The Key Laboratory of Cancer Invasion and Metastasis of the Ministry of Education of China, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China.
Gynecol Oncol. 2019 Dec;155(3):436-443. doi: 10.1016/j.ygyno.2019.10.003. Epub 2019 Oct 8.
Human papillomavirus (HPV) 16/18 genotyping is an effective method for triage of high-risk (hr) HPV-positive women in primary hrHPV screening for cervical cancer. The present study aimed to evaluate whether co-infected with other hrHPV types will affect the risk of cervical carcinogenesis in HPV16/18 positive women.
A total of 313,704 women aged ≥30 years were screened in China. Among them, 4,933 HPV16/18-positive participants underwent colposcopy-directed biopsy. The HPV genotypes were identified using the Cobas HPV genotyping system. Multinomial logistic regression was used to model different HPV16/18 infection patterns.
The overall prevalence rates of hrHPV and HPV16/18 were 7.85% (24,456/311,382) and 1.95% (6,086/311,382) respectively. Among HPV16/18 positive individuals, 33.24% (2,023/6,086) were co-infection with multiple types. Of the 4933 women who underwent colposcopy, their HPV16/18 infection patterns were as follows: 52.38% (2,584/4,933) HVP16 only, 23.54% (1,161/4,933) HPV16 + other hrHPVs, 14.98% (739/4,933) HPV18 only, 6.83% (337/4,933) HPV18 + other hrHPVs, 1.13% (56/4,933) HPV16 + 18, 1.13% (56/4,933) HPV16 + 18+other hrHPVs. After adjusting for cofactors, compared with single HPV16 infection, the risk of developing cervical intraepithelial neoplasia (CIN) grade 3 or greater (CIN3+) was significantly lower in HPV16 + other hrHPVs group (odds ratio [OR] = 0.637, 95% confidence interval [CI] = 0.493-0.822).
HPV16/18 co-infection with other hrHPVs is a common phenomenon. Different HPV16/18 infection patterns may influence the risk of cervical carcinogenesis. HPV16 co-infected with other hrHPVs appears to have a lower associated risk of CIN3+ in ≥30 years old women.
人乳头瘤病毒（HPV）16/18 基因分型是对宫颈癌高危型（hr）HPV 阳性妇女进行初级 hrHPV 筛查的有效方法。本研究旨在评估其他高危型 HPV 共感染是否会影响 HPV16/18 阳性妇女的宫颈癌发生风险。
在中国，共对 313704 名年龄≥30 岁的妇女进行了筛查。其中，4933 名 HPV16/18 阳性参与者接受了阴道镜指导下的活检。采用 Cobas HPV 基因分型系统检测 HPV 基因型。使用多项逻辑回归模型来建立不同的 HPV16/18 感染模式。
高危型 HPV 和 HPV16/18 的总流行率分别为 7.85%（24456/311382）和 1.95%（6086/311382）。在 HPV16/18 阳性个体中，33.24%（2023/6086）为多重感染。在 4933 名接受阴道镜检查的妇女中，HPV16/18 的感染模式如下：HPV16 单独感染 52.38%（2584/4933），HPV16 与其他高危型 HPV 共感染 23.54%（1161/4933），HPV18 单独感染 14.98%（739/4933），HPV18 与其他高危型 HPV 共感染 6.83%（337/4933），HPV16/18 共感染 1.13%（56/4933），HPV16/18 与其他高危型 HPV 共感染 1.13%（56/4933）。在调整了混杂因素后，与单一 HPV16 感染相比，HPV16 与其他高危型 HPV 共感染组（HPV16 与其他高危型 HPV 共感染）发生宫颈上皮内瘤变（CIN）3 级及以上（CIN3+）的风险显著降低（比值比 [OR] = 0.637，95%置信区间 [CI] = 0.493-0.822）。
HPV16/18 与其他高危型 HPV 的共感染是常见现象。不同的 HPV16/18 感染模式可能会影响宫颈癌的发生风险。HPV16 与其他高危型 HPV 共感染似乎与≥30 岁妇女的 CIN3+风险较低相关。
