高危型HPV持续感染的影响因素探讨

Investigation on factors for persistent high-risk human papilloma virus infection

目的:探讨高危型人乳头状瘤病毒(HR-HPV)持续感染的影响因素。方法:对148例HR-HPV阳性患者进行问卷调查及随访,调查宫颈HR-HPV感染患者持续感染影响因素,探讨各因素与宫颈HR-HPV持续感染的关系。全部病例随访3年。结果:HR-HPV感染持续感染率为21.62%,自然清除率为69.59%,病毒清除时间为6个月到2年,中位数为18个月。经单因素分析及多因素非条件回归分析后结果提示,年龄、职业、最初病毒负荷量、性伴侣个数、配偶性伴侣个数、避孕方式以及生殖道各类炎症与HR-HPV持续感染呈正相关,是HPV持续感染的影响因素(P<0.01);与患者是否吸烟、受教育程度及初次性生活年龄无明显相关性(P>0.05)。结论:年龄较大、不用避孕套避孕、性伴侣数目多、生殖道各种炎症或高病毒负荷量患者具有更高的HR-HPV持续感染率,应予以适当治疗并定期随访。对于无症状、低病毒负荷量的HR-HPV感染者宜密切随访,避免过度治疗。

Objective： To investigate the factors affecting high-risk human papilloma virus （HR-HPV） persistence. Methods： One hundred and forty eight HR-HPV positive cases with benign cervical pathologic diagnosis were enrolled in the study. The effective factors for persistent infection were analyzed. All patients were followed up for 3 years. Results： The rate of HR-HPV infection was 21.62%. HR- HPV infection spontaneous clearance rate was 69.59%, with the clearance time from 6 months to 2 years and the median viral clearance time of 18 months. Single factor analysis and multivariate regression analysis both showed that age, occupation, the initial viral load, number of sexual partners, sexual companion number, contraception and reproductive tract inflammation were the positive factors affecting the spontaneous HPV clearance （P〈0.01）. While smoking, level of education and age of first sexual experience had no obvious contribution （P〉 0.05）. All the patients were continuously followed up. Conclusion： The resuhs show that older women, sex without condom, the number of sexual partners, reproductive tract inflammation and high viral load of HR-HPV infection are factors for higher persistent infection rate. Thus, intensive sereening and proper treatment are recommended. The over treatment should be avoided for eases with asymptomatie or low viral load of HR-HPV infection.