Thomas D B, Ray R M, Kuypers J, Kiviat N, Koetsawang A, Ashley R L, Qin Q, Koetsawang S
Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Am J Epidemiol. 2001 Apr 15;153(8):740-8. doi: 10.1093/aje/153.8.740.
Between September 1991 and September 1993, husbands of women with and without cervical neoplasia and commercial sex workers in one brothel and one massage parlor in Bangkok, Thailand, were interviewed; serologic tests for sexually transmitted infections were performed; and cervical and penile scrapings were tested for human papillomavirus (HPV) DNA. The risks of cervical carcinoma in monogamous women and of oncogenic HPV in their husbands were associated with the men's having unprotected intercourse with prostitutes. The prevalence of oncogenic HPV was higher in commercial sex workers than in women attending gynecologic and family planning clinics. Oncogenic HPV prevalence declined with age in human immunodeficiency virus (HIV)-negative, but not in healthy HIV-positive, commercial sex workers and was weakly associated with hepatitis B antigenemia, suggesting that persistence of HPV infection is due to subtle changes in immunity. Associations of HPV with recent pregnancy and oral contraceptive use suggest that hormonal factors may increase the risk of cervical neoplasia by enhancing persistence of HPV infection. The prevalence of high-grade squamous intraepithelial lesions was strongly related to oncogenic HPV types and weakly to HIV infection only in their presence. Commercial sex workers in Bangkok are reservoirs of oncogenic HPV, and cervical cancer in monogamous Thai women develops in part as a result of transmission of these viruses to them by their husbands from prostitutes.
1991年9月至1993年9月期间，对泰国曼谷一家妓院和一家按摩院中有和没有宫颈肿瘤的女性的丈夫以及商业性工作者进行了访谈；进行了性传播感染的血清学检测；并对宫颈和阴茎刮片进行了人乳头瘤病毒（HPV）DNA检测。一夫一妻制女性患宫颈癌的风险及其丈夫感染致癌性HPV的风险与男性与妓女进行无保护性交有关。商业性工作者中致癌性HPV的患病率高于在妇科和计划生育诊所就诊的女性。在人类免疫缺陷病毒（HIV）阴性的商业性工作者中，致癌性HPV患病率随年龄下降，但在健康的HIV阳性商业性工作者中并非如此，且与乙肝抗原血症弱相关，这表明HPV感染的持续存在是由于免疫方面的细微变化。HPV与近期妊娠和口服避孕药使用之间的关联表明，激素因素可能通过增强HPV感染的持续存在而增加宫颈肿瘤的风险。高级别鳞状上皮内病变的患病率与致癌性HPV类型密切相关，仅在存在HIV感染时与HIV感染弱相关。曼谷的商业性工作者是致癌性HPV的储存宿主，一夫一妻制泰国女性的宫颈癌部分是由于其丈夫从妓女那里将这些病毒传播给她们所致。
