郑州市女性人乳头状瘤病毒感染的流行病学特征及分析

目的 调查和分析郑州市户口女性人乳头状瘤病毒（human papillomavirus，HPV）感染情况及常见的21种HPV亚型的感染分布。方法 采用自愿报名的方式，对有郑州市户口的年满18周岁的女性应用实时荧光PCR技术进行HPV筛查和亚型分型检测。结果 在50502例检测样本中HPV感染样本共计4740例，总感染率9.39%。年龄别分析表明，在18~30岁、31~40岁、41~50岁、>50岁4组的HPV感染阳性率分别是8.55%（78/912）、8.98%（1042/11608）、9.06%（2219/24500）、10.39%（1401/13482）。在所有样本中，高危和低危HPV病毒感染发生率分别是8.88%（4485/50502）和1.08%（534/50502）。高危HPV感染以第52亚型为最高，占比高达20.99%（995/4740）；其次是16亚型，占18.00%（853/4740）；再次为58亚型，占比13.73%（651/4740）。低危感染以81亚型为最高，占比7.66%（363/4740）；6型次之，占比2.78%（132/4740）；11型最低，占比1.08%（51/4740）。在4740例HPV阳性标本中有单一感染3208例，占比67.68%（3208/4740）。多重感染1532例，占比32.32%（1532/4740）。在多重感染中，包括二重感染989例，三重感染275例，四重感染71例，五重感染20例和六重感染3例。在二重感染中，最常见的亚型组合是52型+58型。结论 郑州市的女性人口HPV感染率在全国来说，处于较低的水平。HPV感染率随年龄增加而略有增加，50岁以后发生高危HPV亚型多重感染的可能性大大增加。感染最常见的前3位高危HPV亚型依次是52型、16型和58型。

Epidemiological Features and Analysis of Human Papilloma Virus Infection among Female Residents of Zhengzhou

Objective To study the prevalence of human papillomavirus(HPV)infection and type-distribution of 21 common types in the cervix of female residents in Zhengzhou.Methods Female residents in Zhengzhou at age of 18 or older were voluntarily enrolled in the study. Real-time fluorescent quantitative-PCR was applied to do the cervical HPV screening test and geno-typing.Results Of the 50502 cases, 4740 were HPV positive, which including 78/912 (8.55%) at age of 18 to 30, 1042/11608(8.98%) at age of 31 to 40, 2217/24500(9.06%) at age of 41 to 50, 1401/23482 (10.39%) at age of >50. The overall prevalence of HPV infection was 9.39% (4740/50502). Among the HPV positive cases, prevalence of high-risk-HPVs (HR-HPVs) and low-risk-HPVs (LR-HPVs) were 8.88% (4485/50502) and 1.08% (534/50502) respectively. Of those 21 types of HPV, HPV 52 was the most common HR-HPV accounting for 20.99% (995/4740), HPV 16 was the next one, accounting for 7.66%(363/4740), HPV 58 was the third leading infection accounting for 13.73%(651/4740). Among LR-HPVs, the most common was HPV 81 accounting for 7.66% (363/4740),and the next one was HPV 6 accounting for 2.78% (132/4740), HPV 11 was the third one accounting for 1.08% (51/4740). There were 1532 of multi-infections accounting for 32.32% (1532/4740). Of multi-infections, there were 989 of double-infections, 275 of triple-infections, 71 of quadruple-infections, 20 of quintuple-infections, and 3 of sextuple-infections. Of all different double-infections, HPV 52+ HPV58 was the most common combination.Conclusion Compared and analyzed with other HPV epidemiological survey results in China, the prevalence of HPVs in Zhengzhou city was at low level nationally which was going up with age gradually. However, the risk to get multiple HR-HPV infections increased significantly if people were older than 50. The leading three HPV types were HPV-52, 16 and 58.