Conesa-Zamora Pablo, Ortiz-Reina Sebastián, Moya-Biosca Joaquín, Doménech-Peris Asunción, Orantes-Casado Francisco Javier, Pérez-Guillermo Miguel, Egea-Cortines Marcos
Grupo de Patología Molecular y Farmacogenética FFIS011, Hospital Universitario Santa María del Rosell, Cartagena, Spain.
BMC Infect Dis. 2009 Aug 10;9:124. doi: 10.1186/1471-2334-9-124.
Human Papillomavirus (HPV) genotype distribution and co-infection occurrence was studied in cervical cytologic specimens from Murcia Region, (southeast Spain), to obtain information regarding the possible effect of the ongoing vaccination campaign against HPV16 and HPV18.
A total of 458 cytologic specimens were obtained from two outpatient gynecological clinics. These included 288 normal benign (N/B) specimens, 56 atypical squamous cell of undetermined significance (ASC-US), 75 low-grade squamous intraepithelial lesions (LSIL) and 39 high-grade squamous intraepithelial lesions (HSIL). HPV genotyping was performed using PCR and tube array hybridization.
The most frequent genotype found was HPV16 (14.9% in N/B; 17.9% in ASC-US; 29.3% in LSIL and 33.3% HSIL). Distribution of other genotypes was heavily dependent on the cytologic diagnoses. Co-infections were found in 15.3% of N/B, 10.7% of ASC-US, 48% of LSIL and 25.6% of HSIL cases (significantly different at p < 0.001). Strikingly, in N/B diagnoses, genotypes from A5 species were found as coinfecting in all cases. Genotypes from A7 or A9 species appeared in co-infections in 56.5% and 54% respectively whereas genotypes from A6 species appeared in 25.1% of cases.
HPV vaccination might prevent 34.6% and 35.8% of LSIL and HSIL, respectively. Co-infection rate is dependent on both cytologic diagnosis and HPV genotype. Moreover, genotypes belonging to A5, A7 and A9 species are more often found as co-infections than genotype pertaining to A6 species. This suggests that phylogenetically related genotypes might have in common similar grades of dependency for cervical epithelium colonization.
对西班牙东南部穆尔西亚地区宫颈细胞学标本中的人乳头瘤病毒（HPV）基因型分布及合并感染情况进行研究，以获取有关正在进行的针对HPV16和HPV18疫苗接种活动可能产生影响的信息。
从两家妇科门诊共获取458份细胞学标本。其中包括288份正常良性（N/B）标本、56份意义不明确的非典型鳞状细胞（ASC-US）、75份低级别鳞状上皮内病变（LSIL）和39份高级别鳞状上皮内病变（HSIL）。采用聚合酶链反应（PCR）和管阵列杂交技术进行HPV基因分型。
最常见的基因型是HPV16（在N/B中占14.9%；在ASC-US中占17.9%；在LSIL中占29.3%；在HSIL中占33.3%）。其他基因型的分布在很大程度上取决于细胞学诊断。在N/B病例中，15.3%发现合并感染；ASC-US病例中为10.7%；LSIL病例中为48%；HSIL病例中为25.6%（p<0.001时差异显著）。引人注目的是，在N/B诊断中，所有病例均发现A5种基因型合并感染。A7或A9种基因型分别在56.5%和54%的合并感染中出现，而A6种基因型在25.1%的病例中出现。
HPV疫苗接种可能分别预防34.6%的LSIL和35.8%的HSIL。合并感染率取决于细胞学诊断和HPV基因型。此外，与A6种基因型相比，A5、A7和A9种基因型更常出现合并感染。这表明系统发育相关的基因型在宫颈上皮定植的依赖程度上可能有相似之处。
