Department of Pathology, Kiang Wu Hospital, Macao Special Administrative Region, Shatin, China.
J Med Virol. 2010 Oct;82(10):1724-9. doi: 10.1002/jmv.21826.
Population-specific epidemiological data on human papillomavirus (HPV) infection are essential for formulating strategies to prevent cervical cancer. The age-specific prevalence of HPV infection was determined among 1,600 women enrolled for cervical screening in Macao. A U-shaped age-specific prevalence curve with a first peak (prevalence rate, 10%) at 20-25 years and a second peak (13%) at 51-55 years was observed. Co-infections with multiple types were detected in 32.5% of HPV-positive subjects and without significant variation among different age groups (P = 0.318). The majority (84.6%) of the positive samples harbored high- or probable high-risk HPV types, and these types also exhibited a similar U-shaped age-specific prevalence curve. In contrast, low and unknown-risk HPV types remained at a low prevalence (1.5-2.5%) throughout the age groups between 20 and 50 years, and with a small peak (4.5%) at 51-55 years. HPV 52 was the most common type found in 26.8% of positive samples, followed by HPV 16 (15.5%), HPV 68 (11.4%), HPV 18 and HPV 58 (8.9% each), HPV 54 (8.1%), HPV 53 (7.3%), HPV 39 (6.5%), HPV 33 and HPV 66 (5.7% each). In conclusion, because of the early peak of infection, vaccination and educational campaigns in Macao should start early and target at teenagers. The presence of a second peak containing mainly high-risk HPV types in older women indicates the need to evaluate the cover of the cervical screening programme for older women. Further study to determine the contribution of HPV 52 in high-grade cervical neoplasia and invasive cancers in Macao is warranted.
人口特异性流行病学数据对于制定预防宫颈癌的策略至关重要。本研究旨在调查澳门地区妇女人乳头瘤病毒（HPV）感染的年龄特异性流行率，并分析其型别分布特征。对 1600 名接受宫颈癌筛查的妇女进行了 HPV 感染的年龄特异性流行率研究。结果显示 HPV 感染呈 U 型年龄分布，20-25 岁年龄段 HPV 感染率为 10%，51-55 岁年龄段为 13%。HPV 阳性者中多重 HPV 感染率为 32.5%，不同年龄段之间差异无统计学意义（P=0.318）。84.6%的 HPV 阳性样本中存在高危或疑似高危 HPV 型别，且这些型别同样呈 U 型年龄分布。相比之下，低危和未知型别 HPV 流行率较低（20-50 岁之间 1.5%-2.5%，51-55 岁时略有上升，为 4.5%）。26.8%的 HPV 阳性样本中最常见的 HPV 型别为 HPV 52，其次为 HPV 16（15.5%）、HPV 68（11.4%）、HPV 18 和 HPV 58（8.9%）、HPV 54（8.1%）、HPV 53（7.3%）、HPV 39（6.5%）、HPV 33 和 HPV 66（5.7%）。综上所述，澳门地区 HPV 感染呈现双峰型分布，20 岁之前为第一高峰，50 岁之后为第二高峰。由于感染高峰出现较早，澳门地区的疫苗接种和教育宣传活动应尽早开展并针对青少年。而 50 岁以上妇女 HPV 感染的第二高峰主要由高危型 HPV 型别组成，提示需要对该年龄段妇女的宫颈癌筛查计划的覆盖率进行评估。有必要进一步研究 HPV 52 在澳门地区宫颈癌前病变和浸润性癌中的作用。
