Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection.
Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection.
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DOI：
10.1186/1471-2334-12-166
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发表时间：
2012-07-28
影响因子：
3.7
通讯作者：
Palefsky J
中科院分区：
文献类型：
--
作者：
Couture MC;Page K;Stein ES;Sansothy N;Sichan K;Kaldor J;Evans JL;Maher L;Palefsky J
尽管宫颈癌是柬埔寨的主要癌症，但大多数妇女没有接受宫颈癌的常规筛查，治疗选择也很少。此外，关于宫颈HPV的流行率或该国妇女中存在的基因类型，我们一无所知。年轻的性活跃女性，特别是那些有多个性伴侣的女性，感染HPV的风险最高。我们调查了柬埔寨金边从事性工作的年轻女性中宫颈HPV的患病率和基因类型，以及相关的危险因素。我们对220名年轻女性(15-29 岁)进行了一项横断面研究，这些女性在不同的场所从事性工作，包括妓院或娱乐场所，以及在街道、公园和私人公寓从事自由职业的女性。宫颈标本采集采用标准细胞刷片技术。通过聚合酶链式反应(PCR)和使用类型特异性探针对29种单独的HPV类型以及10种不常见的HPV类型的混合进行HPVDNA检测。所有参与者还使用血液样本进行了艾滋病毒状况筛查。采用多因素Logistic回归分析，评估HPV感染的危险因素。宫颈HPV41.1%。HPV51和70最常见(5.0%)，其次是16例(4.6%)、71例(4.1%)和81例(3.7%)。36名女性(16.4%)感染多种基因，23.3%感染至少一种致癌HPV型。在多因素分析中，有HIV感染和性伴数量较多与宫颈HPV感染相关。感染多种基因的危险因素包括作为自由职业的女性性工作者(FSW)或在妓院工作，最近滥用药物，性伴侣数量多，以及艾滋病毒感染。这是柬埔寨关于宫颈HPV患病率和基因类型的第一项研究。我们发现，HPV感染在年轻女性中很常见，特别是在感染艾滋病毒的女性中。这些结果突显了迫切需要可获得的宫颈癌筛查和治疗，以及覆盖柬埔寨现有的HPV亚型的预防性疫苗。
Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia. We conducted a cross-sectional study among 220 young women (15–29 years) engaged in sex work in different venues including brothels or entertainment establishments, and on a freelance basis in streets, parks and private apartments. Cervical specimens were collected using standard cytobrush technique. HPV DNA was tested for by polymerase chain reaction (PCR) and genotyping using type-specific probes for 29 individual HPV types, as well as for a mixture of 10 less common HPV types. All participants were also screened for HIV status using blood samples. Multivariate logistic regression analyses were conducted to assess risk factors for any or multiple HPV infection. The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection. This is the first Cambodian study on cervical HPV prevalence and genotypes. We found that HPV infection was common among young FSW, especially among women infected with HIV. These results underscore the urgent need for accessible cervical cancer screening and treatment, as well as for a prophylactic vaccine that covers the HPV subtypes present in Cambodia.