Age-specific prevalence of cervical human papillomavirus infection and cytological abnormalities in women in Gauteng Province, South Africa
Age-specific prevalence of cervical human papillomavirus infection and cytological abnormalities in women in Gauteng Province, South Africa
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DOI：
10.7196/samj.6514
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发表时间：
2013-05-01
期刊：
影响因子：
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通讯作者：
Dreyer, G
中科院分区：
文献类型：
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作者：
Richter, K;Becker, P;Dreyer, G
背景南非豪登省公共卫生系统的妇女大多未接受宫颈癌筛查，且人类免疫缺陷病毒（HIV）感染的背景流行率较高。本横断面研究描述了该城市和郊区人群中人乳头瘤病毒（HPV）感染和细胞学异常的年龄特异性患病率。在2009年3月至2011年9月期间，1 524名在公营基层医疗诊所就诊的妇女应邀参加了子宫颈癌筛查研究。所有参与者均接受常规细胞学筛查，并使用HPV线性阵列基因分型试剂盒（罗氏分子系统）进行HPV检测。结果。在1472例具有有效细胞学结果的女性中，17.3%（n=255）检测到异常，其中9.1%（n=134）为高度鳞状上皮内病变，0.5%（n=8）提示鳞状细胞癌。在1445例资料完整的妇女中，HPV DNA总检出率为74.6%（n= 1078），高危型检出率为54.3%（n=784）。19.5%（n=282）的妇女检测到HPV 16和/或18型。宫颈特异性HPV感染率呈平台型曲线。HPV感染和细胞学异常的患病率比以前在南非和其他地方的一般人群中报道的要高得多。以前仅在对艾滋病毒抗体阳性妇女的研究中描述了较高的年龄特异性流行率和类似的平台状年龄特异性流行病学曲线。这些研究结果对发展中国家规划和发展宫颈筛查方案具有一定的意义，这些国家的艾滋病毒背景流行率很高，大部分人口未经筛查。
Background. Women accessing the public health system in Gauteng province, South Africa are largely unscreened for cervical cancer and have a high background prevalence of human immunodeficiency virus (HIV) infection.Objectives. This cross-sectional study describes the age-specific prevalence of human papillomavirus (HPV) infection and cytological abnormalities among this urban and pen-urban population.Method. Over the period March 2009 - September 2011, 1 524 women attending public sector primary healthcare clinics were invited to participate in a cervical cancer screening study. All participants were screened with conventional cytology and HPV testing undertaken using the HPV linear array genotyping kit (Roche Molecular Systems).Results. Of 1 472 women with valid cytology results, abnormalities were detected in 17.3% (n=255), of which 9.1% (n=134) were high-grade squamous intraepithelial lesions, and 0.5% (n=8) suggestive of squamous carcinoma. Of the 1 445 women with complete data, the overall and high-risk HPV DNA prevalences were 74.6% (n=1 078) and 54.3% (n=784), respectively. HPV type 16 and/or 18 were detected in 19.5% (n=282) of women. Age-specific prevalence of HPV showed a plateau-shaped curve.Conclusions. The prevalences of HPV infection and abnormal cytology were much higher than previously reported in general populations in South Africa and elsewhere. Higher age-specific prevalence and similar plateau-like age-specific epidemiological curves have previously only been described in studies among HIV-positive women. These findings have implications for planning and development of cervical screening programmes in developing countries with largely unscreened populations with a high background prevalence of HIV.