Banura Cecily, Franceschi Silvia, van Doorn Leen-Jan, Arslan Annie, Kleter Bernhard, Wabwire-Mangen Fred, Mbidde Edward K, Quint Wim, Weiderpass Elisabete
Faculty of Medicine, Makerere University, Kampala, Uganda.
Int J Cancer. 2008 Nov 1;123(9):2180-7. doi: 10.1002/ijc.23762.
The proportion of women who have already been exposed to human papillomavirus (HPV) infection by the time they first become pregnant, and the influence of pregnancy and delivery on the course of HPV infection are unclear. In Kampala, Uganda, 987 young primiparous pregnant women aged <25 years had gynaecological examination and liquid-based cytology. In the follow-up, women acted as their own controls, i.e., 1st/2nd versus 3rd trimesters (105 women), and during pregnancy versus after delivery (289 women). HPV was assessed using highly sensitive PCR assays. Prevalence of HPV and HIV infections at baseline were 60.0% and 7.3%, respectively. HPV16 and 18 were detected in 8.4% and 5.8%, respectively, i.e., less frequently than HPV51 (8.7%) and 52 (12.1%). At follow-up new HPV infections were detected in 42.9% of women between the 1st/2nd and 3rd trimesters, and 38.1% between pregnancy and delivery, but 50.4% and 71.8% of HPV infections, respectively, cleared, leaving HPV prevalence unchanged in the different periods. Prevalence of cytological abnormalities diminished after delivery (from 21.2% to 12.4%). Presence of genital warts and sexually transmitted infections other than HPV were the strongest risk factors for prevalent or incident HPV infection. Clearance was lower among HIV-positive women. In conclusion, HPV prevalence was high in primiparous women in Uganda, but pregnancy did not seem to be a period of special vulnerability to the infection.
首次怀孕时已感染人乳头瘤病毒（HPV）的女性比例，以及怀孕和分娩对HPV感染病程的影响尚不清楚。在乌干达坎帕拉，987名年龄小于25岁的初产孕妇接受了妇科检查和液基细胞学检查。在随访中，女性自身作为对照，即孕早期/中期与孕晚期（105名女性），以及孕期与产后（289名女性）。使用高灵敏度PCR检测法评估HPV。基线时HPV和HIV感染率分别为60.0%和7.3%。分别检测到8.4%的HPV16和5.8%的HPV18，即其检出频率低于HPV51（8.7%）和HPV52（12.1%）。在随访中，42.9%的女性在孕早期/中期与孕晚期之间检测到新的HPV感染，38.1%在孕期与产后之间检测到新感染，但分别有50.4%和71.8%的HPV感染清除，不同时期的HPV感染率未变。产后细胞学异常率降低（从21.2%降至12.4%）。尖锐湿疣的存在以及除HPV之外的性传播感染是HPV现患或新发感染的最强危险因素。HIV阳性女性的清除率较低。总之，乌干达初产女性中HPV感染率较高，但怀孕似乎并非HPV感染的特殊易感时期。
