南非夸祖鲁-纳塔尔省感染和未感染艾滋病毒的年轻女性中的高危型人乳头瘤病毒：疫苗接种的意义。

High-risk human papillomavirus types in HIV-infected and HIV-uninfected young women in KwaZulu-Natal, South Africa: implications for vaccination.

机构信息

a Department of Infection, Prevention and Control , University of KwaZulu-Natal, School of Laboratory Medicine and Medical Science , Durban , South Africa.

b Department of Biomedical and Clinical Technology , Durban University of Technology , Durban , South Africa.

出版信息

Infect Dis (Lond). 2017 Aug;49(8):601-608. doi: 10.1080/23744235.2017.1312513. Epub 2017 Apr 12.

DOI:10.1080/23744235.2017.1312513

PMID:28403727

Abstract

BACKGROUND

High-risk human papillomavirus (hr-HPV) infections and low-grade squamous intraepithelial lesions occur frequently in young women. The available vaccines cover up to seven hr-HPV genotypes (HPV16, HPV18, HPV31, HPV33, HPV45, HPV52 and HPV58) and two low-risk HPV types (HPV6 and HPV11). The objective of this study was to describe the hr-HPV genotypes present among HIV-uninfected and HIV-infected young women in rural high schools.

METHODS

Cervicovaginal lavages were obtained from sexually active young women recruited from high schools in KwaZulu-Natal (n = 1223). HPV testing was done by the polymerase chain reaction using GP5+/GP6 + primers and enzyme immunoassay. HIV testing was done using rapid test kits.

RESULTS

Of the 1223 cervicovaginal lavages, 301 (25%) were positive for hr-HPV. The HPV prevalence was higher in HIV infected (32.20%, 95% CI: 0.27-0.38) than in HIV-uninfected women (22.50%, 95% CI: 0.21-0.26), (p = .001). Similarly, multiple infections were slightly more common in HIV infected (59.32%) than in HIV-uninfected women (53.51%), (p = .37). The nine predominant genotypes in descending order were HPV types 16 (n = 99, 22.10%), 51 (n = 58, 12.91%), 18 (n = 56, 12.50%), 35 (n = 50, 11.10%), 33 (n = 47, 10.82%), 56 (n = 42, 9.31%), 45 (n = 34, 7.60%), 52 (n = 32, 7.14%) and 59 (n = 31, 6.91%). HPV 35, 51, 56 and 59 (40.62%), which are not covered by any vaccine, were among the most prevalent in the schools of KwaZulu-Natal.

CONCLUSION

Four of the most predominant high-risk HPV types in this region are not covered by the new nine-valent HPV vaccine.

摘要

背景

高危型人乳头瘤病毒（hr-HPV）感染和低级别鳞状上皮内病变在年轻女性中很常见。现有的疫苗可预防多达七种 hr-HPV 基因型（HPV16、HPV18、HPV31、HPV33、HPV45、HPV52 和 HPV58）和两种低危型 HPV 类型（HPV6 和 HPV11）。本研究的目的是描述在农村高中中未感染 HIV 的年轻女性和感染 HIV 的年轻女性中存在的 hr-HPV 基因型。

方法

从夸祖鲁-纳塔尔省（KwaZulu-Natal）的高中招募性活跃的年轻女性，采集宫颈阴道灌洗液。使用聚合酶链反应（PCR）和酶免疫测定法，用 GP5+/GP6+引物检测 HPV。使用快速检测试剂盒进行 HIV 检测。

结果

在 1223 份宫颈阴道灌洗液中，有 301 份（25%）为 hr-HPV 阳性。在感染 HIV 的女性中 HPV 患病率（32.20%，95%CI：0.27-0.38）高于未感染 HIV 的女性（22.50%，95%CI：0.21-0.26），（p=0.001）。同样，多重感染在感染 HIV 的女性中（59.32%）略高于未感染 HIV 的女性（53.51%），（p=0.37）。按降序排列，最常见的九个基因型依次为 HPV 16 型（99 例，22.10%）、51 型（58 例，12.91%）、18 型（56 例，12.50%）、35 型（50 例，11.10%）、33 型（47 例，10.82%）、56 型（42 例，9.31%）、45 型（34 例，7.60%）、52 型（32 例，7.14%）和 59 型（31 例，6.91%）。该地区最常见的四种高危 HPV 类型 HPV 35、51、56 和 59（40.62%）不受任何疫苗的保护。