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基于一项社区纵向研究的低级别宫颈上皮内瘤变女性高危型人乳头瘤病毒感染的动态特征

Dynamic characteristics of high-risk HPV infection in women with low-grade cervical intraepithelial neoplasia, based on a community longitudinal study.

作者信息

Zhao Kailu, Li Huimin, Cui Meng, Song Li, Lyu Yuanjing, Ding Ling, Wang Jintao

机构信息

Department of Epidemiology, School of Public Health, Shanxi Medical University, 56, Xinjian Nan Road, Taiyuan, 030001, China.

Department of Epidemiology and Health Statistics, School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, 712046, China.

出版信息

Eur J Clin Microbiol Infect Dis. 2025 Mar;44(3):671-679. doi: 10.1007/s10096-024-05036-x. Epub 2025 Jan 4.

Abstract

BACKGROUND

High-risk human papillomavirus (HR-HPV) infection is the primary cause of cervical cancer and precancerous lesions. Approximately 35% of women with low-grade cervical intraepithelial neoplasia (CIN1) may experience persistence or progression to high-grade lesions. Yet, the dynamic characteristics of HR-HPV infection in women with CIN1 remain unclear.

METHODS

A total of 564 women diagnosed with CIN1, recruited from a community-based cohort, underwent a 24-month follow-up at 6th, 12th, and 24th month intervals. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated to evaluate the risk of HR-HPV infection prognosis and their associated factors. Kaplan-Meier survival curves illustrated the dynamic changes of HR-HPV infection and association between HR-HPV infection prognosis and various influencing factors.

RESULTS

HPV16 was the predominant carcinogenic genotype, followed by HPV58 and HPV52. Over the 24-month follow-up, persistent HPV16 infection occurred in 10.6% of women, with 14.4% converting from positive to negative and 4% developing HPV16 positivity from baseline HR-HPV negativity. Rates of persistent infection for HPV58, 52, 18, and 56 decreased over time, with HPV58, 52, and 31 infections more likely to turn HR-HPV negative. Additionally, rates of positive conversion from negative for HPV58, 56, 33, and 66 increased with extended follow-up time. Variables associated with dynamic characteristics of HR-HPV infection prognosis included personal hygiene, age of first menarche, age at first sexual intercourse, educational level, age, and menopausal status (all P < 0.05).

CONCLUSIONS

These findings contribute to understanding the dynamic characteristics of HR-HPV infection prognosis in women with CIN1 and its association with non-viral factors.

摘要

背景

高危型人乳头瘤病毒(HR-HPV)感染是宫颈癌及癌前病变的主要病因。约35%的低级别宫颈上皮内瘤变(CIN1)女性可能会出现持续性感染或进展为高级别病变。然而,CIN1女性中HR-HPV感染的动态特征仍不清楚。

方法

从一个社区队列中招募了564名诊断为CIN1的女性,分别在第6、12和24个月进行为期24个月的随访。计算风险比(HRs)及95%置信区间(CI),以评估HR-HPV感染预后风险及其相关因素。Kaplan-Meier生存曲线说明了HR-HPV感染的动态变化以及HR-HPV感染预后与各种影响因素之间的关联。

结果

HPV16是主要的致癌基因型,其次是HPV58和HPV52。在24个月的随访中,10.6%的女性发生了持续性HPV16感染,14.4%的女性从阳性转为阴性,4%的女性从基线HR-HPV阴性发展为HPV16阳性。HPV58、52、18和56的持续性感染率随时间下降,HPV58、52和31感染更有可能转为HR-HPV阴性。此外,随着随访时间延长,HPV58、56、33和66从阴性转为阳性的比例增加。与HR-HPV感染预后动态特征相关的变量包括个人卫生、初潮年龄、首次性交年龄、教育水平、年龄和绝经状态(均P<0.05)。

结论

这些发现有助于了解CIN1女性中HR-HPV感染预后的动态特征及其与非病毒因素的关联。

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