在埃塞俄比亚亚的斯亚贝巴的一些妇产科诊所，高危型人乳头瘤病毒感染和宫颈细胞学异常的负担和基因型分布。
Burden and genotype distribution of high-risk Human Papillomavirus infection and cervical cytology abnormalities at selected obstetrics and gynecology clinics of Addis Ababa, Ethiopia.
机构信息
International Clinical Laboratories, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
BMC Cancer. 2019 Aug 5;19(1):768. doi: 10.1186/s12885-019-5953-1.
BACKGROUND
Human papillomavirus is recognized as a major cause of cervical cancer. It is estimated that annually, 7,095 women are diagnosed with cervical cancer and 4,732 die from the disease in Ethiopia. Understanding that the screening practice is very poor and the coverage is very limited, this disease burden is one of the major public health agendas in Ethiopia. This study aimed to assess the burden and genotype distribution of high-risk human papillomavirus (HR HPV) infection and cervical cytology abnormalities at selected obstetrics and gynecology clinics of Addis Ababa, Ethiopia.
METHODS
An institutional-based cross-sectional study design was employed from June to October 2015. Cervical samples were collected from 366 participants based on inclusion criteria. HR HPV DNA was analyzed using an Abbott Real-Time PCR system, and cervical cytology screening was performed using the conventional Pap-smear technique. Data were entered in to Epi-data version 13 and analyzed using STATA version 11.
RESULTS
The overall HR HPV burden and abnormal cytology were 13.7 and 13.1%, respectively. The majority of HR HPV types were other than types 16 and 18. Of the total abnormal cytology results, 81.3% were low-grade squamous intraepithelial lesions (LSILs), and 12.5 and 6.3% were atypical squamous cells of undetermined significance (ASCUS) and high-grade squamous intraepithelial lesions (HSILs), respectively. Residence, occupation, and HIV serostatus were significantly associated with HR HPV infection. Among the variables, age, age at first marriage, and education were the only ones associated with cervical cytology abnormalities. The overall agreement between the real-time PCR and Pap cytology screening methods was 78.96% (Kappa value of 0.12, 95% CI (0.00-0.243), P = 0.01).
CONCLUSIONS
Non-16/18 HR HPV genotypes represented the largest proportion of HR HPV infections in this study. Women without cervical cytology abnormalities had the highest frequency of HR HPV infection. A large-scale community-based cohort study shall be designed and implemented to further identifying the persistent genotype and assessing the changes in cervical epithelial cell lines.
背景
人乳头瘤病毒（HPV）被认为是宫颈癌的主要病因。据估计，每年埃塞俄比亚有 7095 名妇女被诊断患有宫颈癌，有 4732 人死于该病。鉴于筛查实践非常薄弱，覆盖面非常有限，因此该病负担是埃塞俄比亚主要的公共卫生议程之一。本研究旨在评估在埃塞俄比亚亚的斯亚贝巴选定的妇产科诊所中高危型人乳头瘤病毒（HR HPV）感染和宫颈细胞学异常的负担和基因型分布。
方法
本研究采用 2015 年 6 月至 10 月期间的基于机构的横断面研究设计。根据纳入标准，从 366 名参与者中采集宫颈样本。使用 Abbott 实时 PCR 系统分析 HR HPV DNA，使用传统巴氏涂片技术进行宫颈细胞学筛查。数据输入 EpiData 版本 13，并使用 STATA 版本 11 进行分析。
结果
总体 HR HPV 负担和异常细胞学分别为 13.7%和 13.1%。大多数 HR HPV 型别并非 16 型和 18 型。在总异常细胞学结果中，81.3%为低级别鳞状上皮内病变（LSIL），12.5%和 6.3%分别为不典型鳞状细胞意义不明确（ASCUS）和高级别鳞状上皮内病变（HSIL）。居住地、职业和 HIV 血清阳性状态与 HR HPV 感染显著相关。在这些变量中，年龄、初婚年龄和教育程度是唯一与宫颈细胞学异常相关的因素。实时 PCR 和巴氏细胞学筛查方法之间的总体一致性为 78.96%（Kappa 值为 0.12，95%CI（0.00-0.243），P=0.01）。
结论
在本研究中，非 16/18 HR HPV 基因型代表 HR HPV 感染的最大比例。无宫颈细胞学异常的妇女 HR HPV 感染频率最高。应设计并实施大规模的基于社区的队列研究，以进一步确定持续性基因型并评估宫颈上皮细胞系的变化。
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