大学新生人乳头瘤病毒认知现状调查

人乳头瘤病毒(hum an pap illom avirus,HPV)是一种性传播疾病的病原体⁽¹⁾,主要感染皮肤、消化道、呼吸道和生殖道等上皮细胞,并且HPV感染与宫颈癌关系密切⁽²⁾。研究显示,中国大学生首次发生性行为的平均年龄<20岁,25%的男生有过婚前性行为⁽³⁾。     

乌鲁木齐市天山区女性人乳头瘤病毒感染情况调查

目的 了解乌鲁木齐市天山区女性人乳头瘤病毒(human papillomavirus, HPV)感染现状及其优势亚型,并分析影响感染的相关因素,为新疆地区降低女性HPV感染及其治疗提供参考依据。 方法 2020年6月1日—2021年5月31日随机抽取新疆乌鲁木齐市天山区所辖7个片区的5 600例妇女为研究对象,进行HPV检测,采用自行设计的统一调查表,对调查对象年龄、教育程度、性生活史、婚育史、流产史等进行问卷调查。 结果 共5 145例女性完成HPV检测,检出HPV阳性患者1 029例,检出率为20.00%,其中高危型818例,高危型感染率为15.90%。高危型HPV优势基因亚型为HPV16、52、58、33、18。所有年龄段均以单一感染为主,单一感染率为12.30%(633/5 145)。多元logistic回归结果显示,首次性生活年龄<23岁、首次分娩年龄<25岁、性伴侣≥2个、具有流产史是HPV感染的独立危险因素,OR(95%CI)值分别为:1.770 (1.009~2.850)、1.581(1.070~2.335)、2.804 (1.530~5.138)、2.319 (1.293~4.158);分娩次数2次和分娩次数≥3次是HPV感染的独立危险因素,OR(95%CI)值分别为:1.672 (1.114~2.509)、2.050 (1.402~2.999);年龄26~35岁、46~55岁是HPV感染的独立保护因素,OR(95%CI)值分别为:0.843 (0.730~0.972)和0.807(0.685~0.952);大专及以上学历是HPV感染的独立保护因素,OR(95%CI)值为0.710 (0.560~0.900)。相较于避孕套避孕方式,节育环、结扎、避孕药是HPV感染的危险因素,OR(95%CI)值分别为:3.142 (1.432~6.896)、2.998 (1.337~6.723)、3.391 (1.850~6.213)。 结论 乌鲁木齐市天山区妇女HPV感染率为20.00%,以高危型 HPV 感染者居多。年龄<25岁、受教育程度低、初次性生活年龄小、性伴侣数多、分娩次数≥2、具有流产史的女性为HPV感染的高危人群。应加强高危人群性行为健康知识的宣传教育,在适龄人群中推广HPV疫苗接种,预防感染。     

河源地区妇女宫颈感染人乳头瘤病毒调查分析

目的调查分析广东河源地区妇女宫颈感染HPV基因型别的分布情况,为预防HPV感染和宫颈癌防治提供实验诊断依据。方法采用基因芯片技术对1 037例妇女的宫颈脱落细胞标本行21种HPV基因型别检测,并对227例阳性患者中的163例进行病理活检。结果 1 037例受检妇女中感染HPV 227例,感染率为21.89%,检出20种基因型,共314项,高危型269项,占85.67%;低危型45例,占14.33%,未检出基因亚型为42。高危型感染率排在前五位的依次是HPV52(18.47%)、HPV16(11.78%)、HPV58(11.15%)、HPV53(7.32%)、HPV18(5.1%);低危型以HPV11、HPVCP8304与HPV6多见。单一感染171例,占75.33%,双重感染34例,占14.98%,多重感染22例,占9.69%。HPV感染率最高在30³9岁年龄组,阳性率为26.56%。163人进行病理活检,137人有宫颈组织病变,病变率达到84%。结论河源地区妇女HPV总感染率较高,HPV基因分型检测对宫颈癌的预防、早发现和早诊疗具有重要临床意义。     

人乳头瘤病毒的核酸检测

高危型人乳头瘤病毒(HPV)感染与宫颈癌发生密切相关,低危型感染可引起外生殖器湿疣和宫颈上皮内低度病变。对HPV感染的诊断主要依赖于病毒核酸的检测,方法有探针直接检测、信号放大系统和核酸扩增技术等。其中核酸扩增结合杂交技术对人乳头瘤病毒进行分型,具有较好敏感性和特异性。基因芯片技术具有高通量,自动化等优点,适合人群筛查和流行病学研究。理想的HPV检测方法是具有可调整的临界阳性判定标准以适应不同的需要,同时能进行基因分型。     

对人乳头瘤病毒认知度较高人群人乳头瘤病毒感染状况及基因型分析

目的:了解对人乳头瘤病毒(HPV)认知度较高人群的宫颈HPV感染状况及基因亚型分布情况。方法:对妇儿医院1 184例参加医院2012年度体检的已婚女职工,采用核酸分子快速导流杂交基因芯片技术进行21种HPV亚型感染检测。结果:1 184例中检测出HPV阳性106例,阳性率为8.95%。在阳性感染者中,高危亚型感染者为89例,占阳性感染者83.96%。单1种、合并2种、3种、4种HPV感染分别为88例(83.02%),15例(14.15%),2例(1.89%),1例(0.94%)。亚型感染率相对较高的5个亚型依次为HPV 52(31.13%)、HPV 58(17.92%)、CP 8304(14.15%)、HPV 53(12.26%)、HPV 16(8.49%)。23岁~、30岁~、40岁~、50岁~、≥60岁各年龄段HPV感染率分别为9.15%、9.45%、10.64%、5.56%、9.09%。结论:对HPV认知度较高人群宫颈HPV感染率相对较低,主要为单一亚型感染,HPV 52、HPV 58、CP 8304是最主要感染亚型。进行HPV-DNA检测和分型对宫颈癌的防治具有重要意义。     

人乳头瘤病毒与宫颈病

宫颈癌在女性肿瘤中居第2位,占癌症患者总数的15％,现已明确人乳头瘤病毒（HPV）感染是宫颈癌的根本致病因素。研究证实,大多数宫颈上皮内瘤样病变（CIN）伴有HPV感染,90％宫颈癌标本可以检测出HPVDNAE[1]。     

人乳头瘤病毒亚型感染导致宫颈病变的调查

【目的】通过调查不同亚型人乳头瘤病毒(HPV)感染与宫颈病变的关系,探讨HPV分型检测在宫颈疾病筛查中的应用价值。【方法】收集2017年1月至2018年9月在上海市第一人民医院宫颈疾病门诊就诊HPV分型检测阳性的全部患者共1851例。以病理学诊断为金标准进行阴道镜检查及宫颈组织活检,分析HPV各亚型的感染分布情况及其与宫颈病变的相互关系。【结果】在1851例患者中,以高危型人乳头瘤病毒(HR-HPV)感染为主,HPV16检出率居首位,其次为HPV52、HPV58、HPV53等,其中病理组织活检结果阳性患者共234例,检出宫颈上皮内瘤变(CIN)2级以上病变者77例。HPV16型感染者CIN2级以上比例为11.8%(45/380),高于HPV52、HPV58等其他高危亚型感染者2.4%(32/1328),差异有统计学意义(χ^2=61.60,P<0.001)。在年龄因素中,>35岁组HPV高危阳性比例为96.91%(1225/1264),高于≤35岁组94.38%(554/587),差异有统计学意义(χ^2=6.898,P=0.009)。HPV分型检测检出CIN1级以上病变为12.64%(234/1851),而液基薄层细胞学检测(TCT)检出CIN1级以上病变为8.59%(159/1851),TCT作为筛查手段其检出率低于HPV检测方法(χ^2=16.01,P<0.001)。【结论】HPV亚型感染依次以HPV16、HPV52、HPV58、HPV53、HPV18递减,HR-HPV感染与宫颈病变发生密切相关,且随着高危感染的升高,其宫颈病变程度也升高。HPV分型检测较TCT筛查宫颈病变检出率更高。     

浙江地区妇女生殖道人乳头瘤病毒感染亚型的检测及流行病学分析

人乳头瘤病毒(HPV)感染是导致宫颈鳞癌和上皮内瘤病变等发生的必要因素~([1]).通常在性活跃期的最初几年,有75%以上的女性会在不同阶段感染HPV.而持续性的高危型HPV感染将会增加宫颈细胞癌变的危险性.因此,HPV基因分型检测成为筛查及预防宫颈癌的有效手段之一.本研究分析浙江地区生殖道标本的HPV基因分型检测结果,以了解HPV各亚型的感染及分布情况.     

人乳头瘤病毒和其他因素与宫颈癌关系的研究

对４９例宫颈癌病人和６５例非癌妇女进行了人乳头瘤病（ＨＰＶ）ＤＮＡ序列测定及妇科卫生、生育和矽丈夫等情况调查。结果表明两组中ＨＰＶ阳性率分别为４９％和６．１５％。在调整年龄、文化水平和吸烟３因素后，宫颈癌的危险因素有妇科卫生差、多孕多生、丈夫包皮过长和ＨＰＶ感染等。几个因素共同作用时，除年龄因素外仅ＨＰＶ的ＯＲ值有显著性，表明它可能是从暴露上述危险因素到宫颈癌发生过程中的中间生物标志。     

天津市和平区2008—2010年性病疫情分析

目的了解天津市和平区2008—2010年性传播疾病的流行态势,并为进一步开展性病的预防控制工作提供依据。方法用描述流行病学方法对资料进行分析。结果 2008—2010年,本辖区共报告性病病例1 034例,6个街区均有分布,其中男性640例,女性394例,男女比例为1.62∶1;年龄最大的73岁,最小的不到1岁,其中20～49岁年龄组占83.75%。职业主要以家务及待业(18.76%)、商业服务(18.76%)和工人(12.77%)为主。3年的发病率分别为106.27/10万,96.92/10万,59.10/10万,各种性病报告发病率由高到低依次为梅毒(51.22/10万)、生殖道沙眼衣原体感染(16.20/10万)、尖锐湿疣(10.21/10万)、淋病(6.24/10万)、生殖器疱疹(1.69/10万)和人类免疫缺陷病毒/艾滋病(HIV/AIDS)感染(1.69/10万)。结论该地区2008—2010年性病年发病率呈逐年下降趋势,主要病种梅毒下降明显,但是出现了母婴垂直传播病例,造成了二代传播。应当根据本区性病发病的特点和趋势,完善相关防治策略。     

武汉市2014—2018年性病门诊男性就诊者艾滋病哨点监测结果分析

目的 了解武汉市性病门诊男性就诊者艾滋病监测情况,分析目标人群高危行为以及HIV、HCV和梅毒感染状况,为制定科学的防艾措施提供依据.方法 按照《全国艾滋病哨点监测实施方案》,用连续采样方法,对2014—2018年监测期内所有符合条件的对象进行问卷调查并采集血样进行检测,每年监测400人,共完成样本量2000例.采用卡...     

深圳市妇女子宫颈人乳头瘤病毒感染分子流行病学分析

目的了解深圳市妇女子宫颈人乳头瘤病毒(HPV)感染流行病学特征。方法应用聚合酶链反应(PCR)结合反向寡核苷酸探针斑点杂交技术对深圳市妇幼保健院近5年参加子宫颈癌筛查的HPV感染者基因亚型进行分析。结果参加宫颈癌筛查9683人,HPV阳性1455例,感染率为14.5%,平均年龄为(34.1±9.0)岁。25岁以下年龄组感染率明显高于其他年龄组,差异有统计学意义(P<0.01)。2009-2010年感染率显著高于2006-2008年,差异有统计学意义(P<0.01)。前3位高危基因亚型是HPV16(22.4%)、52(12.1%)、58(11.3%);2联及以上混合感染178例,占12.2%;混合感染前10位HPV基因亚型构成中以高危基因亚型为主;从低年龄组到高年龄组,HPV多重基因亚型混合感染发生率呈现明显下降趋势(趋势χ2=32.350,P<0.01)。结论深圳市女性人群HPV阳性率较高,不同时期存在差异;在常见的高危亚型中,HPV18并不占主导地位;低年龄组HPV感染率和多重基因亚型混合感染率高;混合感染中以高危亚型联合其他基因型感染为主。     

人类乳头瘤病毒与宫颈癌关系的研究

用Southern blot核酸杂交技术检测宫颈组织HPV16DNA相关序列。山东省116例宫颈癌病人的癌组织HPV16DNA相关序列阳性率为50．9％，36例无宫颈疾病妇女的宫颈组织阳性率为5．6％，宫颈癌与HPV16有强的联系。OR＝17．60，X^2=23.47，P＜0．01。HPV16DNA相关序列阳性率与宫颈癌病人的年龄、肿瘤的组织类型、临床类型及临床分期均无统计学上联系（P均大于0．25）。本文首次从山东省宫颈癌病人组织中检测到HPV33DNA4例及HPV31DNA1例。     

Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs) in a City of Northern India

Introduction:Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs.Results:The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client''s demand for unsafe sex were found to be significant in causing STI.Conclusions:Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia, and having sex without condom for extra money, failure to persuade the client and not doing anything were found to be important predictors for presence of STI.     

Factors associated with Human Papilloma Virus (HPV) vaccine recommendation by physicians in Lebanon,a cross-sectional study

Persistent Human Papilloma Virus (HPV) infection is associated with the development of cervical cancer, a leading cause of female death worldwide. In Lebanon, cervical cancer is the 6th most common cancer amongst girls and women aged 14–44 years. Cervical cancer is preventable through HPV vaccination; however, Lebanon does not include HPV vaccination in its national routine vaccination schedule. Hence, physician recommendation is key for patient vaccine uptake. We conducted a cross-sectional study in Beirut, Lebanon to assess factors affecting physician recommendation regarding HPV vaccination. Physicians practicing in Obstetrics and Gynecology (OBGYN), Pediatrics, Family Medicine and Infectious Diseases were included in the study. In total, 228 physicians completed the survey (28.79% response rate). The survey consisted of a set of demographic and HPV knowledge questions along with clinical vignettes. The vignettes presented theoretical patients who differed in gender, age, sexual activity, social background and whether the patient presented with his mother or not. The results show that physicians tend to recommend the vaccine more commonly for vignettes presenting female patients, with an Adjusted Odds Ratio (AOR) of 6.8. Also, physicians were more likely to recommend the vaccine for vignettes with patients coming from a non-conservative background (AOR = 2.1), vignettes where patients claim to be sexually active (AOR = 2.7) and vignettes where patients presented with their mother (AOR = 1.4). Physicians tend to recommend the vaccine less in vignettes with married patients (AOR = 0.5). Physicians with higher knowledge scores recommended the vaccine more often (AOR = 3.4). Overall, OBGYN physicians recommended the vaccine less than pediatricians (AOR = 0.5). These results show that Lebanese physicians’ recommendations rely on factors external to international guidelines. The results also highlight the importance of knowledge in adequate patient consultation. Thus, improved physician awareness towards international guidelines and physician education regarding HPV vaccination is essential in order to improve patient care in Lebanon.     

昆山市性病门诊就诊妇女性传播疾病感染情况分析

目的了解性病门诊就诊妇女性传播疾病(STD)感染状况.方法对2003年1月1日～12月31日到昆山市疾病预防控制中心门诊部初诊女性患者进行STD感染状况调查,取宫颈分泌物检测解脲支原体(UU)、沙眼衣原体(CT)、淋球菌(NG)等;取阴道分泌物检测念珠菌、阴道毛滴虫及细菌性阴道病,同时采血做梅毒快速血浆反应素试验(RPR).结果 STD的检出率为35.98%,STD构成比为非淋菌性宫颈炎44.10%、尖锐湿疣31.03%、淋病20.77%、梅毒3.59%、生殖器疱疹0.51%;阴道炎的总检出率为25.46%,其中霉菌18.08%、滴虫4.80%、细菌性阴道病2.58%.结论昆山市STD仍处于稳定的增长过程.     

云南省某市女性性工作者阴道冲洗与性传播疾病的关系

目的了解云南省某市女性性工作者(FSWs)阴道冲洗情况以及艾滋病病毒(HIV)和各种性传播疾病(STD)的感染情况。方法招募FSWs调查其社会人口统计学、行为学、HIV／AIDS知识以及生殖健康状况,采集静脉血进行HIV、单纯疱疹病毒2型(HSV-2)和梅毒血清学检测,采集尿液、宫颈分泌物和阴道分泌物标本进行尿吗啡、淋球菌和沙眼衣原体及阴道毛滴虫检测。结果共收集血液标本833份,其中84份经确认为HIV抗体阳性,感染率为10．1％,梅毒感染率为8．2％(68／833),HSV-2感染率为68．4％(570／833);阴道和宫颈分泌物标本各832份,淋球菌感染率为11．5％(96／832),沙眼衣原体感染率为28．2％(235／832),阴道毛滴虫感染率为11．9％(99／832)。多因素logistic回归模型分析显示,与阴道冲洗有关的影响因素为汉族、中高档性服务场所、听说过艾滋病、工作场所≥4个、过去一年出现过下腹部疼痛。结论阴道冲洗是HIV和某些STD感染的危险因素。     

Improving the performance of reflex Human Papilloma Virus (HPV) testing in triaging women with atypical squamous cells of undetermined significance (ASCUS): A restrospective study in a tertiary hospital in United Arab Emirates (UAE)

IntroductionCervical cancer is the second commonest cancer in women worldwide. Infection with oncogenic types of human Papillomavirus (HPV) is the most important risk factor for developing cervical cancer. Reflex High risk HPV (HR-HPV) testing is of significant value in the assessment of Papanicolaou (Pap) smear results where ASCUS are identified.ObjectiveTo improve the performance of reflex HR-HPV testing in triage of ASCUS and analyze the factors impacting it.MethodologyIn this study, we generated a database of 9641 women who had cervical smears collected during the study period from the cytopathology record in a large tertiary hospital in UAE. These included 297 smears with ASCUS diagnosis. All cases were retrospectively followed up with a mean duration of 2.44 years. We analyzed data according to the outcome based on several follow-up Pap smear analysis as the reference assessment.ResultsWe detected HR-HPV infection in 17.9% of cases. 9.1% <25, 28.8% 25–34 and 62.1% ≥35 years old. HR-HPV prevalence was higher among premenopausal women (20.7%) compared to postmenopausal women (9.5%) (P-value = 0.044). The rate of progression to high grade lesions was also higher (28.7%) in the premenopausal group compared to (12.8%) in the postmenopausal group. Reflex HPV testing had an overall sensitivity of 41.1%, specificity of 88.2%, positive predictive value (PPV) of 62.1%, and negative predictive value (NPV) of 75.9% in detection of cervical lesions. These figures were higher on combining premenopausal status and complaint of abnormal bleeding or discharge/itching (66.7%, 93.3%, 66.8% and 93.3% respectively).ConclusionsThe sensitivity, specificity and NPV of reflex HPV testing in the triage of ASCUS cases can be more accurate in premenopausal women upon adding age group and presenting complaint as a triage item. This improves the performance of reflex HPV testing and the subsequent selection of high risk patients for colposcopy.     

江西省2013-2017年人感染H7N9禽流感病例流行特征及时空聚集性分析

目的分析不同流行期江西省人感染H7N9禽流感病例的流行病学特点,为疫情防控提供依据。方法采用流行病学个案调查表对我省2013-2017年报告的人感染H7N9禽流感确诊病例进行流行病学调查,所得数据进行描述性流行病学分析和时空聚集性分析。结果52例病例主要发生在冬春季节,其中2017年发病数的73.08%;男女性别比例为1.47∶1,2017年前后病例的性别分布差异无统计意义(χ^2=0.049,P=0.82);2017年前后40岁以下和40岁以上病例分布差异有统计学意义(χ^2=4.17,P=0.041);前瞻性时空聚集性分析共探测到2个时空聚集区域,2016年12月至2017年3月赣东北地区存在聚集性(RR=26.43,LLR=37.88,P<0.01),2017年1月至2017年3月,聚集地为赣西北地区(RR=28.07,LLR=20.52,P<0.01)。结论尽管病例的大部分流行性别学相关指标未发生明显的变化,但2017年1-3月人感染H7N9禽流感发病存在较强的时空聚集性。