合并肛周疣状赘生物的男性HIV/AIDS患者肛周组织HPV感染情况

Cross-sectional study of HPV infection in perianal tissues of HIV-infected men with perianal diseases in Shanghai

目的了解上海市男性合并肛周疣状赘生物的HIV感染者肛周组织样本中HPV的感染率及其基因亚型。方法收集2009年1月至2018年6月上海市公共卫生临床中心外科HIV阳性男性肛周疣状赘生物患者的流行病学信息及病变组织石蜡样本,应用HPV分型检测试剂盒进行分型检测,对HPV的感染率及其基因亚型分布特征进行统计分析。结果共入组201例患者,其中190例检测到21种HPV基因型别中的至少任意一种,任一亚型HPV感染率为94.5%(190/201);任一高危亚型(HR)感染率为51.2%,任一低危亚型(LR)感染率为92.0%。HR-HPV感染率最高的为HPV16,感染率10.9%;其他依次为HPV39(9.0%)、HPV58(8.5%)、HPV18(8.0%)、HPV51(7.5%)、HPV52(6.0%)和HPV66(6.0%)。LR-HPV感染率最高的为HPV11,感染率75.6%;其次为HPV6(34.8%)和HPV81(4.0%)。研究对象多重HPV感染常见,感染两种及以上亚型者占57.2%,但良性肛周疣状赘生物组与肛周肿瘤组在HPV感染分布上差异无统计学意义(χ^(2)=2.71,P=0.438)。结论本研究中男性合并肛周疣状赘生物的HIV感染者绝大多数感染HPV,多重亚型感染率和高危亚型感染率均超过一半,有必要针对该人群开展HPV预防干预。

Objective This cohort study aimed to disclose the prevalence and genotype distribution of human papillomavirus(HPV) infection in perianal tissues of the human immunodeficiency virus(HIV)-infected men with perianal diseases in Shanghai.Methods From January 2009 to June 2018,HIV-positive male patients with perianal diseases who received surgery in Shanghai Public Health Clinical Center and met the inclusion criteria were enrolled in the study.Epidemiological data and formalin-fixed paraffin-embedded(FFPE) perianal tissue samples from surgery were collected.Tissue dewaxing and HPV DNA extraction were performed,and then the HPV genotyping was conducted.HPV prevalence and genotype distribution were analyzed.Results Totally,201 participants were analyzed.Among them,190 cases were tested positive for at least one of the 21 HPV genotypes.The prevalence of HPV infection was 94.5%(190/201) for any type,51.2% for high risk(HR)-HPV type,and 92.0% for low risk(LR)-HPV type.The most prevalent HRHPV was HPV16(10.9%),followed by HPV39(9.0%),HPV58(8.5%),HPV18(8.0%),HPV51(7.5%),HPV52(6.0%)and HPV66(6.0%).The most prevalent LR-HPV was HPV11(75.6%),followed by HPV6(34.8%) and HPV81(4%).57.2% of the participants were infected with more than two types of HPV.No significant difference in the distribution of multiple subtypes of HPV infection was reached between the benign and malignant tumor groups(χ^(2)=2.71,P=0.438).Conclusion Most HIV-infected men with perianal diseases in this research were infected with HPV.More than half of them were infected with multiple types and HR-HPV,underscoring urgent needs of HPV prevention and intervention in HIV-infected males patients.