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移植肾后潜伏 HPV 感染的再激活。

Reactivation of Latent HPV Infections After Renal Transplantation.

机构信息

Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands.

Department of Nephrology, Radboud University Medical Center, Nijmegen, the Netherlands.

出版信息

Am J Transplant. 2017 Jun;17(6):1563-1573. doi: 10.1111/ajt.14181. Epub 2017 Feb 2.

Abstract

Female renal transplant recipients (RTRs) have an increased risk for developing human papillomavirus (HPV)-related (pre)malignant lesions of the genital tract. This study aims to assess the genital prevalence of HPV before and after renal transplantation (RT). In female patients who were counseled for RT at the Radboud University Medical Center Nijmegen, the Netherlands, gynecological examination was performed at first visit, and 1 and 2 years later. HPV self-sampling and questionnaires on sexual behavior were performed every 3 months. In 65 patients who underwent RT, the high-risk human papillomavirus (hrHPV) prevalence as assessed with the highly sensitive SPF -LiPA test increased significantly from 19% before to 31% after RT (p = 0.045). Based upon the clinically validated Cobas 4800 HPV test, the hrHPV prevalence increased from 10% before to 14% after RT (p = 0.31). During follow-up, no changes in sexual behavior were reported. Thirty-three patients who did not undergo RT showed a hrHPV prevalence of 21% at study entry and of 27% after 12 months with the sensitive test, and a stable prevalence of 16% with the clinically validated test. The results of this study indicate that activation of latent HPV infections may contribute to the increased risk of HPV-related (pre)malignant lesions in female RTRs.

摘要

女性肾移植受者(RTR)发生人乳头瘤病毒(HPV)相关生殖道(前)恶性病变的风险增加。本研究旨在评估肾移植(RT)前后女性生殖道 HPV 的流行情况。在荷兰奈梅亨拉德堡大学医学中心接受 RT 咨询的女性患者中,在首次就诊时、1 年后和 2 年后进行妇科检查。每 3 个月进行一次 HPV 自我采样和性行为问卷调查。在 65 名接受 RT 的患者中,采用高灵敏度 SPF-LiPA 试验评估高危型 HPV(hrHPV)的流行率从 RT 前的 19%显著增加到 RT 后的 31%(p = 0.045)。基于经临床验证的 Cobas 4800 HPV 检测,hrHPV 的流行率从 RT 前的 10%增加到 RT 后的 14%(p = 0.31)。在随访期间,未报告性行为发生变化。33 名未接受 RT 的患者在研究开始时用敏感试验检测出 21%的 hrHPV 流行率,12 个月后为 27%,用经临床验证的检测方法检测出稳定的 16%的流行率。本研究结果表明,潜伏 HPV 感染的激活可能导致女性 RTR 中 HPV 相关(前)恶性病变风险增加。

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