2015—2021年浙江省台州市女性HPV基因型特征分析

Analysis of the characteristics of HPV genotypes in Taizhou in Zhejiang Province from 2015 to 2021

目的 了解浙江省台州市女性人乳头状瘤病毒(papillomavirus,HPV)流行情况以及基因型分布特点。方法 收集2015年1月—2021年12月在台州医院和恩泽医院就诊的女性患者,取宫颈脱落细胞标本进行HPV DNA分型检测。结果调查HPV患者48 573例,总感染率为25.33%,高危型HPV感染率为19.91%,排名前5位的型别依次为HPV52、58、16、53、39。低危型HPV感染率为8.92%,排前三为HPV61、81、6。按年龄分为11个组,各年龄组感染率差异有统计学意义(χ^(2)=490.39,P<0.05),16~<21岁混合感染大于单一感染,其他年龄都是以单一感染为主。在单一感染中除16~<21岁以单一低危型HPV感染为主,其他年龄都是以单一高危型感染为主。2价、4价和9价疫苗针对的病毒基因分型的占比为12.36%、18.66%、44.89%,无疫苗针对的其他高危病毒基因分型占比为32.17%,各年龄组之间差异有统计学意义(χ^(2)=5 401.79,P<0.01)。2015—2021年HPV感染主要以单一高危感染为主,单一高危感染在总感染例数中的占比在2015—2017年保持平稳,2017—2020呈现上升趋势,2021年回落至2017年水平。2 048例双重感染患者中,低危型和高危型混合感染占52.0%。混合感染排在前5位基因型为HPV81、61、52、43、6。结论 台州市女性HPV感染率较高,主要以单一高危型为主,建议16~<26岁人群可接种4价或9价疫苗,其他年龄段接种9价疫苗。

Objective To investigate the prevalence,genotype distribution and vaccination guidance of human papillomavirus(HPV)among women in Taizhou.Methods Women who visited Taizhou Hospital and Enze Hospital between January 2015 and December 2021 were recruited,and samples of exfoliated cervical cells were collected for HPV DNA typing detection.Results A total of 48573 women were investigated,The overall infection rate was 25.33%,and the infection rate of high-risk HPV was 19.91%,with the top five genotypes being HPV52,58,16,53,and 39.The infection rate of low-risk HPV was 8.92%,with the top three being HPV61,81 and 6.Divided into 11 groups by age,there was a statistically significant difference in the infection rate across different age groups(χ^(2)=490.39,P<0.05).In the age group of 16-<21 years old,mixed infection was more common than single infection,in contrast to the other age groups.Regarding single infection,infection by single high-risk HPV was common across all the age groups except for the 16-<21 years age group in which infection by single low-risk HPV was more common.The proportion of genotypes targeted by 2-,4-and 9-valent HPV vaccines were 12.36%,18.66%,and 44.89%respectively.The proportion of high-risk genotypes not protected against by any currently available vaccines were 32.17%,and the difference between the age groups was statistically significant(χ^(2)=5401.79,P<0.01).During the whole study period from 2015 to 2021,the infected cases were mainly due to single high-risk genotype,the proportion of single high-risk infections in the total number of infections remained stable from 2015 to 2017,gradually increased from 2017 to 2020,and dropped to the level of 2017 in 2021.Among 2048 patients with co-infection,52.0%were co-infected by a low-risk type and a high-risk type.The top five genotypes detected in mixed co-infection cases were HPV81,61,52,43 and 6.Conclusions The infection rate of HPV in Taizhou may be very high,and mainly due to single high-risk genotype infection.It may be recommended that people aged 16-<26 years be vaccinated with 4-valent or 9-valent vaccine,and people of other age groups be vaccinated with 9-valent vaccine.