Marais Dianne J, Constant Debbie, Allan Bruce, Carrara Henri, Hoffman Margaret, Shapiro Samuel, Morroni Chelsea, Williamson Anna-Lise
Institute of Infectious Disease and Molecular Medicine and Division of Medical Virology, Department Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa.
J Clin Microbiol. 2008 Feb;46(2):732-9. doi: 10.1128/JCM.01322-07. Epub 2007 Dec 12.
There is a high incidence of cervical cancer in South African women. No large studies to assess human papillomavirus virus (HPV) infection or HPV type 16 (HPV-16) exposure have occurred in the region, a requirement for policy making with regards to HPV screening and the introduction of vaccines. Control women (n = 1,003) enrolled in a case control study of hormonal contraceptives and cervical cancer were tested for 27 cervical HPV types by reverse line blot analysis. The seroprevalence of HPV-16 immunoglobulin G (IgG) and IgA antibodies was assessed by a virus-like particle-based enzyme-linked immunoassay of 908 and 904 control women, respectively, and of 474 women with cervical cancer. The cervical HPV prevalence was 26.1%. The HPV-16 IgG seroprevalence was 44.4% and the HPV-16 IgA seroprevalence was 28.7% in control women, and these levels were significantly higher (61.8% and 52.7%, respectively) for women with cervical cancer (odds ratio [OR], 2.1 and 2.8, respectively). The cervical HPV prevalence showed an association with cervical disease, and the HPV-16 IgG prevalence decreased while the HPV-16 IgA prevalence increased with increasing age (P < 0.05). The prevalence of oncogenic HPV types (including HPV-16) decreased with age, whereas nononcogenic HPV types showed limited association with age. Multivariate analysis revealed cervical HPV infection to be associated with herpes simplex virus type 2 infection (OR, 1.7) and increasing years of education (OR, 1.9). HPV-16 IgG antibodies were inversely associated with current smoking status (OR, 0.6), and the presence of HPV-16 IgA antibodies was inversely associated with the use of alcohol (OR, 2.1) and inversely associated with the use of oral contraceptives (OR, 0.6). High levels of exposure to HPV, and particularly HPV-16, were evident in this population. The apparent increase of serum HPV-16 IgA with increasing age requires further investigation.
南非女性宫颈癌发病率很高。该地区尚未开展大规模研究来评估人乳头瘤病毒（HPV）感染或16型HPV（HPV - 16）暴露情况，而这是制定HPV筛查和引入疫苗政策的必要条件。参与激素避孕药与宫颈癌病例对照研究的对照女性（n = 1,003）通过反向线印迹分析检测了27种宫颈HPV类型。分别对908名和904名对照女性以及474名宫颈癌女性进行基于病毒样颗粒的酶联免疫测定，评估HPV - 16免疫球蛋白G（IgG）和IgA抗体的血清阳性率。宫颈HPV感染率为26.1%。对照女性中HPV - 16 IgG血清阳性率为44.4%，HPV - 16 IgA血清阳性率为28.7%，而宫颈癌女性的这些水平显著更高（分别为61.8%和52.7%）（优势比[OR]分别为2.1和2.8）。宫颈HPV感染率与宫颈疾病有关，随着年龄增长，HPV - 16 IgG感染率下降而HPV - 16 IgA感染率上升（P < 0.05）。致癌性HPV类型（包括HPV - 16）的感染率随年龄下降，而非致癌性HPV类型与年龄的关联有限。多变量分析显示，宫颈HPV感染与2型单纯疱疹病毒感染（OR，1.7）以及受教育年限增加（OR，1.9）有关。HPV - 16 IgG抗体与当前吸烟状况呈负相关（OR，0.6），HPV - 16 IgA抗体的存在与饮酒（OR，2.1）呈负相关，与口服避孕药的使用（OR，0.6）呈负相关。该人群中HPV，尤其是HPV - 16的高暴露水平明显。血清HPV - 16 IgA随年龄增长而明显增加的现象需要进一步研究。
