Cervical human papillomavirus deoxyribonucleic acid persists throughout pregnancy and decreases in the postpartum period
Cervical human papillomavirus deoxyribonucleic acid persists throughout pregnancy and decreases in the postpartum period
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DOI：
10.1016/s0002-9378(99)70602-2
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发表时间：
1999-05-01
影响因子：
9.8
通讯作者：
Brown, DR
中科院分区：
文献类型：
--
作者：
Fife, KH;Katz, BP;Brown, DR
目的：我们的目标是确定持续性的人乳头瘤病毒感染的宫颈在一个前瞻性的评估队列的孕妇观察到从第一个三个月，直到posterial.Study设计：一组232名妇女参加了在第一个三个月的怀孕和宫颈阴道灌洗标本收集的人乳头瘤病毒的脱氧核糖核酸检测。他们在妊娠晚期（146名患者可用）和分娩后4至12周（83名患者可用）再次进行采样。结果：在妊娠早期，31%的患者检测结果为人乳头瘤病毒脱氧核糖核酸阳性，而35.6%的阳性结果在妊娠晚期（P = 1.0）。妊娠早期检测结果与产后结果（83例患者的配对数据）的比较显示，阳性率从39.8%下降到26.5%（P = 0.04）。比较孕晚期结果与产后结果（74例患者的配对数据）显示阳性率从35.1%下降到25.7%（P = 0.12）。当将人类乳头瘤病毒阳性标本分为“高癌症风险”类型时，（9种病毒类型通常与发育不良或恶性肿瘤相关）和“低癌症风险”类型（5种类型通常发现于良性病变），类似的趋势，虽然不是所有的比较都有统计学意义。结论：在怀孕期间，可检测到的人乳头瘤病毒脱氧核糖核酸的患病率增加，这是以前报道的（Fife等，Am J Obstet Gynecol 1996，174：1437-93），在整个怀孕期间保持在类似水平，但在产后期间下降。这一观察结果与妊娠生理变化引起的病毒活化最为一致。
OBJECTIVE: Our goal was to determine the persistence of human papillomavirus infection of the cervix in a prospectively evaluated cohort of pregnant women observed from the first trimester until after delivery.STUDY DESIGN: A group of 232 women were enrolled in the first trimester of pregnancy and had cervicovaginal lavage specimens collected for detection of the deoxyribonucleic acid of human papillomavirus. They underwent sampling again in the third trimester (146 patients available) and at 4 to 12 weeks after delivery (83 patients available). Human papillomavirus deoxyribonucleic acid was detected by means of the Hybrid Capture assay.RESULTS: In the first trimester of pregnancy, 31% of the patients had positive test results for human papillomavirus deoxyribonucleic acid, whereas 35.6% had positive results in the third trimester (P = 1.0). A comparison of first-trimester test results with postpartum results (paired data available from 83 patients) showed a decline from 39.8% positivity to 26.5% (P = .04). Comparing third-trimester results with postpartum results (paired data available from 74 patients) showed a decline from 35.1% to 25.7% positivity (P = .12). When specimens positive for human papillomavirus were divided between those containing "high cancer risk" types (9 virus types often associated with dysplasia or malignancy) and "low cancer risk" types (5 types usually found in benign lesions), similar trends were seen, although not all comparisons were statistically significant.CONCLUSION: The increased prevalence, during pregnancy, of detectable human papillomavirus deoxyribonucleic acid, which was previously reported (Fife et al, Am J Obstet Gynecol 1996,174:1437-93), persists at a similar level throughout pregnancy but declines in the postpartum period. This observation is most consistent with activation of the virus by the physiologic changes of pregnancy.