Liao Guangdong, Jiang Xiyi, She Bin, Tang Huijuan, Wang Zhongyong, Zhou Hongrong, Ma Yan, Xu Weidong, Xu Hongxing, Chen Wen, Ji Jianguang, Xi Mingrong, Chen Tianhui
Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children Affiliated to the Ministry of Education, Sichuan University, Chengdu, China.
Front Oncol. 2020 Apr 7;10:449. doi: 10.3389/fonc.2020.00449. eCollection 2020.
The epidemiological feature of human papillomavirus (HPV) infection is distinctive in China. We aimed to investigate the multi-infection patterns and co-infection preference of 27 HPV types among gynecological outpatients across China. Overall 137,943 gynecological outpatients were recruited from eight tertiary hospitals located in seven regions of China, between July 1st, 2014 and December 31st, 2016. The overall, region-specific, age-specific and type-specific prevalence of HPV infection were calculated, respectively. The pattern of HPV infection was also evaluated. Furthermore, rate ratio was calculated to evaluate the co-infection preference of any two HPV genotypes. The overall prevalence of 27 HPVs' [17 high-risk (hr)/10 low-risk (lr)] infection was 23.5%. The age-specific HPV prevalence showed a "U-shaped" pattern. The most prevalent hrHPV genotypes were 16, 52, and 58. Multiple infections were detected in 25.8% of the HPV-positive women, in which dual infection was more prevalent. HPV 16/18 were likely to co-infected with HPV 31 but unlikely with HPV 52/58, i.e., the co-infection of HPV 16 with HPV 31 was high (3.5-fold), but low for HPV 58 (1.8-fold), and 52 (1.2-fold), while the co-infection of HPV 18 with HPV 31 was high (4.3-fold), but low for HPV 52 (1.9-fold), and 58 (1.7-fold). We found age-specific prevalence of HPV infection showed a "U-shaped" pattern for high and low risk HPV, suggesting the importance of screening among younger women and the necessary of detection among older women. We found a novel co-infection preference of HPV 16/18 with 31, 52, and 58, suggesting a need of developing and marketing prophylactic HPV vaccines that protect against more genotypes in China.
人乳头瘤病毒（HPV）感染的流行病学特征在中国具有独特性。我们旨在调查中国各地妇科门诊患者中27种HPV类型的多重感染模式和共感染偏好。2014年7月1日至2016年12月31日期间，从中国七个地区的八家三级医院招募了总计137,943名妇科门诊患者。分别计算了HPV感染的总体、地区特异性、年龄特异性和类型特异性患病率。还评估了HPV感染模式。此外，计算率比以评估任意两种HPV基因型的共感染偏好。27种HPV（17种高危型/10种低危型）感染的总体患病率为23.5%。年龄特异性HPV患病率呈“U”形模式。最常见的高危型HPV基因型为16、52和58。25.8%的HPV阳性女性检测到多重感染，其中双重感染更为普遍。HPV 16/18可能与HPV 31共感染，但不太可能与HPV 52/58共感染，即HPV 16与HPV 31的共感染率较高（3.5倍），而与HPV 58（1.8倍）和52（1.2倍）的共感染率较低，而HPV 18与HPV 31的共感染率较高（4.3倍），但与HPV 52（1.9倍）和58（1.7倍）的共感染率较低。我们发现高危和低危HPV感染的年龄特异性患病率呈“U”形模式，这表明年轻女性筛查的重要性以及老年女性检测的必要性。我们发现了HPV 16/18与31、52和58的新型共感染偏好，这表明在中国需要研发和推广能预防更多基因型的预防性HPV疫苗。
