Prevalence, acquisition, and clearance of cervical human papillomavirus infection among women with normal cytology: Hawaii Human Papillomavirus Cohort Study.
Prevalence, acquisition, and clearance of cervical human papillomavirus infection among women with normal cytology: Hawaii Human Papillomavirus Cohort Study.
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DOI：
10.1158/0008-5472.can-08-1380
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发表时间：
2008-11-01
期刊：
影响因子：
11.2
通讯作者：
Hernandez BY
中科院分区：
文献类型：
--
作者：
Goodman MT;Shvetsov YB;McDuffie K;Wilkens LR;Zhu X;Thompson PJ;Ning L;Killeen J;Kamemoto L;Hernandez BY
在老年妇女中，特别是在多民族人群中，很少有关于宫颈人乳头瘤病毒(HPV)发病率和持续时间的自然历史研究。从夏威夷瓦胡岛的诊所招募了972名年龄在18岁至85岁之间的性行为活跃女性，并对其进行了平均15个月(范围2-56个月)的跟踪调查，检测了HPV感染和清除的病毒和非病毒决定因素。采用PGMY09/PGMY11引物系统，在基线和每隔4个月采集宫颈细胞标本进行细胞学和HPVDNA的PCR检测。在研究开始时，宫颈HPV感染率为25.6%。在随访期内，总共观察到476例特定于基因的感染事件。高危(HR)HPV类型的发病率(9.26/1000妇女月)与低危(LR)HPV类型(8.24/1000妇女月)相似。最常见的HR-HPV感染类型是HPV-52、HPV-16和HPV-31；合并宫颈HPV感染后，其发病率显著增加。宫颈HPV感染随着年龄、收入和长期使用口服避孕药而减少，随性伴侣数量、使用激素乳膏、饮酒和避孕套的使用而增加。队列参与者在随访期间清除了476起事件感染中的265起。LR-HPV感染比HR-HPV感染清除更快(中位数为180天，而HR-HPV感染为224天)。老年妇女和患有多发性感染的妇女的清除时间增加了。我们的数据表明，宫颈HPV感染和清除的几个病毒和非病毒决定因素可能用于宫颈癌预防计划。
Few natural history studies of cervical human papillomavirus (HPV) incidence and duration have been conducted among older women, especially from multiethnic populations. Viral and nonviral determinants of HPV acquisition and clearance were examined among 972 sexually active women, ages 18 to 85 years, recruited from clinics on Oahu, Hawaii, and followed for a mean duration of 15 months (range, 2–56 months). Interviews and cervical cell specimens for cytology and HPV DNA detection by PCR, using the PGMY09/PGMY11 primer system, were obtained at baseline and at 4-month intervals. The prevalence of cervical HPV infection was 25.6% at study entry. A total of 476 incident genotype-specific infections were observed during the follow-up period. The incidence of high-risk (HR) HPV types (9.26 per 1,000 woman-months) was similar to low-risk (LR) HPV types (8.24 per 1,000 woman-months). The most commonly acquired HR-HPV types were HPV-52, HPV-16, and HPV-31; and their incidence was increased significantly with a coexisting cervical HPV infection. Cervical HPV acquisition decreased with age, income, and long-term use of oral contraceptives and increased with number of sexual partners, use of hormonal creams, alcohol drinking, and condom use by a sexual partner. Cohort participants cleared 265 of the 476 incident infections during follow-up. LR-HPV infections cleared more rapidly than did HR-HPV infections (median, 180 days versus 224 days). Clearance times were enhanced among older women and women with multiple infections. Our data suggest several viral and nonviral determinants of cervical HPV acquisition and clearance that might be used in cervical cancer prevention programs.