School of Health Sciences, University of Tampere, Tampere, Finland.
Uganda Virus Research Institute, Entebbe, Uganda.
J Gen Virol. 2011 Dec;92(Pt 12):2776-2783. doi: 10.1099/vir.0.035923-0. Epub 2011 Aug 10.
To understand the prospects for human papillomavirus (HPV) mass vaccination in the setting of a developing country, we studied the co-occurrence of seropositivity to multiple high-risk (hr) HPV types among HIV-positive and HIV-negative Ugandan women. Our seroepidemiological study was conducted among 2053 women attending antenatal clinics. Sera were analysed for antibodies to eight hrHPV types of the α-7 (18/45) and α-9 (16/31/33/35/52/58) species of HPV by using a multiplex serology assay. Our results show that seropositivity for greater than one hrHPV type was as common (18 %) as for a single type (18 %). HIV-positive women had higher HPV16, HPV18 and HPV45 seroprevalences than HIV-negative women. In multivariate logistic regression analysis, age (>30 years) and level of education (secondary school and above) reduced the risk, whereas parity (>5) and HIV-positivity increased the risk for multiple hrHPV seropositivity. However, in stepwise logistic regression analyses, HIV-status remained the only independent, stand-alone risk factor [odds ratio (OR) 1.7, 95 % confidence interval (CI) 1.0-2.8). On the other hand, the risk of HPV16 or HPV18 seropositive women, as compared to HPV16 or HPV18 seronegative women, for being seropositive to other hrHPV types was not significantly different when they were grouped by HIV-status (ORHPV16/HIV+ 12, 95 % CI 4.5-32 versus ORHPV16/HIV- 22, 95 % CI 15-31 and ORHPV18/HIV+ 58, 95 % CI 14-242 versus ORHPV18/HIV- 45, 95 % CI 31-65). In conclusion, seropositivity to HPV16, HPV18 and to non-vaccine hrHPV types is common in Ugandan women, suggesting that there is little natural cross-protective immunity between the types. HIV-positivity was an independent, stand-alone, albeit moderate risk factor for multiple hrHPV seropositivity. HPV mass vaccination may be the most appropriate method in the fight against cervical cancer in the Ugandan population.
为了了解在发展中国家推广人乳头瘤病毒（HPV）大规模疫苗接种的前景，我们研究了在乌干达 HIV 阳性和 HIV 阴性女性中，多种高危型（hr）HPV 型别血清阳性的同时发生情况。我们的血清流行病学研究是在 2053 名参加产前检查的女性中进行的。使用多重血清学检测方法分析了血清中针对 8 种α-7（18/45）和α-9（16/31/33/35/52/58）型 HPV 的 hrHPV 型别抗体。我们的研究结果表明，多种 HRHPV 型别血清阳性的发生率与单一型别血清阳性的发生率（18%）一样常见（18%）。与 HIV 阴性女性相比，HIV 阳性女性 HPV16、HPV18 和 HPV45 的血清阳性率更高。在多变量逻辑回归分析中，年龄（>30 岁）和教育水平（中学及以上）降低了风险，而产次（>5 次）和 HIV 阳性增加了多重 HRHPV 血清阳性的风险。然而，在逐步逻辑回归分析中，HIV 状态仍然是唯一独立的、孤立的危险因素[比值比（OR）1.7，95%置信区间（CI）1.0-2.8]。另一方面，与 HPV16 或 HPV18 血清阴性的女性相比，HPV16 或 HPV18 血清阳性的女性，按照 HIV 状态分组时，对其他 HRHPV 型别的血清阳性率没有显著差异（HPV16/HIV+的 OR 为 12，95%CI 为 4.5-32，而 HPV16/HIV-的 OR 为 22，95%CI 为 15-31；HPV18/HIV+的 OR 为 58，95%CI 为 14-242，而 HPV18/HIV-的 OR 为 45，95%CI 为 31-65）。总之，在乌干达女性中，HPV16、HPV18 和非疫苗型 HRHPV 型别的血清阳性很常见，这表明这些型别之间几乎没有自然交叉保护免疫力。HIV 阳性是多重 HRHPV 血清阳性的一个独立、孤立的、尽管是中度危险因素。HPV 大规模疫苗接种可能是乌干达人群对抗宫颈癌的最恰当方法。
