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人乳头瘤病毒感染:流行病学、生物学、宿主相互作用、癌症发展、预防和治疗。

Human papillomavirus infection: Epidemiology, biology, host interactions, cancer development, prevention, and therapeutics.

机构信息

Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Rev Med Virol. 2024 May;34(3):e2537. doi: 10.1002/rmv.2537.

DOI:10.1002/rmv.2537
PMID:38666757
Abstract

Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections worldwide. It is caused by the HPV, a DNA virus that infects epithelial cells in various mucous membranes and skin surfaces. HPV can be categorised into high-risk and low-risk types based on their association with the development of certain cancers. High-risk HPV types, such as HPV-16 and HPV-18, are known to be oncogenic and are strongly associated with the development of cervical, anal, vaginal, vulvar, penile, and oropharyngeal cancers. These types of HPV can persist in the body for an extended period and, in some cases, lead to the formation of precancerous lesions that may progress to cancer if left untreated. Low-risk HPV types, such as HPV-6 and HPV-11, are not typically associated with cancer but can cause benign conditions like genital warts. Genital warts are characterised by the growth of small, cauliflower-like bumps on the genital and anal areas. Although not life-threatening, they can cause discomfort and psychological distress. HPV is primarily transmitted through sexual contact, including vaginal, anal, and oral sex. It can also be transmitted through non-penetrative sexual activities that involve skin-to-skin contact. In addition to sexual transmission, vertical transmission from mother to child during childbirth is possible but relatively rare. Prevention of HPV infection includes vaccination and safe sexual practices. HPV vaccines, such as Gardasil and Cervarix, are highly effective in preventing infection with the most common high-risk HPV types. These vaccines are typically administered to adolescents and young adults before they become sexually active. Safe sexual practices, such as consistent and correct condom use and limiting the number of sexual partners, can also reduce the risk of HPV transmission. Diagnosis of HPV infection can be challenging because the infection is often asymptomatic, especially in men. In women, HPV testing can be done through cervical screening programs, which involve the collection of cervical cells for analysis. Abnormal results may lead to further diagnostic procedures, such as colposcopy or biopsy, to detect precancerous or cancerous changes. Overall, HPV infection is a prevalent sexually transmitted infection with significant implications for public health. Vaccination, regular screening, and early treatment of precancerous lesions are key strategies to reduce the burden of HPV-related diseases and their associated complications. Education and awareness about HPV and its prevention are crucial in promoting optimal sexual health. This study aimed to carry out a literature review considering several aspects involving HPV infection: Global distribution, prevalence, biology, host interactions, cancer development, prevention, therapeutics, coinfection with other viruses, coinfection with bacteria, association with head and neck squamous cell carcinomas, and association with anal cancer.

摘要

人乳头瘤病毒(HPV)感染是全球最常见的性传播感染之一。它由 HPV 引起,HPV 是一种 DNA 病毒,感染各种黏膜和皮肤表面的上皮细胞。HPV 可以根据其与某些癌症发展的关系分为高危型和低危型。高危 HPV 型,如 HPV-16 和 HPV-18,已知具有致癌性,与宫颈癌、肛门癌、阴道癌、外阴癌、阴茎癌和口咽癌的发展密切相关。这些类型的 HPV 可以在体内持续存在很长时间,并且在某些情况下,会导致癌前病变的形成,如果不治疗,这些病变可能会发展为癌症。低危 HPV 型,如 HPV-6 和 HPV-11,通常与癌症无关,但会引起生殖器疣等良性疾病。生殖器疣的特征是在生殖器和肛门区域生长出小的、像菜花一样的肿块。虽然不会危及生命,但它们会引起不适和心理困扰。HPV 主要通过性接触传播,包括阴道、肛门和口交。也可以通过涉及皮肤与皮肤接触的非穿透性性活动传播。除了性传播之外,母亲在分娩过程中垂直传播给孩子的情况也有可能发生,但相对较少。HPV 感染的预防包括疫苗接种和安全性行为。HPV 疫苗,如 Gardasil 和 Cervarix,在预防最常见的高危 HPV 型感染方面非常有效。这些疫苗通常在青少年和年轻人开始性行为之前接种。安全性行为,如坚持正确使用避孕套和限制性伴侣的数量,也可以降低 HPV 传播的风险。HPV 感染的诊断具有挑战性,因为感染通常无症状,尤其是在男性中。在女性中,HPV 检测可以通过宫颈筛查计划进行,该计划包括收集宫颈细胞进行分析。异常结果可能需要进一步的诊断程序,如阴道镜检查或活检,以检测癌前病变或癌症变化。总的来说,HPV 感染是一种普遍存在的性传播感染,对公共卫生有重大影响。疫苗接种、定期筛查和早期治疗癌前病变是降低 HPV 相关疾病及其相关并发症负担的关键策略。关于 HPV 及其预防的教育和意识对于促进最佳性健康至关重要。本研究旨在对 HPV 感染的几个方面进行文献综述:全球分布、流行率、生物学、宿主相互作用、癌症发展、预防、治疗、与其他病毒的合并感染、与细菌的合并感染、与头颈部鳞状细胞癌的关联、与肛门癌的关联。

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