出生后前3年婴儿口腔和生殖器黏膜中的高危型人乳头瘤病毒（HPV）DNA：来自芬兰HPV家庭研究的经验

High-risk types of human papillomavirus (HPV) DNA in oral and genital mucosa of infants during their first 3 years of life: experience from the Finnish HPV Family Study.

作者信息

Rintala Marjut A M, Grénman Seija E, Järvenkylä Marja E, Syrjänen Kari J, Syrjänen Stina M

机构信息

Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.

出版信息

Clin Infect Dis. 2005 Dec 15;41(12):1728-33. doi: 10.1086/498114. Epub 2005 Nov 7.

DOI:10.1086/498114

PMID:16288396

Abstract

BACKGROUND

This study is aimed to clarify data on the acquisition, persistence, and clearance of high-risk types of human papillomavirus (HPV) DNA from the mucosa and the determinants of persistent mucosal HPV infection in infants.

METHODS

Oral and genital scrapings from 324 infants were collected at birth, 3 days after delivery, and 1, 2, 6, 12, 24, and 36 months after delivery and tested for the presence of HPV DNA by nested polymerase chain reaction and hybridization with 12 high-risk HPV oligoprobes. HPV status and demographic data for parents were analyzed.

RESULTS

During the follow-up period (median duration, 26.2 months), HPV DNA was found to be present in 12%-21% of oral scrape samples and in 4%-15% of genital scrape samples obtained from the infants. Oral HPV infection was acquired by 42% of children, cleared by 11%, and persisted in 10% of the infants, whereas 37% were never infected. The corresponding figures for genital HPV infection were 36%, 14%, 1.5%, and 47%. Kaplan-Meier analysis revealed that both the cumulative incidence of infection and clearance of HPV were parallel in oral and genital sites. Persistent oral HPV infection in the child was significantly associated with persistent oral HPV infection in the mother at month 36 of follow-up, hand warts in the mother, young age at onset of sexual activity for the mother, and the mother's use of oral contraception, as well as with the father's oral HPV status at 24 months. Persistent genital HPV infection in the infant was predicted by if the mother had started smoking at 18-21 years of age and by a history of genital warts.

CONCLUSIONS

Persistent carriage of high-risk HPV types was detected in oral and genital mucosa specimens obtained from 10% and 1.5% of the infants during their first 26 months of life. The rates of acquisition and clearance of HPV were similar in oral and genital mucosa.

摘要

背景

本研究旨在阐明婴儿黏膜高危型人乳头瘤病毒（HPV）DNA的获得、持续存在及清除情况，以及持续性黏膜HPV感染的决定因素。

方法

收集324名婴儿出生时、出生后3天、出生后1、2、6、12、24和36个月时的口腔和生殖器刮片，采用巢式聚合酶链反应及与12种高危HPV寡核苷酸探针杂交的方法检测HPV DNA的存在情况。分析婴儿的HPV状态及父母的人口统计学数据。

结果

在随访期（中位持续时间26.2个月）内，从婴儿获得的口腔刮片样本中12% - 21%检测到HPV DNA，生殖器刮片样本中4% - 15%检测到HPV DNA。42%的儿童获得口腔HPV感染，11%清除感染，10%持续感染，37%从未感染。生殖器HPV感染的相应数字分别为36%、14%、1.5%和47%。Kaplan - Meier分析显示，HPV感染的累积发生率和清除率在口腔和生殖器部位是平行的。随访36个月时，儿童持续性口腔HPV感染与母亲持续性口腔HPV感染、母亲手部疣、母亲性活动开始年龄较小、母亲使用口服避孕药以及父亲24个月时的口腔HPV状态显著相关。婴儿持续性生殖器HPV感染可通过母亲在18 - 21岁开始吸烟以及有生殖器疣病史来预测。