广州地区HIV阳性者合并HPV感染情况分析

Prevalence of HPV among HIV positive population

目的了解广州地区艾滋病病毒(HIV)阳性人群中人乳头瘤病毒(HPV)感染状况,基因型特征及与HIV阴性人群的差异。方法选择门诊患有尖锐湿疣或疑似尖锐湿疣患者作为研究对象,采用基因芯片技术对外生殖器部位进行HPV检测,采用SPSS 19.0统计软件进行χ~2检验。结果共选择HIV阳性者320例和HIV阴性者2 619例。在HIV阳性组中,HPV感染率为76.88%(246例),高危型HPV感染率为57.19%(183例),低危型HPV感染率为58.75%(188例);HIV阴性组三者感染率分别为30.58%,23.10%,13.06%,两组比较差异均有统计学意义(P<0.01)。HPV检出率,男性HIV阳性组中为80.00%(232/290),HIV阴性组为52.56%(226/430),差异有统计学意义(χ~2=56.01,P<0.01);女性HIV阳性组中为46.67%(14/30),HIV阴性组为26.27%(575/2 189),差异有统计学意义(χ~2=6.3,P<0.05)。低危型HPV在HIV阳性组检出率前三位为HPV 6(32.19%)、11、CP8304,在HPV阴性组检出率与之排序相同,但HPV6的检出率仅4.54%。高危型HPV在HIV阳性组检出率前5位依次为HPV16、52、58、51和18型,在HIV阴性组前5位依次为HPV16、52、58、18和39型。HIV阳性组最多有十重感染,HIV阴性组最多有八重感染。三重及以上感染者,HIV阳性组为49.59%(122/246),HIV阴性组为14.11%(113/801)。HIV阳性组中有253例同时检测了CD4+T淋巴细胞计数,<500个/μL和≥500个/μL两组分别在HPV阳性率、低危型HPV感染率、多重基因型感染率中的差异均有统计学意义,而在高危型HPV感染率的差异无统计学意义。结论 HIV阳性人群中HPV总感染率,高危型HPV感染率,低危型HPV感染率,男,女性HPV感染率均明显高出HIV阴性组,需要高度重视,从多方面做好HPV相关性恶性肿瘤的预防。

Objective To compare the prevalence and genotype distribution of human papillomavirus(HPV)between human immunodeficiency virus(HIV)positive and negative populations.Methods Patients with condyloma aeuminatum or persons with suspected condyloma aeuminatum were enrolled into this study and classified into HIV positive group(n=320)and HIV negative group(n=2 619).Gene chip analysis was performed to detect HPV and determine HPV genotypes in mucocutaneous samples collected from the external genitalia of the subjects.The CD4+T number was detected in 253 patients among the HIV positive group,who were classified into CD4+T<500 and CD4+T≥500 groups.Statistical analysis was carried out by chi square test and SPSS software version 19.0.Results The prevalence rates of HPV infection,high risk HPV types and low risk HPV types were significantly higher in HIV positive group than in HIV negative group(76.87%vs30.58%)(57.19%vs.30.58%)(58.75%vs.13.06%),respectively,P<0.01.The detection rate of HPV was also higher in HIV positive men and women compared with HIV negative men and women,respectively(80%vs.52.56%),(46.7%vs.26.27%).Although the top three genotypes of low risk HPV were types 6,11 and CP8304 in both HIV positive and negative groups;the prevalence rate of HPV 6 was 32.19%in HIV positive group,only 4.54%in HIV negative group.The top five genotypes of high risk HPV were types 16,52,58,51 and 18 in HIV positive group,and types 16,52,58,18 and 39 in HIV negative group.Co-infections with multiple HPV subtypes were common in both groups.The number of concurrent HPV genotypes was as high as 10 in HIV positive group,and 8 in HIV negative group.The prevalence rate of co-infections with three or more HPV genotypes in HIV positive group was 49.6%,while 14.2%in HIV negative group.The prevalence rates of HPV infection,low risk HPV types,multiple HPV subtypes were significantly higher in CD4+T<500 than in CD4+T≥500 groups.However,the prevalence rates of high risk HPV types were not significantly higher in CD4+T<500 than CD4+T≥500 groups.Conclusion Compared with HIV negative population,HIV positive population shows elevated prevalence of HPV infection,high risk HPV genotypes and low risk HPV genotypes.The prevalence of HPV is higher in HIV positive men and women than in HIV negative men and women.These findings need further clinical attention.HPV related cancer should be prevented in many ways.