Smith Jennifer S, Melendy Amy, Rana Rashida K, Pimenta Jeanne M
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
J Adolesc Health. 2008 Oct;43(4 Suppl):S5-25, S25.e1-41. doi: 10.1016/j.jadohealth.2008.07.009.
Global data on age-specific prevalence of human papillomavirus (HPV) infection overall, and for high-risk HPV types 16 and 18, are essential for the future implementation of HPV prophylactic vaccines for cervical cancer prevention.
A systematic review of peer-reviewed publications was conducted to summarize worldwide data on genital HPV-DNA prevalence in women. Studies with clear descriptions of polymerase chain reaction or hybrid capture detection assays were included.
A total of 346,160 women were included in 375 studies. Of 134 studies with age-stratified HPV prevalence data (116 low sexual risk populations, 18 high sexual risk populations), over 50% were from Europe and the Middle East (38%) and North America (19%), with smaller proportions from Asia and Australia (21%), Central and South America (11%), and Africa (10%). Across all geographical regions, data on HPV prevalence were generally limited to women over 18 years of age. Consistently across studies, HPV infection prevalence decreased with increasing age from a peak prevalence in younger women (< or =25 years of age). In middle-aged women (35-50 years), maximum HPV prevalence differed across geographical regions: Africa (approximately 20%), Asia/Australia (approximately 15%), Central and South America (approximately 20%), North America (approximately 20%), Southern Europe/Middle East (approximately 15%), and Northern Europe (approximately 15%). Inconsistent trends in HPV prevalence by age were noted in older women, with a decrease or plateau of HPV prevalence in older ages in most studies, whereas others showed an increase of HPV prevalence in older ages. Similar trends of HPV 16 and/or 18 prevalence by age were noted among 12 populations with available data.
Genital HPV infection in women is predominantly acquired in adolescence, and peak prevalence in middle-aged women appears to differ across geographical regions. Worldwide variations in HPV prevalence across age appear to largely reflect differences in sexual behavior across geographical regions. Further studies of HPV prevalence in adolescents are needed for all geographic regions.
全面了解人乳头瘤病毒（HPV）总体感染率以及高危型HPV 16和18型的年龄特异性感染率，对于未来实施预防宫颈癌的HPV预防性疫苗至关重要。
对同行评审的出版物进行系统综述，以总结全球女性生殖器HPV-DNA感染率的数据。纳入对聚合酶链反应或杂交捕获检测方法有清晰描述的研究。
375项研究共纳入346,160名女性。在134项有年龄分层HPV感染率数据的研究中（116个低性风险人群，18个高性风险人群），超过50%来自欧洲和中东（38%）以及北美（19%），来自亚洲和澳大利亚（21%）、中南美洲（11%）和非洲（10%）的比例较小。在所有地理区域，HPV感染率数据通常仅限于18岁以上的女性。在所有研究中一致的是，HPV感染率随着年龄的增长而下降，在年轻女性（≤25岁）中感染率最高。在中年女性（35 - 50岁）中，HPV最高感染率在不同地理区域有所不同：非洲（约20%）、亚洲/澳大利亚（约15%）、中南美洲（约20%）、北美（约20%）、南欧/中东（约15%）和北欧（约15%）。在老年女性中，HPV感染率随年龄变化的趋势不一致，大多数研究显示老年女性HPV感染率下降或趋于平稳，而其他研究则显示老年女性HPV感染率上升。在有可用数据的12个人群中，HPV 16和/或18感染率随年龄变化的趋势相似。
女性生殖器HPV感染主要在青春期获得，中年女性的最高感染率在不同地理区域似乎有所不同。全球不同年龄的HPV感染率差异似乎在很大程度上反映了不同地理区域性行为的差异。所有地理区域都需要进一步研究青少年中的HPV感染率。
