Cancer Epidemiology Research Program, Institut Català d'Oncologia -IDIBELL, CIBER-ESP, RTICC, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain.
BMC Infect Dis. 2012 Jun 26;12:145. doi: 10.1186/1471-2334-12-145.
Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate socio-demographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain.
The CLEOPATRE Spain study enrolled 3 261 women aged 18-65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection.
A lifetime number of two or more sexual partners, young age (18-25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01).
This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection.
人乳头瘤病毒（HPV）是一种性传播感染，可能导致宫颈癌前病变和癌症的发展。本研究的目的是调查社会人口统计学、生活方式和医疗因素与在西班牙进行宫颈癌筛查的女性中宫颈 HPV 感染的潜在关联。
CLEOPATRE 西班牙研究纳入了来自西班牙 17 个自治区的 3261 名年龄在 18-65 岁之间的参加宫颈癌筛查的女性。使用液基宫颈样本进行细胞学检查和 HPV 检测。使用杂交捕获 II 法确定 HPV 阳性，使用 INNO-LiPA HPV Genotyping Extra assay 进行 HPV 基因分型。使用多变量逻辑回归来确定 HPV 感染的潜在危险因素。
一生中性伴侣的数量为两个或更多、年龄较小（18-25 岁）、生殖器疣病史和未婚状态是 HPV 感染的最强独立危险因素。居住在城市社区、非西班牙出生、受教育程度低和当前吸烟状况也是 HPV 感染的独立危险因素。使用避孕套与 HPV 感染呈弱负相关。与一夫一妻制女性不同，如果其当前伴侣是割礼者，有两个或更多性伴侣的女性感染 HPV 的风险较低（交互作用 P 值，0.005），如果她们是当前吸烟者，则感染 HPV 的风险较高（交互作用 P 值，0.01）。
这是第一项探索西班牙宫颈癌 HPV 感染危险因素的大规模全国性研究。数据强烈表明，与性行为相关的变量是 HPV 感染的主要危险因素。此外，在非一夫一妻制女性中，伴侣的割礼与 HPV 感染风险降低有关，而吸烟与 HPV 感染风险增加有关。
