The burden of human papillomavirus infections and related diseases in sub-saharan Africa.
The burden of human papillomavirus infections and related diseases in sub-saharan Africa.
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DOI：
10.1016/j.vaccine.2012.07.092
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发表时间：
2013-12-29
期刊：
影响因子：
5.5
通讯作者：
Parham, Groesbeck P.
中科院分区：
文献类型：
--
作者：
De Vuyst, Hugo;Alemany, Laia;Lacey, Charles;Chibwesha, Carla J.;Sahasrabuddhe, Vikrant;Banura, Cecily;Denny, Lynette;Parham, Groesbeck P.
尽管缺乏高质量的癌症登记和可靠的死亡率数据，但很明显，人乳头瘤病毒 (HPV) 相关疾病，特别是宫颈癌，是撒哈拉以南非洲 (SSA) 发病和死亡的主要原因。 SSA 的宫颈癌发病率是世界上最高的，并且该疾病是该地区女性癌症死亡的最常见原因。宫颈癌的高发病率是大多数国家无法启动或维持宫颈癌预防服务的结果。此外，细胞学检查正常的女性中 HPV 的患病率似乎高于世界较发达地区，平均为 24%。然而，SSA 存在显着的地区差异，东非和西非的 HPV 感染和宫颈癌发病率最高。预计，由于人口老龄化和人口增长，而且由于缺乏适当的预防服务以及随之而来的人体免疫机能丧失病毒（HIV）/后天免疫机能丧失综合症（AIDS）的流行，SSA的宫颈癌发病率和死亡率将在未来20年上升。 HPV16 和 18 是 SSA 宫颈癌中最常见的基因型，尽管与世界其他地区相比，其他致癌 HPV 类型（例如 HPV45 和 35）也相对更常见。有关其他 HPV 相关肛门生殖器癌症（包括外阴、阴道、肛门和阴茎癌症）的数据有限。生殖器疣很常见，与 HPV 6 型和 11 型有关。HIV 感染会增加所有 HPV 相关疾病的发病率和患病率。 HPV 相关疾病的社会文化决定因素，以及导致社会不稳定的力量的影响，需要进一步研究。减少 SSA HPV 相关疾病过度负担的策略包括适合年龄的预防性 HPV 疫苗接种、为育龄妇女提供宫颈癌预防服务以及控制艾滋病毒/艾滋病。
Despite the scarcity of high quality cancer registries and lack of reliable mortality data, it is clear that human papillomavirus (HPV)-associated diseases, particularly cervical cancer, are major causes of morbidity and mortality in sub-Saharan Africa (SSA). Cervical cancer incidence rates in SSA are the highest in the world and the disease is the most common cause of cancer death among women in the region. The high incidence of cervical cancer is a consequence of the inability of most countries to either initiate or sustain cervical cancer prevention services. In addition, it appears that the prevalence of HPV in women with normal cytology is higher than in more developed areas of the world, at an average of 24%. There is, however, significant regional variation in SSA, with the highest incidence of HPV infection and cervical cancer found in Eastern and Western Africa. It is expected that, due to aging and growth of the population, but also to lack of access to appropriate prevention services and the concomitant human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic, cervical cancer incidence and mortality rates in SSA will rise over the next 20 years. HPV16 and 18 are the most common genotypes in cervical cancer in SSA, although other carcinogenic HPV types, such as HPV45 and 35, are also relatively more frequent compared with other world regions. Data on other HPV-related anogenital cancers including those of the vulva, vagina, anus, and penis, are limited. Genital warts are common and associated with HPV types 6 and 11. HIV infection increases incidence and prevalence of all HPV-associated diseases. Sociocultural determinants of HPV-related disease, as well as the impact of forces that result in social destabilization, demand further study. Strategies to reduce the excessive burden of HPV-related diseases in SSA include age-appropriate prophylactic HPV vaccination, cervical cancer prevention services for women of the reproductive ages, and control of HIV/AIDS.
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影响因子：
51.1
作者：
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