Cottier Olivier, Sahli Roland, Mihaescu Anca, De Grandi Pierre, Boulvain Michel, Gerber Stefan
Department of Obstetrics and Gynecology, University Hospital of Lausanne, Lausanne University, Lausanne, Switzerland.
Am J Obstet Gynecol. 2009 Mar;200(3):286.e1-6. doi: 10.1016/j.ajog.2008.10.011. Epub 2009 Jan 24.
Evaluation of the clinical impact of multiple infections of the cervix by human papillomavirus, including human papillomavirus-16, compared with single human papillomavirus-16 infection.
One hundred sixty-nine women were classified in 3 categories depending on their human papillomavirus profile: human papillomavirus-16 only, human papillomavirus-16 and low-risk type(s), and human papillomavirus-16 and other high-risk type(s). Cervical brush samples were analyzed for human papillomavirus DNA by polymerase chain reaction and reverse line blot hybridization. All women were evaluated with colposcopy during 24 months or more. Management was according to the Bethesda recommendations.
Women infected with human papillomavirus-16 and other high-risk human papillomavirus type(s) presented more progression or no change in the grade of dysplasia, compared with women of the other groups (relative risk [RR], 1.39; 95% confidence interval [CI], 1.07-1.82; P = .02 at 6 months; RR, 2.10; 95% CI, 1.46-3.02; P < .001 at 12 months; RR, 1.82; 95% CI, 1.21-2.72; P = .004 at 24 months).
Coinfection of women with human papillomavirus-16 and other high-risk human papillomavirus type(s) increases the risk of unfavorable evolution.
评估人乳头瘤病毒（包括人乳头瘤病毒16型）多重感染宫颈与单一感染人乳头瘤病毒16型相比的临床影响。
169名女性根据其人乳头瘤病毒检测结果被分为3类：仅感染人乳头瘤病毒16型、感染人乳头瘤病毒16型和低危型、感染人乳头瘤病毒16型和其他高危型。采用聚合酶链反应和反向线印迹杂交技术对宫颈刷取样本进行人乳头瘤病毒DNA分析。所有女性在24个月或更长时间内接受阴道镜检查评估。管理措施依据贝塞斯达建议执行。
与人乳头瘤病毒16型和其他高危型人乳头瘤病毒共感染的女性相比，其他组女性发育异常等级出现更多进展或无变化（6个月时相对危险度[RR]为1.39；95%置信区间[CI]为1.07 - 1.82；P = 0.02；12个月时RR为2.10；95% CI为1.46 - 3.02；P < 0.001；24个月时RR为1.82；95% CI为1.21 - 2.72；P = 0.004）。
女性感染人乳头瘤病毒16型和其他高危型人乳头瘤病毒会增加病情不利发展的风险。
