Department of Hygiene Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece.
J Med Virol. 2009 Dec;81(12):2059-65. doi: 10.1002/jmv.21639.
The aim of the study was to evaluate the prevalence and risk factors of HPV in a gynecologic population attending outpatient clinics using two new molecular tests. The Amplicor HPV test and the Linear Array (LA) HPV Genotyping test were used for the detection of HPV DNA in 320 women. Multiple logistic regression was used to identify independent prognostic factors of HPV positivity. The agreement between the two methods in terms of their qualitative results was 89.3% (kappa: 0.63). Based on the LA results, the overall prevalence of HPV DNA was 49.1%, 95% confidence interval (95% CI: 43.5%, 54.7%). The prevalence of high-risk HPV types was 30.3%. The predominant types were HPV-6 (24.8%) and HPV-16 (20.4%). Among women with normal cytology, the prevalence of HPV was much higher in those presenting other findings, such as inflammation, than those without other abnormal findings (49.5% vs. 31.5%). On the basis of multivariate analysis, the risk of HPV infection was higher among women with multiple sexual partners [>3 vs. 1: OR = 3.1, 95% CI: (1.5, 7.2)], Pap smear findings [low/high-grade lesions vs. negative: OR = 2.8, 95% CI: (1.2, 6.5)], the presence of warts [yes vs. no: OR = 3.0, 95% CI: (1.5, 6.3)] and no history of child birth [no vs. yes: OR = 2.6, 95% CI: (1.0, 6.7)]. Younger age was an additional risk factor for HPV infection with carcinogenic genotypes [OR for 1 year increase = 0.93, 95% CI: (0.89, 0.98)].
本研究旨在通过两种新的分子检测方法评估妇科门诊患者 HPV 的流行率和危险因素。对 320 名女性进行了 Amplicor HPV 检测和 Linear Array(LA)HPV 基因分型检测以检测 HPV DNA。采用多因素逻辑回归分析确定 HPV 阳性的独立预测因素。两种方法在定性结果方面的一致性为 89.3%(kappa 值:0.63)。根据 LA 结果,HPV DNA 的总体流行率为 49.1%,95%置信区间(95%CI:43.5%,54.7%)。高危型 HPV 类型的流行率为 30.3%。主要类型为 HPV-6(24.8%)和 HPV-16(20.4%)。在细胞学正常的女性中,与无其他异常发现的女性相比,有炎症等其他发现的女性 HPV 感染率更高(49.5% vs. 31.5%)。基于多因素分析,HPV 感染的风险在具有多个性伴侣(>3 比 1:OR = 3.1,95%CI:1.5,7.2)、巴氏涂片检查结果(低/高级别病变与阴性:OR = 2.8,95%CI:1.2,6.5)、湿疣存在(有 vs. 无:OR = 3.0,95%CI:1.5,6.3)和无生育史(无 vs. 有:OR = 2.6,95%CI:1.0,6.7)的女性中更高。年龄较小是 HPV 感染的另一个危险因素,与致癌基因型相关(OR 每年增加 = 0.93,95%CI:0.89,0.98)。