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中国北京地区人乳头瘤病毒感染的流行病学和基因型分析。

Epidemiology and genotypes analysis of human papillomavirus infection in Beijing, China.

机构信息

National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.

Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, 100026, China.

出版信息

Virol J. 2024 Jan 16;21(1):19. doi: 10.1186/s12985-024-02292-3.

Abstract

BACKGROUND

This study aimed to investigate the epidemiology of high-risk human papillomavirus (HPV) in the female population in Beijing, China, and identify the relationship between HPV genotypes and host factors.

METHODS

HPV testing was performed on women aged 15-89 (mean age 38.0 ± 10.9 years) from Beijing in 2020. High-risk HPV genotyping real-time polymerase chain reaction was used to determine HPV genotypes. The overall prevalence, age-specific prevalence, genotype distribution, and the correlation between HPV genotypes and cervical cytology were analyzed.

RESULTS

Among the 25,344 study participants, the single and double infection rates were 18.8% (4,777/25,344) and 4.2% (1,072/25,344), respectively. A total of 6,119 HPV-positive individuals were found to have 91.6% negative results for intraepithelial lesion or malignancy (NILM), 5.8% atypical squamous cells of undetermined significance (ASC-US), 0.9% low-grade squamous intraepithelial lesion (LSIL), and 1.7% high-grade squamous intraepithelial lesion (HSIL). In single HPV infections, the HPV16 genotype was highly associated with cervical cytology severity (χ trend = 172.487, P < 0.001). Additionally, HPV infection rates increased gradually with age, and statistical differences were observed across age groups (χ = 180.575; P < 0.001). High-risk HPV genotypes were highly prevalent in women below 25 years of age and those aged 55-59 years. Cluster analysis revealed that the 13 HPV genotypes could be roughly divided into two groups in a single infection; however, patterns of infection consistent with biological characteristics were not observed.

CONCLUSION

High-risk HPV was found in 24.1% of outpatients, with HPV52, HPV58, HPV16, HPV39, and HPV51 being the most common high-risk genotypes. Single high-risk HPV infection was predominant. HPV16, HPV39, HPV51, and HPV52 were associated with cervical lesion progression. HPV16 infection was especially worrying since it aggravates cervical lesions. Because the infection rates of the 13 HPV genotypes differed by age, the peak HPV infection rate should not guide vaccination, screening, and prevention programs. Instead, these initiatives should be tailored based on the regional HPV distribution characteristics. Moreover, it was determined that Beijing's populace needed to receive treatment for HPV39 infection.

摘要

背景

本研究旨在调查中国北京女性人群中高危型人乳头瘤病毒(HPV)的流行病学情况,并确定 HPV 基因型与宿主因素之间的关系。

方法

对 2020 年北京地区年龄在 15-89 岁(平均年龄 38.0±10.9 岁)的女性进行 HPV 检测。采用高危型 HPV 基因分型实时聚合酶链反应检测 HPV 基因型。分析 HPV 总感染率、年龄别感染率、基因型分布以及 HPV 基因型与宫颈细胞学的相关性。

结果

在 25344 名研究对象中,单一和双重感染率分别为 18.8%(4777/25344)和 4.2%(1072/25344)。6119 名 HPV 阳性者中,91.6%(5622/6119)的细胞学结果为未见上皮内病变或恶性细胞(NILM),5.8%(357/6119)为非典型鳞状细胞意义不明确(ASC-US),0.9%(55/6119)为低度鳞状上皮内病变(LSIL),1.7%(105/6119)为高度鳞状上皮内病变(HSIL)。在单一 HPV 感染中,HPV16 基因型与宫颈细胞学严重程度高度相关(趋势 χ2=172.487,P<0.001)。此外,HPV 感染率随年龄逐渐升高,各年龄组间差异有统计学意义(χ2=180.575;P<0.001)。高危型 HPV 感染在<25 岁和 55-59 岁女性中更为常见。聚类分析显示,单一感染中 13 种 HPV 基因型大致可分为两组,但未观察到符合生物学特征的感染模式。

结论

本研究中门诊患者中高危型 HPV 感染率为 24.1%,其中 HPV52、HPV58、HPV16、HPV39 和 HPV51 为最常见的高危型 HPV 基因型。以单一高危型 HPV 感染为主。HPV16、HPV39、HPV51 和 HPV52 与宫颈病变进展有关。HPV16 感染尤其令人担忧,因为它会加重宫颈病变。由于 13 种 HPV 基因型的感染率随年龄而变化,因此,不应以峰值 HPV 感染率来指导疫苗接种、筛查和预防计划。相反,应根据区域 HPV 分布特征制定这些计划。此外,本研究还确定北京地区人群需要治疗 HPV39 感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a5d/10790403/dbcd9b5b906c/12985_2024_2292_Fig1_HTML.jpg

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