University of California San Francisco, Global Health Sciences, 50 Beale street, Suite 1200, San Francisco, CA 94105, USA.
BMC Infect Dis. 2012 Jul 28;12:166. doi: 10.1186/1471-2334-12-166.
Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia.
We conducted a cross-sectional study among 220 young women (15-29 years) engaged in sex work in different venues including brothels or entertainment establishments, and on a freelance basis in streets, parks and private apartments. Cervical specimens were collected using standard cytobrush technique. HPV DNA was tested for by polymerase chain reaction (PCR) and genotyping using type-specific probes for 29 individual HPV types, as well as for a mixture of 10 less common HPV types. All participants were also screened for HIV status using blood samples. Multivariate logistic regression analyses were conducted to assess risk factors for any or multiple HPV infection.
The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection.
This is the first Cambodian study on cervical HPV prevalence and genotypes. We found that HPV infection was common among young FSW, especially among women infected with HIV. These results underscore the urgent need for accessible cervical cancer screening and treatment, as well as for a prophylactic vaccine that covers the HPV subtypes present in Cambodia.
尽管宫颈癌是柬埔寨的主要癌症，但大多数女性没有接受常规的宫颈癌筛查，而且治疗选择很少。此外，人们对该国女性中宫颈人乳头瘤病毒（HPV）的流行情况以及存在的基因型一无所知。年轻的性活跃女性，尤其是那些有多个性伴侣的女性，感染 HPV 的风险最高。我们检查了在柬埔寨金边从事性工作的年轻女性（15-29 岁）中宫颈 HPV 的流行情况和基因型，以及与 HPV 感染相关的危险因素。
我们对在不同场所（包括妓院或娱乐场所，以及街头、公园和私人公寓自由职业）从事性工作的 220 名年轻女性进行了横断面研究。使用标准的宫颈刷技术采集宫颈标本。使用聚合酶链反应（PCR）检测 HPV DNA，并使用针对 29 种 HPV 型别和针对 10 种不太常见 HPV 型别的混合体的型特异性探针进行 HPV 基因分型。所有参与者还使用血液样本筛查艾滋病毒状况。采用多变量 logistic 回归分析评估任何 HPV 感染或多种 HPV 感染的危险因素。
宫颈 HPV 的患病率为 41.1%。HPV 51 和 70 最为常见（5.0%），其次是 16（4.6%）、71（4.1%）和 81（3.7%）。36 名妇女（16.4%）感染了多种基因型，23.3%感染了至少一种致癌 HPV 型。在多变量分析中，感染艾滋病毒和性伴侣较多与宫颈 HPV 感染相关。感染多种基因型的危险因素包括作为自由职业女性性工作者（FSW）或在妓院工作、最近滥用药、性伴侣较多以及感染艾滋病毒。
这是柬埔寨第一项关于宫颈 HPV 流行率和基因型的研究。我们发现，HPV 感染在年轻 FSW 中很常见，尤其是在感染艾滋病毒的女性中。这些结果强调了迫切需要普及宫颈癌筛查和治疗，以及需要一种预防疫苗来覆盖柬埔寨存在的 HPV 亚型。
