加纳农村地区基因型特异性HPV清除和再感染的动态可能会影响HPV筛查方法

Amrei Krings , Gifty Boateng , Priscilla Dunyo , Joseph E. Amuah , Rashid A. Adams , Lois Adunyame , Dinah O. Nkansah , Comfort M. Wormenor , Benjamin T. Hansen , Isaac Gedzah , Richard H. Asmah , Edwin K. Wiredu , Andreas M. Kaufmann
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引用次数: 7

摘要

持续的人乳头瘤病毒(HPV)感染是宫颈癌发展的先决条件。很少有研究调查了低收入和中等收入国家的高危HPV清除情况。我们的研究调查了加纳北通古地区妇女的HPV清除和持续时间超过四年。2010/2011年,在加纳阿克拉收集了500名患者的宫颈拭子并进行了HPV基因分型(巢式多重PCR)。2014年,104名此前高危HPV检测呈阳性且未接受治疗的女性重新接受了HPV检测。细胞刷样品进行基因分型(GP5+/6+ PCR &德国柏林的Luminex-MPG读出器。阳性检测的患者接受阴道镜检查,并在必要时进行治疗。在2010/2011年检测高危HPV+的104名妇女中,7名(6.7%;95%CI: 2.7-13.4%)在4年后(平均年龄39岁)有≥1例持续性高危感染。九十七(93年,3%;95%CI: 86.6-97.3%), 22例(21.2%;95%CI: 13.8 ~ 30.3%)有其他基因型的新发高危感染。发现的持续型为HPV 16、18、35、39、51、52、58和68。其中检出1例CIN2 (HPV 68)和1例微侵润性宫颈癌(HPV 16)。这一纵向观察数据表明,单轮HPV筛查可能导致过度转诊。包括特定类型的HPV重新检测或额外的分诊方法可以帮助降低随访率。
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Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches

Persistent Human Papillomavirus (HPV) infection is a prerequisite for cervical cancer development. Few studies investigated clearance of high-risk HPV in low-and-middle-income countries. Our study investigated HPV clearance and persistence over four years in women from North Tongu District, Ghana.

In 2010/2011, cervical swabs of 500 patients were collected and HPV genotyped (nested multiplex PCR) in Accra, Ghana. In 2014, 104 women who previously tested positive for high-risk HPV and remained untreated were re-tested for HPV. Cytobrush samples were genotyped (GP5+/6+ PCR & Luminex-MPG readout) in Berlin, Germany. Positively tested patients underwent colposcopy and treatment if indicated.

Of 104 women, who tested high-risk HPV+ in 2010/2011, seven (6,7%; 95%CI: 2.7–13.4%) had ≥1 persistent high-risk‐infection after ~4 years (mean age 39 years). Ninety-seven (93,3%; 95%CI: 86.6–97.3%) had cleared the original infection, while 22 (21.2%; 95%CI: 13.8–30.3%) had acquired new high-risk infections with other genotypes. Persistent types found were HPV 16, 18, 35, 39, 51, 52, 58, and 68. Among those patients, one case of CIN2 (HPV 68) and one micro-invasive cervical cancer (HPV 16) were detected.

This longitudinal observational data suggest that single HPV screening rounds may lead to over-referral. Including type-specific HPV re-testing or additional triage methods could help reduce follow-up rates.

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来源期刊
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审稿时长
14 weeks
期刊介绍: The official Journal of the International Papillomavirus Society Papillomavirus Research (PVR), the Journal of HPV and other Small DNA Tumor Viruses publishes innovative papers related to all aspects of papillomaviruses and other small DNA tumor viruses. The official journal of the International Papillomavirus Society, PVR is an open access publication that aims to bring together virologists, immunologists, epidemiologists and clinicians working in the booming field of HPV and animal papillomaviruses, polyomaviruses and other small DNA tumor viruses and their associated diseases, in order to foster and facilitate interdisciplinary communication. The journal welcomes original research articles, reviews, short communications, opinion articles and regional update reports on papillomaviruses and other tumor viruses in the following sections: a. Biology of papillomaviruses and related viruses from life cycle to cancer b. Epidemiology etiology and natural history studies c. Natural and induced immunity including vaccine research d. Intervention studies and strategies including i. Clinical studies and trials ii. HPV treatments iii. HPV vaccination programs iv. Diagnostics and screening e. Infection and disease prevention, modeling studies f. Guidelines and public health recommendations g. HPV Studies in special populations Regional and local studies on these viruses.
期刊最新文献
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