Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada; Medicity Research Laboratory and Department of Oral Pathology, Faculty of Medicine, Institute of Dentistry, University of Turku, Turku, Finland.
Clin Microbiol Infect. 2014 Nov;20(11):1167-72. doi: 10.1111/1469-0691.12700. Epub 2014 Jul 12.
Persistence of high-risk (HR-) human papillomavirus (HPV) infection of the uterine cervix increases the risk of cervical cancer. Oral HPV infections are among potential covariates of long-term genotype-specific persistent cervical HR-HPV infections. It is not known whether this persistence reflects inability of the host to reject HPV infections in general. A case-control setting was designed to estimate the covariates of long-term persistent cervical HR-HPV infections using multivariate generalized estimating equation (GEE) models. HPV was detected with PCR using GP05+/GP06+-primers and genotyped for 24 HPVs with a Multimetrix-kit. The cases (n=43) included women who had genotype-specific persistent cervical HR-HPV infection for at least 24 months (24M+) and controls were women who tested repeatedly HPV-negative in their cervical samples (n=52). These women represent a sub-cohort of the Finnish Family HPV Study. The cases differed significantly from the HPV-negative controls in several aspects: they were younger, had a longer mean time to incident oral HPV infection (40.7 versus 23.6 months), longer duration of oral HPV persistence (38.4 versus 14.1 months), and longer time to clearance of their oral HPV infection (50.0 versus 28.2 months). In multivariate GEE analysis, the second pregnancy during the follow up was the only independent predictor with significant protective effect against 24M+ persistent cervical HR-HPV infections, OR of 0.15 (95% CI 0.07-0.34). To conclude, long-term persistent cervical HR-HPV infections are associated with a prolonged clearance of oral HR-HPV infections while new pregnancy protects against persistent cervical HR-HPV infections.
宫颈高危型（HR）人乳头瘤病毒（HPV）持续感染会增加宫颈癌的风险。口腔 HPV 感染是长期特定基因型持续性宫颈 HR-HPV 感染的潜在协变量之一。目前尚不清楚这种持续性是否反映了宿主无法普遍拒绝 HPV 感染。本研究采用多变量广义估计方程（GEE）模型设计了病例对照研究，以估计长期持续性宫颈 HR-HPV 感染的协变量。采用 PCR 法用 GP05+/GP06+-引物检测 HPV，并用 Multimetrix 试剂盒对 24 种 HPV 进行基因分型。病例（n=43）包括至少 24 个月持续性宫颈 HR-HPV 感染的女性（24M+），对照组为宫颈样本反复 HPV 阴性的女性（n=52）。这些女性是芬兰家庭 HPV 研究的一个亚队列。病例与 HPV 阴性对照组在多个方面存在显著差异：年龄更小、发生口腔 HPV 感染的平均时间更长（40.7 与 23.6 个月）、口腔 HPV 持续时间更长（38.4 与 14.1 个月）、口腔 HPV 清除时间更长（50.0 与 28.2 个月）。在多变量 GEE 分析中，随访期间的第二次妊娠是唯一具有显著保护作用的独立预测因子，可降低 24M+持续性宫颈 HR-HPV 感染的风险，OR 为 0.15（95%CI 0.07-0.34）。综上所述，长期持续性宫颈 HR-HPV 感染与口腔 HR-HPV 清除时间延长相关，而新妊娠可预防持续性宫颈 HR-HPV 感染。
