Wu C H, Pei R X, Yan J X, Ding L, Lyu Y J, Song L, Wang J, Meng D, Liu H, Qi Z, Hao M, Wang J T
Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China.
Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan 030001, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Dec 10;42(12):2174-2178. doi: 10.3760/cma.j.cn112338-20210408-00291.
To investigate the effect of red blood cell folate on the prognosis of high-risk human papillomavirus (HR-HPV) infection A total of 564 participants with low-grade cervical intraepithelial neoplasias (CINⅠ) were selected from the community-based married women cohort established in 2014. The general baseline information and factors related to HPV infection were collected. Meanwhile, HPV genotyping and levels of folate were measured. The subjects were divided into different levels of exposure group according to the folate levels and followed up for 24 months to observe the changes of HR-HPV infection status. There were four changes, including persistent infection, infection turned negative, from negative to positive and constant negative by comparing HR-HPV infection status at baseline and follow-up to 24 months. 483 participators completed 24 months of follow-up observation, with a follow-up rate of 85.64% (483/564). The rates of persistent infection, infection turned negative, from negative to positive, and the constant negative were 52.45% (75/143), 47.55% (68/143), 19.71% (67/340), 80.29% (273/340), respectively. Our results demonstrated that the risk of persistent infection (a=2.50, 95%: 1.55-4.02) and from negative to positive (a=4.55, 95%: 2.52-8.23) in the low level of folate were significantly higher than that in the high level of folate, especially the risk of homotype persistent infection (a=2.72, 95%: 1.51-4.90). The risk of persistent infection (trend =20.62, <0.001), from negative to positive (trend =31.76, <0.001), persistent homotypic infection (trend =20.09, <0.001) increased with the decrease of red blood cell folate level. On the contrary, no similar results were found in persistent heterotypic infection. A low level of red blood cell folate could increase the risk of HR-HPV persistent infection and from negative to positive. In women with HR-HPV infection, the risk of persistent homotypic infection is higher.
为探讨红细胞叶酸对高危型人乳头瘤病毒（HR-HPV）感染预后的影响，从2014年建立的社区已婚女性队列中选取564例低度宫颈上皮内瘤变（CINⅠ）患者。收集一般基线信息及与HPV感染相关的因素。同时，检测HPV基因分型和叶酸水平。根据叶酸水平将研究对象分为不同暴露水平组，随访24个月，观察HR-HPV感染状态的变化。通过比较基线时和随访至24个月时的HR-HPV感染状态，有4种变化情况，包括持续感染、感染转阴、由阴性转为阳性和持续阴性。483例参与者完成了24个月的随访观察，随访率为85 .64%（483/564）。持续感染、感染转阴、由阴性转为阳性和持续阴性的发生率分别为52.45%（75/143）、47.55%（68/143）、19.71%（67/340）、80.29%（273/340）。我们的结果表明，叶酸水平低时持续感染（α=2.50，95%：1.55 - 4.02）和由阴性转为阳性（α=4.55，95%：2.52 - 8.23）的风险显著高于叶酸水平高时，尤其是同源性持续感染的风险（α=2.72，95%：1.51 - 4.90）。持续感染（趋势=20.62，<0.001）、由阴性转为阳性（趋势=31.76，<0.001）、持续同源性感染（趋势=20.09，<0.001）的风险随红细胞叶酸水平的降低而增加。相反，在持续异型性感染中未发现类似结果。红细胞叶酸水平低会增加HR-HPV持续感染和由阴性转为阳性的风险。在HR-HPV感染的女性中，持续同源性感染的风险更高。
