HPV感染女性合并HIV感染对阴道微生态的影响

Effect of HPV-infected Women Combined with HIV Infection on Vaginal Microecology

目的:分析人乳头瘤病毒(HPV)感染女性合并人类免疫缺陷病毒(HIV)感染对阴道微生态的影响。方法:选取2019年9月—2021年9月在杭州市西溪医院感染科爱心门诊及妇产科门诊就诊的60例已确诊为HIV感染且行抗逆转录病毒疗法(ART)治疗、血CD4+计数>500个/mm3同时合并HPV感染的女性为研究组,同时随机选取70例HIV阴性合并HPV感染女性作为对照组。比较两组阴道微生态菌群情况、高危型HPV阳性情况及研究组高危型与低危型患者阴道微生态菌群情况。结果:研究组乳酸杆菌检出率低于对照组,胺试验阳性率、过氧化氢阳性率、白细胞酯酶检出率均高于对照组,差异均有统计学意义(P<0.05);两组霉菌检出率、滴虫检出率、唾液酶检出率、pH值阳性率比较,差异均无统计学意义(P>0.05)。研究组高危型HPV感染率为55.00%(33/60),高于对照组的22.86%(16/70),差异有统计学意义(P<0.05)。研究组高危型与低危型患者阴道微生态菌群情况比较,差异均无统计学意义(P>0.05)。结论:HPV感染女性合并HIV感染阴道微生态失调的发生率较高,且更易发生高危型HPV感染,临床应关注HIV感染女性阴道微生态情况,可通过调整阴道菌群失衡预防HPV感染。

Objective:To analyze the effect of human papillomavirus(HPV)-infected women combined with human immunodeficiency virus(HIV)on vaginal microecology.Method:From September 2019 to September 2021,60 women who had been diagnosed as HIV infection and treated with antiretroviral therapy(ART),with a blood CD4+count of more than 500/mm3 and HPV infection Department of Infection Care clinic and Department of Obstetrics and Gynecology clinic of Hangzhou Xixi Hospital were selected as the study group,at the same time,70 women who were HIV negative and HPV infected were randomly selected as the control group.The vaginal microflora,positive status of high-risk HPV of two groups and the vaginal microflora of high-risk and low-risk patients in the study group were compared.Result:The detection rate of lactobacilli in the study group was lower than that in the control group,and the positive rate of amine test,hydrogen peroxide and leucocyte esterase in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences between two groups in the detection rate of mold,trichomonas,salivary enzyme and pH value(P>0.05).The infection rate of high-risk HPV in the study group was 55.00%(33/60),which was higher than 22.86%(16/70)in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in vaginal microflora between high-risk and low-risk patients in the study group(P>0.05).Conclusion:The incidence of vaginal microecology disorder in HPV infected women with HIV infection is higher,and high-risk HPV infection is more likely to occur,clinical attention should be paid to the vaginal microecology of HIV infected women,and HPV infection can be prevented by adjusting the imbalance of vaginal flora.