Department of Pediatrics, University of California,San Francisco, CA, USA.
J Infect Dis. 2013 Aug 1;208(3):403-12. doi: 10.1093/infdis/jit175. Epub 2013 Apr 18.
The purpose of this study was to examine the rate of and risks for cervical human papillomavirus type 16 (HPV16) redetection in women with documented or suspected HPV16 infection.
A convenience sample of women aged 13-21 years were seen at 4-month intervals for HPV DNA testing and cytology. Serum samples were obtained at baseline and annually.
A total of 1543 women entered the study. Of the 295 women with detection of HPV16 DNA and subsequent clearance, 18.1% had HPV16 redetected by 8.5 years (88% cleared this second detection by 3 years). Of the 247 women who had antibodies to HPV16 and were HPV16 DNA negative at baseline, 15.3% had HPV16 redetected by year 5. Risks for redetection included douching, current use of medroxyprogesterone, reporting >1 sex partner or having a new sex partner, and having a sexually transmitted infection. Development of cervical intraepithelial neoplasia 2/3 was rare in women with redetection, except for those with prevalent HPV16 infection.
Reappearance of HPV16 DNA was observed in 18% of women. Most are associated with sexual exposure and appear benign. Interpretation of the studies is more complex in women with prevalent infections as it appears that this small subset reflects women with persistence already present at entry.
本研究旨在探讨有明确或疑似 HPV16 感染史的女性中 HPV16 再次检出的比率及其风险因素。
本研究采用便利抽样法，选取年龄在 13-21 岁的女性，每 4 个月进行一次 HPV DNA 检测和细胞学检查。同时在基线和每年采集血清样本。
共有 1543 名女性入组该研究。在 295 名 HPV16 DNA 检测阳性且随后转阴的女性中，18.1%（88%在 3 年内清除了第二次检测到的 HPV16）在 8.5 年内再次检测到 HPV16。在 247 名基线 HPV16 抗体阳性且 HPV16 DNA 阴性的女性中，15.3%在第 5 年再次检测到 HPV16。再次检测到 HPV16 的风险因素包括冲洗、使用醋酸甲羟孕酮、报告 >1 个性伴侣或有新的性伴侣以及性传播感染。除了那些 HPV16 持续感染的女性外，再次检测到 HPV16 的女性很少会发展为宫颈上皮内瘤变 2/3。
18%的女性再次检测到 HPV16 DNA。大多数与性暴露有关，且似乎呈良性。在 HPV16 持续感染的女性中，对这些研究的解释更为复杂，因为似乎这一小部分反映了已经在入组时存在持续性感染的女性。
