Worldwide distribution of human papillomavirus types in cytologically normal women in the international Agency for Research on Cancer HPV prevalence surveys:: a pooled analysis
Worldwide distribution of human papillomavirus types in cytologically normal women in the international Agency for Research on Cancer HPV prevalence surveys:: a pooled analysis
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DOI：
10.1016/s0140-6736(05)67069-9
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发表时间：
2005-09-17
期刊：
影响因子：
168.9
通讯作者：
Franceschi, S
中科院分区：
文献类型：
--
作者：
Clifford, GM;Gallus, S;Franceschi, S
感染人乳头瘤病毒（HPV）的女性比例在不同人群中差异很大，HPV类型的分布也可能如此。我们的目的是比较HPV型分布在代表性样本的妇女来自世界不同regions.Methods妇女被随机选择从一般人群中的13个地区从11个国家（尼日利亚，印度，越南，泰国，韩国，哥伦比亚，阿根廷，智利，荷兰，意大利，和西班牙）。采用标准化方案采集宫颈标本。所有HPV检测均采用基于GP 5 +/6+ PCR的EIA。不同类型的HPV感染的HPV阳性妇女的比例进行了比较研究领域和汇总地区之间的年龄调整的比值比（OR）与相应的95%浮动CIS.Findings 15 613名妇女年龄在15-74岁，没有细胞学异常被纳入汇总分析。不同人群间HPV感染率的差异接近20倍，从西班牙的1.4%（95%CI 0.5-2.2）到尼日利亚的25.6%（22.4-28.8）。尽管HPV总患病率和HPV 16患病率在撒哈拉以南非洲最高，但欧洲HPV阳性妇女感染HPV 16的可能性明显高于撒哈拉以南非洲妇女。（OR 2.64，p=0.0002），感染HPV 16以外的高危型HPV的可能性显著降低（OR 0.57，p=0.004）和/或低风险HPV类型（OR 0.44。p=0.0002）。来自南美洲的妇女HPV类型分布在撒哈拉以南非洲和欧洲之间。亚洲地区之间的异质性是显着的。解释异质性HPV类型分布在不同人群中的妇女，应考虑到在制定筛查试验的病毒和预测的影响，疫苗对感染的发病率。
Background The proportion of women infected with human papillomavirus (HPV) varies greatly across populations, as might the distribution of HPV types. We aimed to compare HPV-type distribution in representative samples of women from different world regions.Methods Women were randomly selected from the general population of 13 areas from 11 countries (Nigeria, India, Vietnam, Thailand, Korea, Colombia, Argentina, Chile, the Netherlands, Italy, and Spain). A standardised protocol was used for cervical specimen collection. All HPV testing was by GP5+/6+ PCR-based EIA. The proportion of HPV-positive women infected with different HPV types was compared by study area and between pooled regions with age-adjusted odds ratios (ORs) with corresponding 95% floating CIS.Findings 15 613 women aged 15-74 years without cytological abnormalities were included in a pooled analysis. Age-standardised HPV prevalence varied nearly 20 times between populations, from 1.4% (95% CI 0.5-2.2) in Spain to 25.6% (22.4-28.8) in Nigeria. Although both overall HPV prevalence and HPV16 prevalence were highest in sub-Saharan Africa, HPV-positive women in Europe were significantly more likely to be infected with HPV16 than were those in sub-Saharan Africa (OR 2.64, p=0.0002), and were significantly less likely to be infected with high-risk HPV types other than HPV16 (OR 0.57, p=0.004) and/or low-risk HPV types (OR 0.44. p=0.0002). Women from South America had HPV-type distribution in between those from sub-Saharan Africa and Europe. Heterogeneity between areas of Asia was significant.Interpretation Heterogeneity in HPV type distribution among women from different populations should be taken into account when developing screening tests for the virus and predicting the effect of vaccines on the incidence of infection.