Human papillomavirus infection at the United States-Mexico border: implications for cervical cancer prevention and control.
Human papillomavirus infection at the United States-Mexico border: implications for cervical cancer prevention and control.
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2001-11
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通讯作者：
A. Giuliano;M. Papenfuss;M. Abrahamsen;C. Denman;J. D. Zapien;J. L. N. Henze;L. Ortega;E. M. B. D. Galaz;Jennifer Stephan;Janine D. Feng;S. Baldwin;F. Garcia;K. Hatch
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作者：
A. Giuliano;M. Papenfuss;M. Abrahamsen;C. Denman;J. D. Zapien;J. L. N. Henze;L. Ortega;E. M. B. D. Galaz;Jennifer Stephan;Janine D. Feng;S. Baldwin;F. Garcia;K. Hatch
美国-墨西哥边境是一个由浸润性宫颈癌发病率最高的国家之一（墨西哥）和发病率最低的国家之一（美国）组成的地区。最近的证据清楚地表明，人乳头瘤病毒（HPV）感染是宫颈癌的原因。已知特定类型HPV的分布在世界不同地区不同，可能抑制或促进HPV致癌的辅助因子也不同。估计致癌HPV的流行率是指导疫苗开发所必需的。本研究的目的是确定致癌和非致癌HPV类型的患病率和HPV的危险因素居住在沿着美国-墨西哥边境的妇女。1997年至1998年，对2319名年龄在15 - 79岁之间的妇女进行了一项横断面研究，这些妇女自我咨询妇科护理。采用PYGMY 09/11 L1通用引物进行PCR检测HPV，并采用反向线印迹法进行HPV基因分型。总体而言，HPV患病率为14.4%，在调整年龄后，各国之间没有观察到显著差异。HPV 16是美国和墨西哥最常见的HPV类型。在高度鳞状上皮内病变的女性中，HPV 58，45，51，31，35，55和73型在墨西哥最常见，HPV 18，31，35，51，52和58型在美国最常见。在这两个国家，HPV感染率随着年龄的增长而线性下降，从15 - 19岁女性的25%下降到56 - 65岁女性的5.3%。与HPV感染显著独立相关的因素是年龄较大[56 - 65岁与15 - 19岁相比的调整后比值比（AOR）= 0.15]，婚姻状况而不是已婚（AOR = 1.58 - 3.29），终身男性伴侣数量增加（≥ 10名伴侣与1名伴侣的AOR = 3.8），同时感染沙眼衣原体（AOR = 1.79）、曾经使用Norplant（AOR = 2.69）和目前使用注射避孕药（AOR = 2.29）。HPV感染的风险因素在不同国家没有差异。这项研究的结果表明，除了HPV 16和18，HPV 31，45，51和58型应考虑纳入在墨西哥分发的HPV预防疫苗。
The United States-Mexico border is a region comprised of a country with one of the highest rates of invasive cervical cancer (Mexico) and a country with one of the lowest rates (United States). Recent evidence clearly indicates that human papillomavirus (HPV) infection is the cause of cervical cancer. The distribution of specific types of HPV is known to vary in different regions of the world, as do the cofactors that may inhibit or promote HPV carcinogenesis. Estimating the prevalence of oncogenic HPV is needed for guiding vaccine development. The purpose of this study was to determine the prevalence of oncogenic and nononcogenic HPV types and risk factors for HPV among women residing along the United States-Mexico border. A cross-sectional study of 2319 women, ages 15-79 years, self-referring for gynecological care was conducted between 1997 and 1998. HPV was detected by PCR using the PYGMY 09/11 L1 consensus primer, and HPV genotyping was conducted using the reverse line blot method. Overall, the HPV prevalence was 14.4% with no significant differences observed by country after adjustment for age. HPV 16 was the most commonly detected HPV type in both the United States and Mexico. Among women with high-grade squamous intraepithelial lesions, HPV types 58, 45, 51, 31, 35, 55, and 73 were most common in Mexico, and HPV types 18, 31, 35, 51, 52, and 58 were most common in the United States. In both countries, HPV prevalence declined linearly with age from 25% among women ages 15-19 years to 5.3% among women 56-65 years. Factors significantly independently associated with HPV infection were older age [adjusted odds ratio (AOR) = 0.15 for ages 56-65 years compared with those 15-19 years], a marital status other than married (AOR = 1.58-3.29), increased numbers of lifetime male partners (AOR = 3.8 for > or =10 partners compared with 1 partner), concurrent infection with Chlamydia trachomatis (AOR = 1.79), ever use of Norplant (AOR = 2.69), and current use of injectable contraceptives (AOR = 2.29). Risk factors for HPV infection did not differ by country. Results from this study suggest that in addition to HPV 16 and 18, HPV types 31, 45, 51, and 58 should be considered for inclusion in an HPV prevention vaccine for distribution in Mexico.