高危型人乳头瘤病毒感染患者病毒清除及持续感染的随访性研究

doi:10.3969/j.issn.1006-7795.2015.02.010

首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (2): 212-218.doi: 10.3969/j.issn.1006-7795.2015.02.010

• HR-HPV感染与宫颈病变的相关问题研究 • 上一篇下一篇

高危型人乳头瘤病毒感染患者病毒清除及持续感染的随访性研究

胥莎莎¹, 何鑫¹, 刘英俏², 刘军¹, 王淑珍¹, 王跃³, 刁小莉³, 曲久鑫⁴

1. 首都医科大学附属北京朝阳医院妇产科, 北京 100020;
2. 首都医科大学附属北京通州潞河教学医院妇产科, 北京 101100;
3. 首都医科大学附属北京朝阳医院病理科, 北京 100020;
4. 首都医科大学附属北京朝阳医院检验科, 北京 100020

收稿日期:2014-12-28 出版日期:2015-04-21 发布日期:2015-04-16
通讯作者: 王淑珍 E-mail:darrywang2003@163.com
基金资助:
北京市自然科学基金(7122069),北京市科学技术委员会科技计划(Z131100004013018),北京市金桥工程种子资金项目(2014-2016)。

Persistence and clearance high risk human papillomavirus types in the population of primary infection: a follow-up study

Xu Shasha¹, He Xin¹, Liu Yingqiao², Liu Jun¹, Wang Shenzhen¹, Wang Yue³, Diao Xiaoli³, Qu Jiuxin⁴

1. Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
2. Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China;
3. Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
4. Clinical Laboratory, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

Received:2014-12-28 Online:2015-04-21 Published:2015-04-16
Supported by:
This study was supported by Natural Science Foundation of Beijing(7122069), Scientific Project of Beijing Municipal Science and Technology Commission(Z131100004013018), Seed Funding of Beijing Jinqiao Project(2014-2016).

摘要/Abstract

摘要： 目的探讨医院机会性筛查人群初次高危型人乳头瘤(high risk human papillomavirus,HR-HPV)感染后病毒自然清除或持续感染的相关因素。方法随访2013年1月1日到2013年12月31日首都医科大学附属北京朝阳医院妇产科初次HR-HPV阳性患者969例。观察HR-HPV感染患者病毒自然清除特征及相关因素,分析年龄、病毒基因分型、多重感染以及初次感染病毒负荷量与病毒自然消除及持续性感染的关系。SPSS 18.0统计软件进行统计学处理,Kaplan-Meier生存分析用于计算病毒清除时间。COX比例风险回归用于病毒清除相关因素分析。结果 969例HR-HPV 感染患者平均病毒清除时间为9.52(95% CI: 9.09~9.95)个月,中位消退时间8(95% CI: 7.65~8.36)个月。不同年龄组HR-HPV自然清除的时间不同(χ²=7.93,P=0.047)。不同亚型HPV自然清除时间不同,清除时间最长的前5位分别是HPV56型、HPV33型、HPV58型、HPV52型、HPV18型。病毒清除时间最短的是依次HPV45型、HPV51型、HPV68型。多病毒联合感染同病毒持续感染相关,联合感染者病毒清除时间明显延长,持续感染时间延长(χ²=18.67,P=0.000)。初次感染的病毒负荷量不同,病毒自然清除时间不同,差异有统计学意义(χ²=18.68,P=0.000)。COX比例风险回归分析显示:年龄(回归系数为-0.082,P=0.046)及多病毒联合感染(回归系数为-0.231,P=0.037)同病毒清除呈负相关,初次感染病毒负荷量分级(回归系数为-0.185,P=0.108)与病毒自然清除时间无相关。结论 HR-HPV基因型为HPV56型、HPV35型、HPV58型、HPV51型、HPV35型,≥50岁女性、多重感染以及初次高病毒负荷量患者,病毒自然清除时间长,更易发生持续性感染。

关键词: 高危型人乳头瘤, 持续感染, 病毒消除, 病毒载量

Abstract: Objective To investigate the persistence and clearance data regarding the 13 types of high risk human papillomavirus(HR-HPV) in the population of primary infection. Methods A total of 969 cases of HR-HPV positive patients were followed up between January 1, 2013 and December 31, 2013. The epidemiological characteristics of HR-HPV persistent infection were analyzed. The age, viral genotyping, HR-HPV multiple genotypes and initial viral load were evaluated. Statistical analyses were performed using SPSS software for Windows (version 18.0). The Kaplan-Meier survival function was used for calculating the time taken for the clearance of HR-HPV. The role of a group of independent variables concerning the time taken until clearance was evaluated using a Cox proportional-hazards regression model. P<0.05 was considered statistically significant. Results The average time of viral clearance was 9.52 months for all of 969 cases(9.09-9.95 months 95% CI). Older women had longer clearance time than the younger women groups(χ²=7.63, P=0.45). It was found that HPV-56, 35, 58, 52 and 18 had the lower probability of being cleared, when that HPV-45, 51 and 68 had the shorter time to be cleared. It was also found that multiple viral infection had the lower probability of being cleared than the single ones(χ²=18.67, P=0.000). Lower viral loads had better clearance compared to those having higher viral loads(χ²=18.68, P=0.000)). It was shown that age (regression coefficient=-0.082, P=0.046)and single or multiple HR-HPV infection (regression coefficient=-0.231, P=0.037) were associated with time to clearance in the present sample, while the lower or higher viral loads (regression coefficient=-0.185, P=0.108) was not associated with time to clearance in the Cox proportional-hazards regression model. Conclusion HPV infection clearance in this study was related to factors such as age, infection type, viral load and the multiple or single viral infections.

Key words: high risk human papillomavirus(HR-HPV), persistence, clearance time, viral load

中图分类号:

R711.74

胥莎莎, 何鑫, 刘英俏, 刘军, 王淑珍, 王跃, 刁小莉, 曲久鑫. 高危型人乳头瘤病毒感染患者病毒清除及持续感染的随访性研究[J]. 首都医科大学学报, 2015, 36(2): 212-218.

Xu Shasha, He Xin, Liu Yingqiao, Liu Jun, Wang Shenzhen, Wang Yue, Diao Xiaoli, Qu Jiuxin. Persistence and clearance high risk human papillomavirus types in the population of primary infection: a follow-up study[J]. Journal of Capital Medical University, 2015, 36(2): 212-218.

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高危型人乳头瘤病毒感染患者病毒清除及持续感染的随访性研究

Persistence and clearance high risk human papillomavirus types in the population of primary infection: a follow-up study

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