Duration and clearance of anal human papillomavirus (HPV) infection among women: the Hawaii HPV cohort study.
Duration and clearance of anal human papillomavirus (HPV) infection among women: the Hawaii HPV cohort study.
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DOI：
10.1086/596758
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发表时间：
2009-03-01
期刊：
影响因子：
--
通讯作者：
Goodman MT
中科院分区：
文献类型：
--
作者：
Shvetsov YB;Hernandez BY;McDuffie K;Wilkens LR;Zhu X;Ning L;Killeen J;Kamemoto L;Goodman MT
肛门癌与人乳头瘤病毒(HPV)感染之间的关系已得到很好的证实；然而，对健康女性肛门HPV的流行病学知之甚少。我们调查了夏威夷一群健康女性的肛门HPV感染持续时间和清除模式。通过对431名性行为活跃的女性进行纵向队列研究，研究了影响肛门HPV清除的病毒和非病毒决定因素。在基线和每隔4个月进行一次访谈，并获取宫颈和肛门细胞样本以进行HPVDNA检测。在431名妇女中，50%的人在从基线到平均1.2年的随访期内，在一次或多次门诊中总共经历了414例肛门HPV感染事件。在这些感染中，58%的患者在随访期间痊愈。高危(HR)肛门感染的清除率为每100个妇女月9.2(95%可信区间：6.9-11.9)，中位持续时间为150天(95%可信区间：132-243天)。HR-HPV清除最慢的类型是HPV-59(中位数350天)和HPV-58(中位数252天)。与肛门癌相关的主要类型HPV-16和-18的中位清除时间分别为132天和212天。推迟肛门HPV清除的非病毒因素包括冲洗、长期吸烟和肛交。大多数肛门HPV感染在相对较短的时间内痊愈。尽管健康女性通常会感染肛门HPV，但它的快速清除表明HPV检测作为肛门癌筛查工具的有效性有限。
The association of anal cancer with human papillomavirus (HPV) infection is well established; however, little is known about epidemiology of anal HPV in healthy women. We investigated patterns of duration and clearance of anal HPV infection in a cohort of healthy women in Hawaii. Viral and non-viral determinants of anal HPV clearance were examined through a longitudinal cohort study of 431 sexually active women. At baseline and at 4-month intervals, interviews were conducted and cervical and anal cell specimens were obtained for HPV DNA detection. Fifty percent of the 431 women experienced a total of 414 incident anal HPV infections at one or more clinic visits from baseline through an average 1.2 year follow-up period. Of these infections, 58% cleared during follow-up. The clearance rate for a high-risk (HR) anal infection was 9.2 (95% confidence interval (CI): 6.9–11.9) per 100 woman-months with a median duration of 150 days (95% CI: 132–243 days). The slowest clearing HR-HPV types were HPV-59 (median, 350 days) and HPV-58 (median, 252 days). Median clearance times for HPV-16 and -18, the predominant types associated with anal cancer, were 132 days and 212 days, respectively. Non-viral factors that delayed clearance of anal HPV included douching, long-term tobacco smoking and anal sex. The majority of anal HPV infections resolve in a relatively short time. Although anal HPV is commonly acquired in healthy women, its rapid clearance suggests limited efficacy of HPV testing as an anal cancer screening tool.
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影响因子：
8.8
作者：
Brewster, D H;Bhatti, L A
通讯作者：
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