Ni Xinyu, Hu Jiaming, Huang Yin, Tao Jinxin, Zhu Hua
Department of Gynecology, The First Affiliated Hospital of Wenzhou, Medical University, Wenzhou, China.
J Med Virol. 2023 Feb;95(2):e28526. doi: 10.1002/jmv.28526.
Persistent human papilloma virus (HPV) infection is known to be associated with cervical lesions. The chief object of the study is to investigate if the pathogenicity of multiple HPV infections is different from a single infection. Furthermore, we would like to corroborate the discrepancy with clearance rates. Between August 1, 2020, and September 31, 2021, 5089 women underwent a colposcopy-directed biopsy in our hospital. We divided the 2999 patients who met the criteria into multiple and single HPV infection groups. The HPV genotypes were identified using the flow cytometry fluorescence hybridization technology. Binary logistic regression and survival analysis were used to perform statistics. Among HPV-positive individuals, 34.78% (1043/2999) were positive for 2 or more HPV types. After adjusting for the main factors, compared with single infection, multiple infections were associated with a significantly decreased risk of high squamous intraepithelial lesions (HSIL) (odds ratio [OR]: 0.570; 95% confidence interval [CI]: 0.468-0.694). In the mean time, the clearance rates of multiple infections were significantly higher (OR: 2.240; 95% CI: 1.919-2.614). When analyzing specific types covered by the 9-valent HPV vaccine, consistency between the lower risk of HSIL and the higher clearance rate was found in the most groups. Compared with a single infection, multiple HPV infections have a lower risk of HSIL, which may be related to its higher clearance rate. It suggests that aggressive treatment of multiple HPV infections early in their detection may be beneficial.
持续性人乳头瘤病毒（HPV）感染已知与宫颈病变相关。本研究的主要目的是调查多重HPV感染的致病性是否与单一感染不同。此外，我们希望通过清除率来证实这种差异。在2020年8月1日至2021年9月31日期间，我院对5089名女性进行了阴道镜引导下活检。我们将符合标准的2999例患者分为多重HPV感染组和单一HPV感染组。采用流式细胞术荧光杂交技术鉴定HPV基因型。使用二元逻辑回归和生存分析进行统计。在HPV阳性个体中，34.78%（1043/2999）为两种或更多种HPV类型阳性。在调整主要因素后，与单一感染相比，多重感染与高级别鳞状上皮内病变（HSIL）风险显著降低相关（比值比[OR]：0.570；95%置信区间[CI]：0.468 - 0.694）。同时，多重感染的清除率显著更高（OR：2.240；95% CI：1.919 - 2.614）。在分析九价HPV疫苗涵盖的特定类型时，大多数组在HSIL较低风险和较高清除率之间发现了一致性。与单一感染相比，多重HPV感染的HSIL风险较低，这可能与其较高的清除率有关。这表明在检测到多重HPV感染后尽早进行积极治疗可能有益。
