Smith E M, Johnson S R, Jiang D, Zaleski S, Lynch C F, Brundage S, Anderson R D, Turek L P
Department of Preventive Medicine, University of Iowa, College of Medicine, Iowa City.
Cancer Detect Prev. 1991;15(5):397-402.
This study examined the effects of pregnancy on the prevalence of HPV infection, comparing 69 pregnant and 54 nonpregnant age-frequency matched female patients. HPV prevalence was detected by DNA hybridization using the ViraPap/ViraType dot blot procedure. The prevalence of HPV among pregnant women increased with gestational age from 8.0% in the first trimester, to 16.7% in the second, and 23.1% in the third trimester. This finding suggests that HPV infection may be activated by hormonal or other effects of pregnancy and may explain why number of pregnancies is known to be associated with increased risk of cervical dysplasia and cancer. Oncogenic HPV types 16/18 and 31/33/35 were identified with almost equal frequency in the study population whereas HPV 6/11 was seen rarely. The logistic regression models indicate that there were no significant differences between HPV positive and HPV negative groups by age, income, number of sex partners, age of first intercourse, average frequency of intercourse per month, number of pregnancies, oral contraceptive duration, or pregnancy status. There were no interaction effects. A current Pap result of cervical dysplasia (OR = 8.9; 95% confidence interval: 2.1, 38.8), oral contraceptive use (OR = 0.1; 0.03, 0.6), and education (OR = 1.4; 1.1, 1.8) were significant predictors of HPV status.
本研究通过比较69名年龄频率匹配的孕妇和54名非孕妇,探讨了妊娠对人乳头瘤病毒(HPV)感染率的影响。采用ViraPap/ViraType斑点杂交法通过DNA杂交检测HPV感染率。孕妇中HPV感染率随孕周增加,从孕早期的8.0%增至孕中期的16.7%,孕晚期为23.1%。这一发现表明,HPV感染可能因妊娠的激素或其他影响而被激活,这或许可以解释为何已知妊娠次数与宫颈发育异常和癌症风险增加有关。在研究人群中,致癌性HPV 16/18型和31/33/35型的检出频率几乎相等,而HPV 6/11型则很少见。逻辑回归模型表明,HPV阳性组和阴性组在年龄、收入、性伴侣数量、首次性交年龄、每月平均性交频率、妊娠次数、口服避孕药使用时长或妊娠状态方面无显著差异。不存在交互作用。目前宫颈发育异常的巴氏涂片结果(比值比=8.9;95%置信区间:2.1, 38.8)、口服避孕药使用情况(比值比=0.1;0.03, 0.6)和受教育程度(比值比=1.4;1.1, 1.8)是HPV感染状态的显著预测因素。