河南地区女性HPV感染及基因型分布研究

Prevalence and genotype distribution of human papillomavirus infections in women of Henan province

目的:研究河南地区女性人乳头瘤病毒(human papillomavirus,HPV)的感染状况及基因型别分布特点,为宫颈癌防治及HPV疫苗研制提供流行病学资料。方法:选取2012-02-2013-05郑州大学第三附属医院妇科门诊、生殖医学门诊、妇女保健及健康体检的河南女性14 873例,采用PCR-反向点杂交技术对14 873例女性进行HPV基因分型检测,可检测HPV16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、73、83和MM4等18种高危亚型以及HPV6、11、42、43和44等5种低危亚型,并对各亚型感染情况进行分析。结果:14 873例女性中共检出HPV阳性者3 566例,总阳性率为23.98%(3 566/14 873),其中高危型感染占69.01%(2 461/3 566),低危型感染占17.33%(618/3 566),低、高危混合感染占13.66%(487/3 566)。23种亚型共检出22种,低危型44未检出。高危型HPV基因型按检出频次由高到低排序依次为16(16.73%)、58(10.17%)、52(9.11%)、56(6.48%)、66(5.76%)、33(4.74%)、68(3.92%)、31(3.60%)、53(3.13%)、59(3.00%)、35(2.53%)、51(2.00%)、73(1.08%)、45(0.94%)、83(0.84%)、39(0.69%)、18(0.61%)和MM4(0.04%);低危型由高到低排序依次为43(11.34%)、6(5.17%)、42(4.76%)、11(3.35%)和44(0)。感染类型以单一感染为主,占71.17%(2 538/3 566),其中以高危型为主,占54.66%(1 949/3 566),低危型占16.52%(589/3 566);多重感染占28.83%(1 028/3 566),其中以二重感染为主,占20.11%(717/3 566)。按年龄将研究对象分为5组,年龄段与HPV感染率呈U型曲线关系,<25岁年龄组HPV感染率高达28.31%,显著高于其他年龄段,χ2=22.747,P<0.001;≥55岁年龄组感染率也呈上升趋势。结论:河南地区HPV感染类型以高危型和单一感染为主,主要感染亚型为16、43、58、52和56。

OBJECTIVE： To study human papillomavirus （HPV） prevalence and genotype distribution among women in Henan province and to provide epidemiological data for the prevention of cervical cancer and development of HPV vaccine. METHODS：The clinical material consisted of 14 873 women,who were from outpatient service of department of gynaecology,reproductive medicine,women＇s health and the health physical examination of the Third affiliated Hospital of Zhengzhou University,during the period from February 2012 up to May 2013. Totally 14 873 samples were detected and genotyped by PCR reverse dot-blot （PCR-RDB）. This method can detect 18 kinds of high-risk subtypes ： HPV16,18,31, 33,35,39,45,51,52,53,56,58,59,66,68,73,83 and MM4,and 5 kinds of low-risk subtypes：HPV6,11,42,43 and 44. The infection status of each subtype were analized. RESULTS： The overall HPV positive rate in females was 23. 98%（3 566/14 873） ,of which 69.01%（2 461/3 566） were infected by high-risk types,17.33%（618/3 566） were infected by low-risk types and 13.66%（487/3 566） were infected by high-risk and low risk types at the same time. In the 23 sub types,22 were checked out and the low-risk HPV 44 was not detected. Eighteen types of high-risk HPV were detected,of which HPV16（16.73%） was the most common type,followed by 58（10.17%） ,52（9.11%） ,56（6.48%）,66（5.76%） ,33 （4.74%） ,68（3.92%）, 31 （3.60%）, 53 （3.13%）, 59 （3.00%）,35 （2.53%）, 51 （2.00%）, 73 （1. 08%）,45 （0.94%）, 83 （0.84%）,39（0.69%）,18（0.61%） and MM4（0.04%）. Four types of low-risk HPV were detected,of which HPV43 （11. 34%） was the most common type,followed by 6（5. 17%） ,42（4.76%） and 11（3.35%）. The type of 44 was not detected. Among the positive females,71.17%（2 538/3 566） was single type infections,of which 54.66% （1 949/3 566） was high-risk infections, and 16.52M （589/3 566） was low-risk infections. Totally 28.83% （1 028/3 566） was multiple H PV infections,of which 20.11% （717/3 566） was double H PV infections. The objects were divided into five groups according to age,and the positive rate according to age showed U-shape with a peak in HPV prevalence among women less than 25 years of age, in this age group, the positive rate were 28.31%, significantly higher than that in other age groups （X2 = 22. 747, P〈0. 001）. The second peak was in the older females aged more than 55 years of age. CONCLUSIONS： The most common types of HPV infection in Henan province are high-risk HPV and single type infection. The leading genotypes are HPV16,43,58,52 and 56.