Bergqvist Laura, Kalliala Ilkka, Aro Karoliina, Auvinen Eeva, Jakobsson Maija, Kiviharju Mari, Virtanen Seppo, Dillner Joakim, Nieminen Pekka, Louvanto Karolina
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland.
Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.
Microorganisms. 2021 Apr 2;9(4):750. doi: 10.3390/microorganisms9040750.
Risk factors for the different human papillomavirus (HPV) genotypes are not well understood, although the risk of cancer is known to vary among them. Our aim was to evaluate the association of diverse behavioral and reproductive factors with genotype-specific HPV prevalence among 879 unvaccinated women aged 18-75 years referred to the colposcopy clinic at Helsinki University Hospital in Finland. Cervical swabs for HPV genotyping were collected in the first visit and assessed for 34 high-risk (hr) and low-risk (lr) HPV genotypes. Participants completed a questionnaire on behavioral, reproductive, and lifestyle factors. Differences in genotype-specific HPV prevalence were analyzed overall and in age groups using binary logistic regression. Smoking was associated with higher prevalence in HPV16 compared with other hrHPV genotypes together with decreasing age, being highest among younger women <30 years old, odds ratio (OR) 3.74 (95% CI 1.42-9.88). The later the sexual debut, the more it seemed to protect from HPV16 infection. The best protection was achieved when the sexual debut took place at >20 years of age, with an OR of 0.43 (95% CI 0.23-0.83). This association was not seen with other hrHPV genotypes. Methods of contraception seemed not to have an effect on hrHPV positivity, regardless of the HPV genotype. The genotype specific hrHPV prevalence differs, depending on behavioral factors, especially among younger women referred to colposcopy.
尽管已知不同人类乳头瘤病毒(HPV)基因型引发癌症的风险各异,但对于不同HPV基因型的风险因素人们还知之甚少。我们的目的是评估芬兰赫尔辛基大学医院阴道镜门诊的879名年龄在18至75岁之间未接种疫苗的女性中,各种行为和生殖因素与特定基因型HPV流行率之间的关联。在首次就诊时采集宫颈拭子进行HPV基因分型,并对34种高危(hr)和低危(lr)HPV基因型进行评估。参与者完成了一份关于行为、生殖和生活方式因素的问卷。使用二元逻辑回归分析总体及各年龄组中特定基因型HPV流行率的差异。与其他hrHPV基因型相比,吸烟与HPV16的较高流行率相关,同时随着年龄降低,在30岁以下的年轻女性中最高,比值比(OR)为3.74(95%置信区间1.42 - 9.88)。首次性行为越晚,似乎越能预防HPV16感染。首次性行为在20岁以后发生时保护效果最佳,OR为0.43(95%置信区间0.23 - 0.83)。其他hrHPV基因型未发现这种关联。避孕方法似乎对hrHPV阳性率没有影响,无论HPV基因型如何。特定基因型的hrHPV流行率因行为因素而异,尤其是在转诊至阴道镜门诊的年轻女性中。