Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
J Med Virol. 2011 Aug;83(8):1362-9. doi: 10.1002/jmv.22116.
Most human papillomavirus (HPV) infections in young women become undetectable by standard assays after a few months. It is possible that many HPV infections do not actually clear, but persist at very low levels for years, becoming detected again later in life. The purpose of this study is to describe HPV 16 clearance, reappearance, and low-level persistence in a cohort of adolescent women. Adolescent women (N = 66), not vaccinated against HPV, were recruited from 1998 to 2008 into a longitudinal study. Self-collected vaginal samples were obtained quarterly and tested for HPV by Linear Array HPV Genotyping Test (LA-HPV). To explore low-level persistence, a type-specific nested PCR for HPV 16 (TSN-PCR-16) was developed. Women with HPV 16 detected by LA-HPV had their negative swabs retested with TSN-PCR-16. Forty-two participants with HPV 16, followed for a mean of 6.3 years, were analyzed. Using LA-HPV, the median duration of HPV 16 detection was 428 days (SD 852.5 days). TSN-PCR-16 detected HPV 16 during periods of LA-HPV non-detection in samples from many women. Using a combination of LA-HPV and TSN-PCR-16 results, the median duration of HPV 16 detection was 1,022.5 days (SD 943.7 days). The durations of detection differed significantly between the two methods (P = 0.0042) with a mean difference of 434.5 days. In adolescent females, duration of HPV 16 detection was significantly longer when TSN-PCR-16 was combined with LA-HPV. Some apparently cleared HPV 16 could be shown to persist at low levels using nested PCR.
大多数年轻女性的人乳头瘤病毒（HPV）感染在几个月后通过标准检测就无法检测到。可能有许多 HPV 感染实际上并未清除，而是在多年内以非常低的水平持续存在，以后在生命中再次被检测到。本研究的目的是描述 HPV 16 在一组青少年女性中的清除、再出现和低水平持续存在情况。招募了未接种 HPV 疫苗的青少年女性（N=66），于 1998 年至 2008 年期间参加了一项纵向研究。每个季度自行采集阴道样本，用线性阵列 HPV 基因分型检测（LA-HPV）检测 HPV。为了探索低水平持续存在情况，开发了针对 HPV 16 的型特异性嵌套 PCR（TSN-PCR-16）。用 LA-HPV 检测到 HPV 16 的女性，用 TSN-PCR-16 对其阴性拭子进行了重新检测。对 42 名 HPV 16 检测阳性、平均随访 6.3 年的参与者进行了分析。使用 LA-HPV，HPV 16 的中位检出时间为 428 天（SD 852.5 天）。在许多女性的样本中，LA-HPV 检测到 HPV 16 的期间，TSN-PCR-16 检测到 HPV 16。使用 LA-HPV 和 TSN-PCR-16 结果的组合，HPV 16 的中位检出时间为 1022.5 天（SD 943.7 天）。两种方法的检出时间差异有统计学意义（P=0.0042），平均差异为 434.5 天。在青少年女性中，当 TSN-PCR-16 与 LA-HPV 联合使用时，HPV 16 的检出时间明显更长。使用嵌套 PCR 可显示一些明显清除的 HPV 16 仍以低水平持续存在。
