测。结果 67例巨大尖锐湿疣患者中63例检测出HPV-DNA,阳性率为94.02%。HPV-DNA阳性者中检出低危型HPV 84例次（占60.87%）,高危型HPV 54例次（占39.13%）。HPV亚型仍以低危型HPV6、11为主,但高危型HPV16、18偏高。结论 巨大尖锐湿疣感染高危型HPV16、18偏高。     

203例女性外阴尖锐湿疣患者宫颈HPV基因型检测及分析

目的:探讨206例女性外阴尖锐湿疣(CA)患者宫颈感染人乳头瘤病毒( HPV)的基因型分布.方法:采用核酸分子快速导流杂交基因芯片技术,对203例女性外阴尖锐湿疣患者宫颈进行HPV感染分型检测.结果:在203例宫颈标本中,本芯片共能检测21种HPV亚型,本实验检测出20种,未发现HPV43型.203份宫颈组织标本中HPV阳性123例,检出率是60.59％,其中单一型别阳性率是65.04％ (80/123),多重型别阳性率是34.95％ (43/123);各型别检出率由高到低依次是HPV11 (35.77％)、6(28.45％)、16( 12.19％)、52( 12.19％)、58(8.98％)、68(8.13％)、66( 6.50％)、CP8304 (5.69％),18(4.87％)、33(4.87％)、44(4.87％)、39(3.25％).结论:根据本组病例,对于女性外阴尖锐湿疣患者,应重视宫颈HPV基因分型的检测;高危型及多重型别感染者有必要进一步检查及随访.     

Human papillomavirus-associated induction of human β-defensins in anal intraepithelial neoplasia

Background  Antimicrobial peptides and proteins (AMPs) are widely distributed effector molecules of the innate immune system with well-known antibacterial activity. However, there is a paucity of information regarding antiviral effects of AMPs.
Objectives  The present study was performed to analyse expression of AMPs in human papillomavirus (HPV)-associated anal skin lesions of human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), a special high-risk group for persistent HPV infections and anal dysplasia.
Methods  Skin lesions were analysed for the presence of LL-37, RNase 7, and human β-defensin (hBD)-1, hBD-2 and hBD-3. Moreover, HPV typing and HPV DNA load determination for HPV types 6, 11, 16, 18, 31 and 33 were performed to evaluate possible correlations between expression of AMPs and lesional HPV types.
Results  Skin biopsies of 45 HIV-positive MSM with anal intraepithelial neoplasia (AIN), anal condylomata acuminata or unaffected anal mucosa, as well as condylomata acuminata of eight HIV-negative MSM, were analysed for AMP mRNA expression. Additionally, immunohistochemical analysis for hBD-2 and hBD-3 was performed in a total of 45 samples. hBD-2 and hBD-3 gene and protein expression was significantly increased in both AIN and condyloma, whereas LL-37, RNase 7 and hBD-1 gene expression did not differ significantly from unaffected anal mucosa. AMP expression correlated neither with the number of HPV types nor with the high-risk and low-risk HPV DNA loads of the quantified types. No significant differences in AMP expression were observed in condylomata of HIV-positive and HIV-negative MSM.
Conclusions  hBD-2 and hBD-3 expression was shown to be significantly upregulated in HPV-associated anal skin lesions of both HIV-positive and HIV-negative MSM. Their biological significance in the innate immunity against these lesions needs further research.     

5-氨基酮戊酸光动力疗法治疗尖锐湿疣的临床观察

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗尖锐湿疣后的病毒清除及复发情况。方法将90例尖锐湿疣患者随机分为三组,治疗组采用ALA-PDT治疗,CO2激光组采用CO2激光治疗,冷冻组采用液氮冷冻治疗。治疗前后取材,进行荧光PCR检测低危型(HPV6,11)、高危型(HPV16,18)HPVDNA。结果治疗组、CO2激光组及冷冻组HPV清除率分别为86.67%,56.67%和53.33%,经ALA-PDT治疗后HPV清除率较液氮冷冻及CO2激光治疗高,差异有显著性(P<0.05);ALA-PDT治疗组(10.00%)与CO2激光组(36.67%)及冷冻组(40.00%)比较,复发率差异均有显著性(P<0.05)。结论ALA-PDT对尖锐湿疣皮损的治疗和控制HPV的潜伏感染都十分重要。     

p73第2外显子第4和14位基因多态性与人乳头状瘤病毒易感性的相关性研究

【摘要】 目的 探讨人乳头状瘤病毒（HPV）易感性与p73基因第2外显子第4和14位碱基多态性的相关性。 方法 收集南京地区尖锐湿疣患者83例、Bowen样丘疹病患者11例的皮损和血样,以在性病门诊进行健康体检的性病高危人群150例为阴性对照,采用直接测序法检测皮损中感染的HPV-DNA序列,并在Genbank Blast上进行比对,鉴定HPV型别,抽提尖锐湿疣和Bowen样丘疹病患者以及阴性对照组的血样DNA,以shP73引物对p73基因片段进行扩增和测序,检测患者和阴性对照组的p73第2外显子第4和14位基因的多态性,分析HPV易感性和宿主p73基因多态性之间的相关性。 结果 83例尖锐湿疣患者皮损中HPV-6型35例占42.2%,HPV-11型34例占41.0%;11例Bowen样丘疹病患者皮损中HPV-16型5例（5/11）,HPV-6型3例（3/11）。p73基因多态性检测,83例尖锐湿疣患者血样测序阳性83例,11例Bowen样丘疹病患者血样测序阳性11例,对照组150例血样测序阳性132例。与对照组相比,三种基因型中,A4T14/A4T14 基因型感染HPV患尖锐湿疣（OR = 4.89,95% CI = 1.50 ~ 15.91）或Bowen样丘疹病（OR = 7.11,95% CI = 1.144 ~ 44.20）的风险更高。G4C14/G4C14基因型与其他两种基因型相比,感染HPV后患Bowen样丘疹病的风险较低（OR = 0.16,95% CI = 0.04 ～ 0.65）。 结论 p73第2外显子携带A4T14基因增加了Bowen样丘疹病和尖锐湿疣的患病风险,但其第4和14位碱基的多态性与罹患高危型与低危型HPV之间并无明显的相关性。     

Anal human papillomavirus DNA screening by Hybrid Capture II in human immunodeficiency virus-positive patients with or without anal intercourse

High risk human papillomaviruses (HPVs) have emerged as risk factors for anal carcinoma, of which incidence is higher in HIV-positive patients than in the general population. The aim of our study was to investigate the prevalence and risk factors for anal HPV infections in HIV-positive patients with or without history of anal intercourse. Fifty HIV 1-infected patients (36 men and 14 women) were tested at entry and followed-up every 3 months for one year for the presence of anal HPV DNA by the Hybrid Capture II trade mark assay. A series of 50 HIV-negative subjects matched for age and sex served as controls. At enrollment, anal HPV DNA was present in 29/50 HIV-positive patients (58 %) and in 3/50 control subjects (6 %). High risk (HR) HPV genotypes were detected in 20/50 HIV-positive patients (40 %) with no difference in homosexual men and other HIV-positive patients. Risk factors for HPV infection were CD4 + cell counts less than 500/microL (RR: 2.13 [95 % CI: 1.0-4.7]) and history of anogenital warts (RR: 2.36 [95 % CI: 1.2-4.6]). The HPV load was higher in patients with CD4+ < or = 500/microL than in patients with CD4 + > 500/microL (p < 0.04). During the follow-up, anal HR HPV DNA was repeatedly identified at high levels in 5 HIV-positive patients. There is some convincing evidence that HIV-positive patients with low CD4+ cells, whatever the routes of HIV transmission, have a high rate of anal HPV infection and might be at increased risk of developing anal neoplastic lesions. Identifying HR HPV infection might be warranted in immunosuppressed patients.