Maswanganye Carol K, Mkhize Pamela P, Matume Nontokozo D
Discipline of Genetics, School of Life Sciences, University of KwaZulu-Natal, Pietermaritzburg 3209, South Africa.
Discipline of Biochemistry, School of Life Sciences, University of KwaZulu-Natal, Pietermaritzburg 3209, South Africa.
Viruses. 2024 Dec 8;16(12):1893. doi: 10.3390/v16121893.
This systematic review and meta-analysis evaluate human papillomavirus (HPV) prevalence, genotype distribution, and associations with cervicovaginal microbiota and cytokine profiles among South African women, where cervical cancer ranks as the second most common cancer. PubMed, SCOPUS, and Web of Science were searched for studies on HPV infection up to 21 September 2024. The pooled prevalence was estimated using a random-effects model, with subgroup analyses by province, sample type, and HIV status. Publication bias was evaluated using funnel plots and Egger's test. Of the 19,765 studies screened, 120 met the inclusion criteria, comprising 83,266 participants. Results indicate a high HPV burden, with a pooled prevalence of 58% (95% CI: 52-64%), varying regionally from 53% (95% CI: 41-65%) to 64% (95% CI: 55-73%), with some regions under-researched. Cervical samples had the highest HPV prevalence (60% (95% CI: 54-66%)), while non-genital samples were less studied. High-risk (HR) HPV types, notably HPV 16 (7.5%), HPV 35 (4.1%), and HPV 18 (3.9%), were prominent, with HPV 35 emphasizing the need for expanded vaccine coverage. HIV-positive women had a higher pooled HPV prevalence (63% (95% CI: 55-71%)). Funnel plot analysis and Egger's test suggested a potential publication bias ( = 0.047). HPV-positive women exhibited lower Lactobacillus levels and an increase in (BV)-associated species like , potentially supporting HPV persistence. Cytokine analysis showed elevated MIP-1α and MIP-1β in HPV infections, though cytokine profiles may depend on HPV genotypes. These findings underscore the need for research on HPV-microbiome-immune interactions and call for comprehensive HPV-prevention strategies, including vaccines targeting regional HPV types and tailored interventions for HIV-positive populations.
本系统评价和荟萃分析评估了南非女性人乳头瘤病毒（HPV）的流行情况、基因型分布及其与宫颈阴道微生物群和细胞因子谱的关联，在南非，宫颈癌是第二大常见癌症。检索了PubMed、SCOPUS和Web of Science截至2024年9月21日关于HPV感染的研究。使用随机效应模型估计合并患病率，并按省份、样本类型和HIV状态进行亚组分析。使用漏斗图和Egger检验评估发表偏倚。在筛选的19765项研究中，120项符合纳入标准，包括83266名参与者。结果表明HPV负担较高，合并患病率为58%（95%CI：52-64%），各地区患病率有所不同，从53%（95%CI：41-65%）到64%（95%CI：55-73%），一些地区研究不足。宫颈样本的HPV患病率最高（60%（95%CI：54-66%）），而非生殖器样本的研究较少。高危（HR）HPV类型，特别是HPV 16（7.5%）、HPV 35（4.1%）和HPV 18（3.9%）较为突出，HPV 35凸显了扩大疫苗覆盖范围的必要性。HIV阳性女性的合并HPV患病率较高（63%（95%CI：55-71%））。漏斗图分析和Egger检验提示存在潜在的发表偏倚（P = 0.047）。HPV阳性女性的乳酸杆菌水平较低，且诸如加德纳菌等与细菌性阴道病（BV）相关的菌种增加，这可能支持HPV持续感染。细胞因子分析显示HPV感染时MIP-1α和MIP-1β升高，不过细胞因子谱可能取决于HPV基因型。这些发现强调了对HPV-微生物群-免疫相互作用进行研究的必要性，并呼吁采取全面的HPV预防策略，包括针对地区性HPV类型的疫苗以及针对HIV阳性人群的定制干预措施。
