Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Front Public Health. 2022 May 17;10:820517. doi: 10.3389/fpubh.2022.820517. eCollection 2022.
Virtually all invasive cervical cancers are caused by persistent genital human papillomavirus (HPV) infection. Therefore, HPV-based screening becomes an essential tool as one of the cervical prevention strategies to reduce the disease burden. Population-specific epidemiologic information on HPV infection among women with cytological abnormalities is essential to inform the strategy of HPV-based screening programme. The study also explored the presence of cutaneous HPV types (Beta-β and Gamma-γ) in cervical infections.
A cross-sectional study on Chinese women aged ≥25 years who were referred to public specialist out-patient clinics for colposcopy or further management of cervical cytological abnormalities were recruited between 2015 and 2016 in Hong Kong. HPV was detected and typified by the novel PCR-based Next-Generation Sequencing (NGS) strategies.
The overall HPV infection rate was 74% and detected in 222 of the 300 respondents, with the prevalence of cutaneous HPV infection being 2.3%. The overall prevalence of HPV infection among women with current cytological abnormalities was 79.1% (197/249). The age-specific prevalence of HPV (any-type HPV infection) among women with cytological abnormalities reached the first peak with 87.9% in the age group of 35-39 years and gradually declined to 56.0% at 55-59 years. While a second peak occurred at 65 years or above (92.9%). HPV58 (13.7%), HPV52 (11.7%), HPV53 (11.2%), HPV16 (10.0%), HPV18 (5.2%), and HPV51 (5.2%) were the top five high-risk HPV genotypes among women with cytological abnormalities. Any-HPV type infection was significantly associated with an abnormal cervical smear (OR = 3.7; 95% CI 2.0-7.1), and high-risk HPV infection was also significantly associated with an abnormal cervical smear (OR = 6.3; 95% CI 3.0-13.5).
New evidence on the second peak of HPV infection at ≥65 years old suggests the necessity to review the current guideline for the cervical screening program extending to age 65 and above. Moreover, the high prevalence of two HPV genotypes-high-risk HPV51 and potential high-risk HPV53, among women with cytological abnormalities-suggests further research work is needed to confirm the contributory role of HPV51 and HPV53 in cervical cancer and the need for inclusion in the next generation of the HPV vaccine.
几乎所有的宫颈癌都是由持续性生殖器人乳头瘤病毒（HPV）感染引起的。因此，HPV 筛查成为减少疾病负担的宫颈癌预防策略之一的重要工具。了解特定人群中细胞学异常妇女的 HPV 感染情况对于 HPV 筛查方案的策略制定至关重要。本研究还探讨了 HPV 感染中皮肤 HPV 类型（β-β 和 γ-γ）的存在。
2015 年至 2016 年，在香港，对因细胞学异常而转诊至专家门诊行阴道镜检查或进一步处理的年龄≥25 岁的中国女性进行了一项横断面研究。采用基于新型聚合酶链反应（PCR）的下一代测序（NGS）策略检测和分型 HPV。
HPV 总感染率为 74%，300 名应答者中有 222 人检测出 HPV，皮肤 HPV 感染率为 2.3%。目前细胞学异常的女性中 HPV 总感染率为 79.1%（197/249）。细胞学异常女性 HPV 感染的年龄特异性患病率在 35-39 岁年龄组达到第一个高峰，为 87.9%，然后逐渐下降至 55-59 岁的 56.0%。65 岁及以上时出现第二个高峰（92.9%）。细胞学异常女性中，HPV58（13.7%）、HPV52（11.7%）、HPV53（11.2%）、HPV16（10.0%）、HPV18（5.2%）和 HPV51（5.2%）是前 5 位高危 HPV 基因型。任何 HPV 型感染与异常宫颈涂片显著相关（OR=3.7；95%CI 2.0-7.1），高危 HPV 感染也与异常宫颈涂片显著相关（OR=6.3；95%CI 3.0-13.5）。
≥65 岁人群 HPV 感染出现第二个高峰的新证据表明，有必要审查目前将宫颈筛查计划延长至 65 岁及以上的指南。此外，细胞学异常女性中 HPV51 和潜在高危 HPV53 两种 HPV 基因型的高流行率表明，需要进一步研究以证实 HPV51 和 HPV53 在宫颈癌中的致病作用以及将其纳入下一代 HPV 疫苗的必要性。
