昆明地区18449例医院就诊患者HPV检出情况分析与疫苗接种建议

目的 分析医院门诊首诊患者生殖道人乳头瘤病毒(HPV)检出情况及亚型分布特征，为昆明地区HPV的预防和疫苗接种提供参考。方法 以2018年1月至2020年12月就诊于昆明市延安医院首诊女性患者18 449例作为研究对象，收集临床资料，应用回顾性研究方法，分析HPV总检出情况，比较不同年龄组、不同年份HPV检出率，分析高危型HPV(HR-HPV)和低危型HPV(IR-HPV)的流行情况。结果 18 449例患者中HPV阳性共2 520例，HPV总检出率为13.7%。2018年至2020年间HPV检出率呈下降趋势(趋势χ²=14.95,P <0.001)。按年龄分组，HPV检出呈“V”型分布，小于20岁组检出率最高，为42.4%；其次是≥60岁组，为19.7%;30～岁组检出率最低，仅为12.0%，差异有统计学意义(χ²=57.080,P <0.001)。最小感染年龄仅为15岁，并且为多重感染。多重感染者共973例，占全部患者5.3%，占阳性患者38.6%。<20岁和≥60岁组均以多重感染为主，20～59岁组则以单一高危型感染最...

Analysis of HPV Detection in 18 449 Hospital Patients in Kunming and HPV Vaccination Recommendations

  Objective  To analyze the detection and subtype distribution characteristics of human papillomavirus （HPV） in the genital tract of the first outpatient in the hospital, and to provide reference for the prevention and vaccination of HPV in the region.   Methods  A total of 18449 first-diagnosed female patients in Yan 'an Hospital of Kunming City from January 2018 to December 2020 were selected as the research objects. Clinical data were collected and a retrospective study was used to analyze the total HPV infection and compare the HPV detection rates in different age groups and years. To analyze the prevalence of high-risk HPV （HR-HPV） and low-risk HPV （IR-HPV）.   Results  Among 18449 patients, 2520 were HPV positive, and the total detection rate of HPV was 13.7%. HPV infection showed a downward trend from 2018 to 2020 （trend χ2 = 4.95, P < 0.001）. According to age group, HPV detection showed a "V" type distribution, with the highest detection rate of 42.4% in the group less than 20 years old. The second group was ≥60 years old （19.7%）. The detection rate in 30-year old group was the lowest, only 12.0%, and the difference was statistically significant （χ2 = 7.080, P < 0.001）. The minimum age of infection was only 15 years and there were multiple infections. There were 973 cases of multiple infection, accounting for 5.3% of all patients and 38.6% of positive patients. Multiple infection was the main infection in < 20 years old group and ≥60 years old group, and single high-risk infection was the most common infection in 20-59 years old group. The top five detected HR-HPV types were HPV52, 53, 58, 16 and 51. The IR-HPV types were HPV81, 42, 43, 6 and 11. In HR-HPV, the dominant detected types changed from HPV52, 16 and 58 in 2018 to HPV52, 53 and 58 in 2019 and 2020.   Conclusions  HPV infection shows a trend of younger age, and the dominant types of HPV infection are different in different age groups. Attention should be paid to the prevention and treatment of HPV52, 53 and 58 infections in this region.