de Sanjosé Silvia, Diaz Mireia, Castellsagué Xavier, Clifford Gary, Bruni Laia, Muñoz Nubia, Bosch F Xavier
Servei d'Epidemiologia i Registre del Càncer, Institut Català d'Oncologia, Barcelona, Spain.
Lancet Infect Dis. 2007 Jul;7(7):453-9. doi: 10.1016/S1473-3099(07)70158-5.
We set out to estimate the age and genotype-specific prevalence of cervical human papillomavirus (HPV) DNA in women with normal cervical cytology worldwide by meta-analysis of a systematic literature review. Reports on HPV prevalence published between January, 1995, and January, 2005, were retrieved. To be included, studies required information on cervical cytology, plus detailed descriptions of study populations, methods used to collect cervical samples, and assays used for HPV DNA detection and typing. Final analyses included 78 studies that could be separated into women with normal cytology, and of which subsets of 44 and 48 studies had data on age and type-specific HPV prevalence, respectively. Overall HPV prevalence in 157 879 women with normal cervical cytology was estimated to be 10.4% (95% CI 10.2-10.7). Corresponding estimates by region were Africa 22.1% (20.9-23.4), Central America and Mexico 20.4% (19.3-21.4), northern America 11.3% (10.6-12.1), Europe 8.1% (7.8-8.4), and Asia 8.0% (7.5-8.4). In all world regions, HPV prevalence was highest in women younger than 35 years of age, decreasing in women of older age. In Africa, the Americas, and Europe, a clear second peak of HPV prevalence was observed in women aged 45 years or older. On the basis of these estimates, around 291 million women worldwide are carriers of HPV DNA, of whom 32% are infected with HPV16 or HPV18, or both. The HPV types most commonly detected are similar to those most commonly described in pre-neoplastic and cancer cases, although the relative contribution of HPV16 and HPV18 is substantially lower in cytologically normal women.
我们通过对系统文献综述进行荟萃分析，旨在估计全球宫颈细胞学正常女性中宫颈人乳头瘤病毒（HPV）DNA的年龄和基因型特异性流行率。检索了1995年1月至2005年1月间发表的关于HPV流行率的报告。纳入的研究需包含宫颈细胞学信息，以及对研究人群、宫颈样本采集方法和HPV DNA检测及分型方法的详细描述。最终分析纳入了78项研究，这些研究可分为宫颈细胞学正常的女性，其中分别有44项和48项研究子集有年龄和HPV型特异性流行率的数据。157879名宫颈细胞学正常的女性中HPV总体流行率估计为10.4%（95%可信区间10.2 - 10.7）。按地区的相应估计值为：非洲22.1%（20.9 - 23.4），中美洲和墨西哥20.4%（19.3 - 21.4），北美洲11.3%（10.6 - 12.1），欧洲8.1%（7.8 - 8.4），亚洲8.0%（7.5 - 8.4）。在所有世界地区，HPV流行率在35岁以下女性中最高，随年龄增长而降低。在非洲、美洲和欧洲，45岁及以上女性中观察到HPV流行率有明显的第二个高峰。根据这些估计，全球约2.91亿女性为HPV DNA携带者，其中32%感染了HPV16或HPV18，或两者皆有。最常检测到的HPV类型与癌前病变和癌症病例中最常描述的类型相似，尽管在细胞学正常的女性中HPV16和HPV18的相对占比要低得多。
