Syrjänen Stina, Shabalova Irena, Petrovichev Nicolaj, Kozachenko Vladimir, Zakharova Tatjana, Pajanidi Julia, Podistov Julia, Chemeris Galina, Sozaeva Larisa, Lipova Elena, Tsidaeva Irena, Ivanchenko Olga, Pshepurko Alla, Zakharenko Sergej, Nerovjna Raisa, Kljukina Ludmila, Erokhina Oksana, Branovskaja Marina, Nikitina Maritta, Grujnberga Valerija, Grujnberg Alexandr, Juschenko Anna, Johansson Bo, Tosi Piero, Cintorino Marcella, Santopietro Rosa, Syrjänen Kari
Department of Oral Pathology, Institute of Dentistry, and MediCity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland.
Sex Transm Dis. 2003 Sep;30(9):680-4. doi: 10.1097/01.OLQ.0000079519.04451.D4.
On a global scale, the New Independent States (NIS) of the former Soviet Union have an intermediate incidence of cervical cancer, the main etiologic factor of which is human papillomavirus (HPV), a major sexually transmitted disease (STD). Recently, the prevalence of all STDs has exploded in these countries.
The goal of this study was to examine the sexual habits and HPV prevalence among females in three NIS countries.
In this multinational (European Community-funded) trial, a series of 3,175 consecutive female patients were examined for HPV status (by Hybrid Capture II) at six clinics in Russia, Belarus, and Latvia. A meticulous survey of their sexual habits and other potential risk factors of HPV infections was made by structured questionnaire.
Three categories of patients were examined: those attending STD clinics (n=722), gynecological patients (n=761), and those who participated in cervical cancer screening (n=1,692). These three categories were significantly differentiated by a large number of key variables, including the HPV detection rate (44.9% of STD patients, 39.8% of gynecological patients, and 24.5% of those who were screened). A wide variety sexual habits of these subjects were predictors of the HPV status in univariate analysis. Binary logistic regression analysis found that six different variables remained as independent predictors of HPV status. Patient category (STD) and (young) age were two highly significant predictors of increased risk (P<0.0001), whereas having a nonsmoking partner and having zero or one partner during the past 2 years were significant protective factors (P=0.004 and P=0.007, respectively).
The results of this study indicate that women and girls in these NIS countries are conservative in many key characteristics of "high-risk" sexual behavior, such as age at onset of sexual activity, number of partners, and casual sex partners. HPV-positive and HPV-negative groups are clearly distinguished by the same variables identified as the key risk factors of HPV infection and cervical intraepithelial neoplasia in Western countries.
在全球范围内，前苏联的新独立国家（NIS）宫颈癌发病率处于中等水平，其主要病因是人类乳头瘤病毒（HPV），这是一种主要的性传播疾病（STD）。最近，这些国家所有性传播疾病的患病率急剧上升。
本研究的目的是调查三个独联体国家女性的性行为习惯和HPV患病率。
在这项跨国（由欧洲共同体资助）试验中，在俄罗斯、白俄罗斯和拉脱维亚的六个诊所，对连续的3175名女性患者进行了HPV状态检测（采用第二代杂交捕获法）。通过结构化问卷对她们的性行为习惯和其他HPV感染潜在风险因素进行了细致调查。
检查了三类患者：性病门诊患者（n = 722）、妇科患者（n = 761）以及参加宫颈癌筛查的患者（n = 1692）。这三类患者在大量关键变量上存在显著差异，包括HPV检测率（性病患者中为44.9%，妇科患者中为39.8%，筛查患者中为24.5%）。在单因素分析中，这些受试者的多种性行为习惯是HPV状态的预测因素。二元逻辑回归分析发现，六个不同变量仍然是HPV状态的独立预测因素。患者类别（性病）和（年轻）年龄是风险增加的两个高度显著预测因素（P < 0.0001），而有不吸烟的伴侣以及在过去两年中有零个或一个伴侣是显著的保护因素（分别为P = 0.004和P = 0.007）。
本研究结果表明，这些独联体国家的妇女和女孩在“高危”性行为的许多关键特征方面较为保守，如首次性行为年龄、性伴侣数量和临时性伴侣。HPV阳性和HPV阴性组通过与西方国家确定为HPV感染和宫颈上皮内瘤变关键风险因素相同的变量明显区分开来。
