Qi Shiyuan, Tang Xiumei, Ye Na, Huang Weilan, Wang Yina, Li Xiaomao
Department of Gynecology, The Third Affiliated Hospital of Sun Yat- sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, China.
Health Management Center, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, China.
BMC Public Health. 2025 Jun 3;25(1):2061. doi: 10.1186/s12889-025-23264-4.
Persistent infection with human papillomavirus (HPV) plays a key role in cervical cancer development. This study aimed to investigate the epidemiological trends and genotype distribution of HPV from 2013 to 2021 in Guangzhou, China.
A retrospective analysis was conducted on 76,898 women who attended either the Gynecology Outpatient Department or underwent routine health examinations at the Health Management Center of Sun Yat-sen University. HPV testing was performed using hybrid capture-based assays, capable of detecting 15 high-risk and 6 low-risk HPV genotypes. Chi-square tests were used to compare HPV genotype prevalence between the two groups and to assess differences in single vs. multiple infections. The Cochran-Armitage trend test was applied to evaluate temporal trends in HPV prevalence.
The overall HPV prevalence was 15.21% [95% CI: 14.95-15.45%], with 16.52% [95% CI: 16.23-16.82%] among 60,399 gynecological outpatients and 10.35% [95% CI: 9.90-10.83%] among 16,499 healthy women. The most prevalent genotypes were HPV-52 (3.31%, 95% CI: 3.18 - 3.43%), HPV-16 (2.30%, 95% CI: 2.2 - 2.41%), and HPV-58 (1.97%, 95% CI: 1.88 - 2.07%), followed by HPV-CP8304 (1.48%, 95% CI: 1.39 - 1.56%), HPV-39 (1.39%, 95% CI: 1.31 - 1.47%). HPV-16, 18, 31, 33, 53, 66, and CP8304 declined (p < 0.05), while HPV-35, 39, 42, 43, 44, 51, 56, and 68 increased (p < 0.05). Single- and multiple-type HPV infections had prevalences of 11.70% [ 95% CI: 11.47-11.93%]and 3.50% [95% CI: 3.37-3.63%], respectively. Both were significantly more prevalent in gynecological outpatients than in health examination participants (p < 0.001). The age distribution of HPV-positive individuals peaked at 30 years.
This study highlights the high prevalence of HPV-52, HPV-16, and HPV-58 in Guangzhou, with single-type infections being predominant. While some genotypes declined, others showed an increasing trend, emphasizing the need for continuous surveillance. These findings offer epidemiological insights to guide targeted vaccination policies. Given the lack of vaccination data, future studies integrating vaccination history and clinical outcomes are needed to clarify HPV genotype trends and their role in cervical cancer prevention.
人乳头瘤病毒（HPV）持续感染在宫颈癌发生中起关键作用。本研究旨在调查2013年至2021年中国广州HPV的流行病学趋势和基因型分布。
对76898名在中山大学健康管理中心妇科门诊就诊或接受常规健康检查的女性进行回顾性分析。采用基于杂交捕获的检测方法进行HPV检测，该方法能够检测15种高危型和6种低危型HPV基因型。采用卡方检验比较两组HPV基因型的患病率，并评估单一感染与多重感染的差异。应用 Cochr an - Armitage趋势检验评估HPV患病率的时间趋势。
HPV总体患病率为15.21%[95%可信区间：14.95 - 15.45%]，其中60399名妇科门诊患者中患病率为16.52%[95%可信区间：16.23 - 16.82%]，16499名健康女性中患病率为10.35%[95%可信区间：9.90 - 10.83%]。最常见的基因型为HPV - 52（3.31%，95%可信区间：3.18 - 3.43%）、HPV - 16（2.30%，95%可信区间：2.2 - 2.41%）和HPV - 58（1.97%，95%可信区间：1.88 - 2.07%），其次是HPV - CP8304（1.48%，95%可信区间：1.39 - 1.56%）、HPV - 39（1.39%，95%可信区间：1.31 - 1.47%）。HPV - 16、18、31、33、53、66和CP8304呈下降趋势（p < 0.05），而HPV - 35、39、42、43、44、51、56和68呈上升趋势（p < 0.05）。单一型和多重型HPV感染的患病率分别为11.70%[95%可信区间：11.47 - 11.93%]和3.50%[95%可信区间：3.37 - 3.63%]。两者在妇科门诊患者中的患病率均显著高于健康检查参与者（p < 0.001）。HPV阳性个体的年龄分布在30岁时达到峰值。
本研究突出了广州HPV - 52、HPV - 16和HPV - 58的高患病率，且以单一型感染为主。虽然一些基因型呈下降趋势，但其他基因型呈上升趋势，强调了持续监测的必要性。这些发现为指导针对性疫苗接种政策提供了流行病学见解。鉴于缺乏疫苗接种数据，未来需要开展整合疫苗接种史和临床结局的研究，以阐明HPV基因型趋势及其在宫颈癌预防中的作用。
