艾滋病妇女感染人类乳头瘤病毒的特征分析

Human Papillomavirus Type Distribution in Women Infected with Human Immunodeficiency Virus: A Case-control Study

目的调查人类免疫缺陷病毒（HIV）阳性妇女的人乳头瘤病毒（HPV）感染状况，分析HPV感染的危险因素。方法178例自愿接受宫颈癌筛查的血清HIV阳性已婚妇女为研究组，具有可比性的178例HIV阴性妇女为对照组。问卷调查受检者信息，基因芯片技术检测23种HPV亚型，流式细胞计数检测受试者CD4T淋巴细胞，二分类Logistic回归分析高危型HPV感染的危险因素。结果研究组与对照组HPV感染率分别为38．2％和20．2％，P〈0．05；高危HPV感染率分别为34．8％和17．4％，P〈0．05；多重HPV感染率分别为14．0％和6．7％，P〈0．05。两组常见高危型HPV的分布类型相似，以HPV16，52，58，18常见。HIV阳性妇女HPV感染的危险因素包括CD4T〈350×10^6／L（OR=2．02，95％CI 0．99—4．01）、丈夫HIV阳性（OR=2．32，95％CI 1．15～4．71）以及妇女通过性途径感染HIV（OR=6．26，95％CI2．43～16．11）。结论HIV阳性妇女的宫颈HPV感染率高且感染谱广，高危和多重HPV感染常见；HIV感染有关的因素是高危型HPV感染的相关因素。

Objective To evaluate the prevalence and risk factors of human papillomaviruses （HPV） among HIV - infected females attending self- referred cervical screening in China. Methods Structured interview and the Linear Array （LA） HPV Genotyping test were used for the detection of HPV DNA among 178 HIV - infected with HIV load negative women and 178 HIV negative women. Peripher- al CD4T cells count and plasma HIV RNA were quantitated in I-IIV positive women. Logistic Regression was used to identify independent prognostic factors of HPV positivity. Results HIV positive women were more likely than HIV negative women to be infected by HPV （38.2% vs 20.2% ,P 〈0.05） ,and by high - risk HPV （34.8% vs 17.4% ,P 〈0.05） ,and by multiple HPV infection （14.0% vs 6.7% ,P 〈0.05 ）. The spectrum of commonly high - risk HPV types detected were similar between HIV positive and HIV negative women （ HPV16,52,58 and 18）. Among HIV - infected women,the risk factors for high - risk HPV infection were CD4 count 〈 350/μl （ OR = 2.02,95% CI 0.99 -4.01 ） , HIV infection through sexual contact （OR = 6.26,95% CI 2.43 - 16.11 ） ,and husband with HIV infection （OR = 2.32,95% CI 1.15 - 4.71 ）. Conclusion We found a higher prevalence of HPV infection in HIV - infected than that in HIV negative Chinese women and HPV16 was the most common type in Hubei province, China. Among HIV positive women,the rate of overall or high - risk HPV infection was associated with the routes of HIV transmission. Factors associated with HIV infection were risk factors for high - risk HPV infection among HIV positive women.