目的探究引起下生殖道隐性感染的性传播病原体与高危型人乳头瘤病毒(high-risk human papillomavirus,hrHPV)共感染及与不同级别宫颈病变之间的相关性。方法选择2017年7月至2018年7月在西安交通大学第一附属医院行宫颈采样的妇女,细胞...目的探究引起下生殖道隐性感染的性传播病原体与高危型人乳头瘤病毒(high-risk human papillomavirus,hrHPV)共感染及与不同级别宫颈病变之间的相关性。方法选择2017年7月至2018年7月在西安交通大学第一附属医院行宫颈采样的妇女,细胞标本检测hrHPV阳性的320例为阳性组,hrHPV阴性的160例为阴性组,使用凯普公司核酸检测PCR试剂盒检测性传播病原体,包括解脲支原体(Ureaplasma urealyticum,UU)第一生物群(U.parvum,Uup1、3、6、14)与第二生物群(U.urealyticum,Uuu)、人型支原体(Mycoplasma hominis,MH)、生殖支原体(Mycoplasma genitalium,MG)和沙眼衣原体(Chlamydia trachomatis,CT)与hrHPV。根据宫颈病变的级别分为Normal(包括正常/宫颈炎)、LSIL(低级别鳞状上皮内病变)、HSIL(高级别鳞状上皮内病变)、ICC(宫颈浸润癌)亚组。卡方检验、Logistic回归分析相关性。结果两组中隐性感染率分别达62.5%vs.59.4%,两组间总体感染率差异无统计学意义。支原体属中,UU感染率最高,Uup14、MH感染与hrHPV有统计学相关性(P=0.003、P=0.005),但Uup14、MH与中国女性最常见的hrHPV基因型或混合型感染相关性均无统计学意义。阳性组中,Normal+LSIL组患者与HSIL+ICC组患者Uup14感染率差异有统计学意义(OR:12.579,95%CI:3.638~43.497,P<0.001)。阴性组中Normal+LSIL组中Uuu、Uup1感染率明显低于HSIL+ICC组,差异有统计学意义(OR:11.646,95%CI:1.493~90.850,P=0.019;OR:7.474,95%CI:1.140~49.015,P=0.036)。结论女性下生殖道性传播病原体隐性感染普遍流行。Uup14感染明显增加了hrHPV阳性者HSIL及ICC风险;Uuu及Uup1感染增加了hrHPV阴性的HSIL及ICC风险。展开更多
BACKGROUND: To evaluate whether the use of male condoms reduces the risk of male-to-female transmissi on of human papillomavirus(HPV) infection, longitudinal studies explicitly designed to evaluate the temporal relati...BACKGROUND: To evaluate whether the use of male condoms reduces the risk of male-to-female transmissi on of human papillomavirus(HPV) infection, longitudinal studies explicitly designed to evaluate the temporal relationship between condom use and HPV infection are needed. METHODS: We followed 82 female university students who reported their first intercourse with a male partner either during the study period or within two weeks before enrollment. Cervical and vulvovaginal samples for HPV DNA testing and Papanicolaou testing were collected at gynecologic examinations every four months. Every two weeks, women used electronic diaries to record information about their daily sexual behavior. Cox proportional-hazards models were used to evaluate risk factors for HPV infection. RESULTS: The incidence of genital HPV infection was 37.8 per 100 patient-years at risk among women whose partners used condoms for all instances of intercourse during the eight months before testing, as compared with 89.3 per 100 patient-years at risk in women whose partners used condoms less than 5 percent of the time(adjusted hazard ratio, 0.3; 95 percent confidence interval, 0.1 to 0.6, adjusted for the number of new partners and the number of previous partners of the male partner). Similar associations were observed when the analysis was restricted to high-risk and low-risk types of HPV and HPV types 6, 11, 16, and 18. In women reporting 100 percent condom use by their partners, no cervical squamous intraepithelial lesions were detected in 32 patient-years at risk, whereas 14 incident lesions were detected during 97 patient-years at risk among women whose partners did not use condoms or used them less consistently. CONCLUSIONS: Among newly sexually active women, consistent condom use by their partners appears to reduce the risk of cervical and vulvovaginal HPV infection.展开更多
文摘BACKGROUND: To evaluate whether the use of male condoms reduces the risk of male-to-female transmissi on of human papillomavirus(HPV) infection, longitudinal studies explicitly designed to evaluate the temporal relationship between condom use and HPV infection are needed. METHODS: We followed 82 female university students who reported their first intercourse with a male partner either during the study period or within two weeks before enrollment. Cervical and vulvovaginal samples for HPV DNA testing and Papanicolaou testing were collected at gynecologic examinations every four months. Every two weeks, women used electronic diaries to record information about their daily sexual behavior. Cox proportional-hazards models were used to evaluate risk factors for HPV infection. RESULTS: The incidence of genital HPV infection was 37.8 per 100 patient-years at risk among women whose partners used condoms for all instances of intercourse during the eight months before testing, as compared with 89.3 per 100 patient-years at risk in women whose partners used condoms less than 5 percent of the time(adjusted hazard ratio, 0.3; 95 percent confidence interval, 0.1 to 0.6, adjusted for the number of new partners and the number of previous partners of the male partner). Similar associations were observed when the analysis was restricted to high-risk and low-risk types of HPV and HPV types 6, 11, 16, and 18. In women reporting 100 percent condom use by their partners, no cervical squamous intraepithelial lesions were detected in 32 patient-years at risk, whereas 14 incident lesions were detected during 97 patient-years at risk among women whose partners did not use condoms or used them less consistently. CONCLUSIONS: Among newly sexually active women, consistent condom use by their partners appears to reduce the risk of cervical and vulvovaginal HPV infection.
