Fife K H, Katz B P, Brizendine E J, Brown D R
Departments of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Am J Obstet Gynecol. 1999 May;180(5):1110-4. doi: 10.1016/s0002-9378(99)70602-2.
Our goal was to determine the persistence of human papillomavirus infection of the cervix in a prospectively evaluated cohort of pregnant women observed from the first trimester until after delivery.
A group of 232 women were enrolled in the first trimester of pregnancy and had cervico-vaginal lavage specimens collected for detection of the deoxyribonucleic acid of human papillomavirus. They underwent sampling again in the third trimester (146 patients available) and at 4 to 12 weeks after delivery (83 patients available). Human papillomavirus deoxyribonucleic acid was detected by means of the Hybrid Capture assay.
In the first trimester of pregnancy, 31% of the patients had positive test results for human papillomavirus deoxyribonucleic acid, whereas 35.6% had positive results in the third trimester (P = 1.0). A comparison of first-trimester test results with postpartum results (paired data available from 83 patients) showed a decline from 39.8% positivity to 26.5% (P =.04). Comparing third-trimester results with postpartum results (paired data available from 74 patients) showed a decline from 35.1% to 25. 7% positivity (P =.12). When specimens positive for human papillomavirus were divided between those containing "high cancer risk" types (9 virus types often associated with dysplasia or malignancy) and "low cancer risk" types (5 types usually found in benign lesions), similar trends were seen, although not all comparisons were statistically significant.
The increased prevalence, during pregnancy, of detectable human papillomavirus deoxyribonucleic acid, which was previously reported (Fife et al, Am J Obstet Gynecol 1996;174:1487-93), persists at a similar level throughout pregnancy but declines in the postpartum period. This observation is most consistent with activation of the virus by the physiologic changes of pregnancy.
我们的目标是在一个从孕早期至产后进行前瞻性评估的孕妇队列中，确定宫颈人乳头瘤病毒感染的持续情况。
一组232名妇女在孕早期入组，采集宫颈阴道灌洗标本以检测人乳头瘤病毒的脱氧核糖核酸。她们在孕晚期再次接受采样（146名患者可用），并在产后4至12周接受采样（83名患者可用）。通过杂交捕获试验检测人乳头瘤病毒脱氧核糖核酸。
在孕早期，31%的患者人乳头瘤病毒脱氧核糖核酸检测结果为阳性，而在孕晚期这一比例为35.6%（P = 1.0）。将孕早期检测结果与产后结果进行比较（83名患者有配对数据），阳性率从39.8%降至26.5%（P =.04）。将孕晚期结果与产后结果进行比较（74名患者有配对数据），阳性率从35.1%降至25.7%（P =.12）。当将人乳头瘤病毒阳性标本分为含有“高癌症风险”类型（9种常与发育异常或恶性肿瘤相关的病毒类型）和“低癌症风险”类型（通常在良性病变中发现的5种类型）时，观察到类似趋势，尽管并非所有比较都具有统计学意义。
先前有报道称孕期可检测到的人乳头瘤病毒脱氧核糖核酸患病率增加（Fife等人，《美国妇产科杂志》1996年；174：1487 - 93），这种情况在整个孕期持续处于相似水平，但在产后阶段有所下降。这一观察结果与孕期生理变化激活病毒最为相符。
