Chan Paul K S, Ho Wendy C S, Wong Martin C S, Chang Alexander R, Chor Josette S Y, Yu Mei-Yung
Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China.
J Med Virol. 2009 Sep;81(9):1635-44. doi: 10.1002/jmv.21575.
This study identified the age-specific prevalence and epidemiologic risk profile for infection with different groups and species of human papillomaviruses (HPV). Structured interview and HPV testing were conducted for 2,604 Chinese women self-referred for cervical screening. Independent risk factors for infection were identified by multiple logistic regressions. Overall, a major peak of HPV infection was observed at women aged 26-30 years, and a minor peak at 46-55 years. This pattern was observed for high-risk, low-risk, and alpha-5/7/9 HPVs; but alpha-3/6 HPVs showed peaks of similar magnitudes in young and older women. Independent risk factors for HPV infection (all types combined) included younger age (OR [95% CI] for >55 vs. < or =30 years = 0.22 [0.09-0.55]; 31-45 vs. < or = 30 years = 0.57 [0.33-0.99]), having > or =4 lifetime sexual partners (2.28 [1.06-4.88]), and smoking (2.24 [1.22-4.10]). Young age and smoking were the most consistent independent risk factors observed across different HPV groups. The risk profile for high-risk HPV was similar to alpha-5/7/9. Single-type infection was associated with having more sexual partners, higher education level and oral contraception; whereas multiple-type infection was associated with smoking. In conclusion, a U-shaped age-specific prevalence curve was observed for HPV infection overall, but with a different pattern for different HPV species. Different HPV groups showed variations in their risk profiles. These data are useful for formulating preventative strategy for HPV-related diseases. Catch-up vaccination program in Hong Kong should cover a wider age group as the first peak of infection occurred relatively late.
本研究确定了不同组别人乳头瘤病毒（HPV）感染的年龄特异性患病率及流行病学风险概况。对2604名因宫颈筛查而自行前来的中国女性进行了结构化访谈和HPV检测。通过多因素逻辑回归确定感染的独立危险因素。总体而言，HPV感染的主要高峰出现在26 - 30岁的女性中，次要高峰出现在46 - 55岁。高危型、低危型和α-5/7/9型HPV均呈现这种模式；但α-3/6型HPV在年轻和年长女性中显示出相似幅度的高峰。HPV感染（所有类型合并）的独立危险因素包括较年轻的年龄（>55岁与≤30岁相比的比值比[95%置信区间]=0.22[0.09 - 0.55]；31 - 45岁与≤30岁相比=0.57[0.33 - 0.99]）、终身性伴侣≥4个（2.28[1.06 - 4.88]）以及吸烟（2.24[1.22 - 4.10]）。年轻和吸烟是在不同HPV组中观察到的最一致的独立危险因素。高危型HPV的风险概况与α-5/7/9型相似。单一型感染与有更多性伴侣、更高教育水平和口服避孕药有关；而多重型感染与吸烟有关。总之，HPV感染总体呈现U型年龄特异性患病率曲线，但不同HPV种类的模式不同。不同HPV组的风险概况存在差异。这些数据有助于制定HPV相关疾病的预防策略。香港的补种疫苗计划应覆盖更广泛的年龄组，因为感染的第一个高峰出现得相对较晚。
