宫颈癌患者HPV16/18型病毒感染及阴道菌群观察

目的探讨宫颈癌与人乳头瘤病毒(HPV)感染高危型HPV(HPV16/18)表达及阴道菌群的关系。方法回顾性分析我院2018年1月-2020年1月收治的37例宫颈癌患者的临床资料,将其设为宫颈癌组。纳入同期于我院治疗的43例宫颈上皮内瘤变(CIN)患者的临床资料设为CIN组。比较两组基础资料(年龄、绝经情况、孕次、产次、HPV16/18阳性表达、阴道菌群、饮食卫生习惯和家族遗传史)差异,并对有差异信息进行赋值,以多因素Logistic回归模型分析宫颈癌发生的危险因素。结果经单因素分析,两组患者年龄、绝经情况、孕次和产次比较,差异无统计学意义(P>0.05)；宫颈癌组HPV16/18阳性、阴道菌群失调、饮食卫生习惯较差以及存在家族遗传史患者数显著多于CIN组(P<0.05)。经多因素Logistic回归分析证实HPV16/18阳性、阴道菌群失调、饮食卫生习惯较差以及存在家族遗传史是宫颈癌发生的危险因素(P<0.05)。结论宫颈癌发生危险因素较多,临床应针对存在危险因素的患者加强监测并给予相应干预从而降低宫颈癌发生风险。     

482例产褥期阴道微生态调查

目的了解产褥期妇女阴道微生态状况,为临床保健提供循证依据。方法选择长兴县妇幼保健院产后门诊复查的产褥期妇女482例及来院体检的健康妇女86例,采集阴道分泌物作pH、病原体、清洁度和阴道微生态功能检查,进行阴道微生态学评价、比较。结果 482例产褥期阴道pH为(4.62±0.62);阴道清洁度Ⅲ~Ⅳ127例;微生态正常者75例,占15.56%;微生态失调者407例,占84.43%。86例健康妇女阴道pH(4.38±0.65);阴道清洁度Ⅲ~Ⅳ14例;微生态正常者34例,占39.53%;微生态失调者52例,占60.47%。差异有统计学意义。结论产褥期妇女阴道微生态发生改变,表现为pH升高,清洁度下降,微生态失调比例明显升高,应引起临床保健工作者关注。     

南宁市妇女人乳头状瘤病毒感染及阴道微生态状况的流行病学调查

目的调查南宁市妇女生殖道人乳头状病毒感染、阴道微生态环境状况及相关的危险因素。方法于2014年1月至2014年10月,在我院妇科门诊就诊的妇女进行生殖道感染的机会性筛查,共1000人。通过问卷调查收集调查对象的人口学信息和相关危险因素信息,并行常规妇科检查、生殖道微生物检测、宫颈脱落细胞HPV分型检测。应用SPSS 19.0统计软件作相关统计分析。结果 1000名调查对象中,HPV感染263例,感染率为26.3%,混合感染占25%,其中58、52型是HPV感染的主要型别,单因素及多因素研究分析,初次性生活年龄过早(18岁)、多个性伴侣(≥2个)是HPV病毒感染的高危因素。对阴道微生态环境的单因素及多因素分析显示,细菌性阴道病是HPV病毒感染的高危因素。结论南宁市妇女的HPV感染型别主要为58、52型,初次性生活年龄早,细菌性阴道病是HPV感染的独立危险因素。     

绝经后妇女阴道微生态改变与人乳头瘤病毒感染的相关性

目的探讨绝经后妇女阴道微生态改变与人乳头瘤病毒(HPV)感染的相关性。方法选取2018年3月至2019年3月就诊于周口市中心医院妇科门诊绝经后妇女873例为研究对象,根据感染的HPV-DNA基因分型结果分组,检测研究对象阴道分泌物的清洁度、病原体及阴道微生态相关指标,对阴道微生态改变和HPV感染相关性进行统计分析。结果 873例调查对象中有137例(15.7%)HPV感染者。HPV感染组和未感染组相比较,清洁度(χ~2=20.2,P0.001)、菌群密集度(χ~2=17.8,P0.001)、pH值异常率(χ~2=14.0,P0.001)和白细胞酯酶(χ~2=15.5,P0.001)、唾液酸苷酶阳性率(χ~2=8.7,P=0.003)差异有统计学意义,菌群多样性、H_2O_2阳性率差异无统计学意义(均P0.05)。多因素回归分析显示清洁度、菌群密集度、pH值异常和白细胞酯酶阳性率异常与HPV感染明显相关(均P0.05),OR值及95%CI分别为0.334(0.197～0.569)、0.517(0.318～0.840)、0.471(0.291～0.764)、0.450(0.276～0.735)。结论绝经后HPV感染患者存在阴道微生态失调,且HPV感染与清洁度、菌群密集度、pH值异常和白细胞酯酶阳性率异常有关。     

阴道微生态平衡与高危型HPV感染分析

目的了解高危型HPV感染与阴道微生态平衡是否有关。方法选取2014年1月至2014年12月山西医科大学第二医院妇产科门诊就诊同时进行了阴道微生态检查及HPV检查的患者3 861例作为研究对象,对其阴道微生态检查的结果进行分析。结果 (1)细菌性阴道病组、滴虫阴道炎组、混合性阴道炎组与阴道微生态正常组相比,高危型HPV感染的发生率差异有统计学意义(P0.05)。(2)多因素分析的结果表明高危型HPV感染与细菌性阴道病及滴虫阴道炎的存在有关,细菌性阴道病的OR值3.792(95%CI3.196,4.500),滴虫阴道炎的OR值0.646(95%CI0.500,0.843),差异具有统计学意义(P0.05)。结论阴道微生态环境的改变尤其是细菌性阴道病及滴虫阴道炎与高危型HPV感染发生率的升高有关。     

妇科门诊阴道镜检查人群阴道微生态改变与人乳头瘤病毒感染的相关性

目的 初步探讨妇科门诊阴道镜检查人群人乳头瘤病毒（human papillomavirus,HPV）感染与其阴道微生态改变的相关性,以了解妇科疾病患者病原体感染与其阴道稳态和生殖道健康的关系。方法 随机选择2020年4月到2022年4月在我院妇科门诊行阴道镜检查的患者130例,均进行阴道微生态和宫颈HPV检测。根据HPV DNA基因分型结果进行分组,检测HPV感染组和未感染组人群阴道分泌物的清洁度、病原体和阴道微生态相关指标,对阴道微生态改变和HPV感染的相关性进行统计学分析。结果 130例研究对象中,HPV感染者101例（77.69%）。101例HPV感染者中,以单一感染（76例,58.46%）为主,其中又以单一HR-HPV（high-risk HPV）感染（72例,55.38%）为主。101例HPV感染者中,有21种HPV亚型被检出,排名前5位的亚型分别为HPV16、HPV52、HPV58、HPV53、HPV18,占比分别为16.15%、9.23%、8.46%、6.92%、5.38%。101例HPV感染者和29例HPV未感染者相比,阴道清洁度、阴道pH值、白细胞数量异常、白细胞酯酶...     

孕晚期胎膜早破危险因素相关性分析

摘要：目的 探讨孕晚期发生胎膜早破的危险因素及其与胎膜早破的相关性。方法 回顾性分析2017年1月至2018年12月医院收治的350例孕晚期孕妇的临床资料,根据孕妇有无发生胎膜早破分为观察组和对照组。对比两组可能导致胎膜早破相关因素的差异,并采用多因素Logistic回归分析法明确影响胎膜早破的相关因素,重点探讨GBS、支原体、衣原体感染与胎膜早破的关系。结果 350例孕妇胎膜早破发生率为14.86%（52/350）。观察组与对照组年龄、主动或被动吸烟、产次、人工流产史、妊娠期高血压、妊娠期糖尿病、胎位横位/臀位和子宫肌瘤患者构成比差异均无统计学意义（均P＞0.05）。观察组多胎妊娠、产检＜5次、巨大儿、羊水过多、头盆不称、GBS感染、解脲支原体感染和沙眼衣原体感染患者构成比均高于对照组,差异有统计学意义（均P＜0.05）。经Logistic回归分析均是导致胎膜早破的危险因素（均P＜0.05）。结论 导致胎膜早破的危险因素较多,其中孕晚期生殖道GBS、支原体和衣原体感染与胎膜早破关系紧密,临床应采取针对性防治措施,以降低胎膜早破发生风险,改善妊娠结局。     

宫颈上皮内瘤变患者宫颈环形电切术后HPV持续感染的高危因素分析及其对阴道微生态和免疫调节功能的影响

摘要 目的：探讨宫颈上皮内瘤变（CIN）患者宫颈环形电切术（LEEP）后人乳头瘤病毒（HPV）持续感染的高危因素及其对阴道微生态和免疫调节功能的影响。方法：选取2020年1月～2021年1月我院收治的347例行LEEP治疗的CIN患者,根据LEEP后1年是否HPV持续感染分为HPV持续感染组（n=41）和HPV转阴组（n=306）。收集患者临床资料,单因素及多因素Logistic回归分析CIN患者LEEP后HPV持续感染的影响因素。比较1年后复诊时HPV持续感染组与HPV转阴组阴道微生态状况和外周血细胞免疫、体液免疫指标水平。结果：与HPV转阴组比较,HPV持续感染组年龄≥45岁、术前HPV多重感染、术前HPV病毒载量≥100 RLU/CO、手术切缘HPV感染阳性比例更高,初次性生活年龄＜20岁比例更低（P＜0.05）。多因素Logistic回归分析显示,年龄≥45岁（OR=1.034,95%CI：1.009～1.060）、术前HPV多重感染（OR=1.371,95%CI：1.042～1.806）、术前HPV病毒载量≥100 RLU/CO（OR=1.198,95%CI：1.058～1.356）、手术切缘HPV感染阳性（OR=1.313,95%CI：1.144～1.507）为CIN患者LEEP后HPV持续感染的危险因素（P均＜0.05）。复诊时HPV持续感染组阴道优势菌为乳杆菌、菌群密集度和菌群多样性Ⅱ～Ⅲ级比例低于HPV转阴组,pH值高于HPV转阴组（P＜0.05）。复诊时HPV持续感染组外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺、免疫球蛋白A（IgA）、IgG、IgM水平低于HPV转阴组,CD8⁺高于HPV转阴组（P＜0.05）。结论：CIN患者LEEP后HPV持续感染与年龄、术前HPV多重感染、术前HPV病毒载量、手术切缘HPV感染有关,LEEP后HPV持续感染可导致CIN患者阴道微生态和免疫调节功能受损。     

200例先天性尿道下裂患儿的临床特征及其危险因素分析

目的:研究200例先天性尿道下裂患儿的临床特征及其危险因素。方法:选择2016年1月~2019年12月我院收治的先天性尿道下裂患儿200例进行研究,记作观察组,另取同期于我院接受体检的健康儿童200例作为对照组,分析观察组患儿的临床分型情况,比较两组儿童父母的一般情况、儿童出生情况,并采用多因素Logistic回归分析先天性尿道下裂的影响因素。结果:200例先天性尿道下裂患儿临床分型按照占比从高到低的顺序依次为阴茎体型46.50%(93/200)、阴茎阴囊型28.00%(56/200)、冠状沟型17.00%(34/200)、阴囊型4.50%(9/200)、阴茎头型3.00%(6/200)、会阴型1.00%(2/200)。观察组父亲生活性接触化学物、母亲流产史、母亲孕期饮食缺乏肉类、母亲孕期饮食缺乏鱼类、母亲孕期应用保胎药、母亲孕期吸烟或被动吸烟人数占比均高于对照组(均P<0.05)。观察组早产、低出生体重人数占比高于对照组(均P<0.05)。经多因素Logistic回归分析显示,父亲生活性接触化学物、母亲流产史、母亲孕期饮食缺乏肉类、母亲孕期饮食缺乏鱼类、母亲孕期应用保胎药、母亲孕期吸烟或被动吸烟、早产、低出生体重均是先天性尿道下裂的危险因素(均P<0.05)。结论:先天性尿道下裂患儿临床分型以阴茎体型为主,双亲不良生活习惯、化学物接触史以及早产、低出生体重均是先天性尿道下裂的危险因素,值得临床重点关注。     

高危型HPV感染与阴道微生物组关系

目的 通过分析高危型人乳头瘤病毒(HPV)感染患者的阴道菌群,探讨HPV感染与阴道微生物组的关系。方法 选取于国际和平妇幼保健院体检中心体检的63例HPV阴性女性(对照组)及39例高危型HPV感染者(HPV感染组)为研究对象。对细菌16S rDNA的V1V2域扩增后,使用高通量测序法分析两组对象阴道微生物组的组成与结构差异。结果 在门水平上,两组对象均以厚壁菌门(Firmicutes)为主要优势门,其在感染组中占55.0%,在对照组中占88.4%。Alpha多样性指数分析表明感染组患者的阴道菌群多样性均高于对照组,差异有统计学意义(P0.05)。LEfSe结果显示加德纳菌属在感染组低级别鳞状上皮内病变(LSIL)型患者中为优势菌,乳杆菌属为对照组优势菌。结论 高危型HPV感染者阴道菌群多样性增加。加德纳菌属为LSIL与HPV阴性女性的差异菌,乳杆菌属为HPV阴性女性阴道特征菌。     

青海地区46273例女性宫颈HPV检测结果分析

摘要 目的：根据青海地区妇女宫颈人乳头瘤病毒（HPV）检测结果,分析宫颈高危HPV（HR-HPV）感染分布特点,为指导HPV疫苗接种提供理论依据。方法：采用Hybriuax技术检测21种高危型HPV亚型,对2014年1月-2020年2月于我院就诊的46273例女性宫颈人乳头瘤病毒分型检测。结果：46273例妇女中,高危HPV阳性率10.23%,高危HPV阳性率和年龄之间存在线性趋势,随年龄的增大感染比例上升。单一高危亚型HPV感染前三位的HPV亚型为16、58和39,合计占到45.64%。HPV亚型感染以单高危阳性为主,占总HPV阳性数的88.26%,占全部筛查人数的9.03%。HPV16、58、31、68亚型阳性率和年龄段之间存在线性趋势,随年龄的增大感染比例上升。HPV感染亚型检出构成比各年龄段均以HPV16感染排在第一位,排在第二位除61-70岁为双高危外,均为HPV58为主。结论：青海地区女性HPV感染率较高,以单一高危型感染为主,HPV16、58、39、52是主要的感染亚型,所以应针对青海地区HPV感染状况设计具有针对性的预防HPV感染亚型的疫苗。     

High Burden of Human Papillomavirus (HPV) Infection among Young Women in KwaZulu-Natal,South Africa

Objectives

HPV infection causes cervical cancer, yet information on prevalence and risk factors for HPV in Africa remain sparse. This study describes the prevalence of HPV genotypes and risk factors associated with HPV among young women ≤ 30 years of age in KwaZulu-Natal (KZN), South Africa.

Methods

Cervicovaginal lavage samples were tested for HPV genotypes in 224 women enrolled in a prospective cohort study. Clinical, behavioural and demographic data were collected. We measured prevalence of HPV genotypes and using logistic regression, examined for factors associated with HPV.

Results

Median age of participants was 21 years [interquartile range (IQR):18–23]. The overall prevalence of HPV was 76.3% (171/224) with multiple and single genotypes prevalent in 56.3% and 20.1% of women respectively. Proportion of women with high-risk genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56 and 58) was 54.5%. Women not living with their partner [adjusted odds ratio (aOR)] = 3.42 95% CI1.22–9.60; p = 0.019), was significantly associated with HPV infection and high-risk HPV genotype infection.

Conclusion

The high burden of HPV and associated risk behaviours highlight the need to intensify behavioural interventions to prevent HPV acquisition in young women. The large scale delivery of HPV vaccine should be prioritised to prevent HPV acquisition and reduce HPV-related morbidity.     

Prevalence and risk factors of Human Papillomavirus (HPV) infection in southern Chinese women - a population-based study

Background

Persistent high-risk type Human papillomavirus (HPV) infection is recognized as a necessary cause of cervical cancer. This study aimed to compare the HPV prevalence and risk factors between women residing in Hong Kong (HK) and Guangzhou (GZ) region of China.

Methodology/Principal Findings

A total of 1,570 and 1,369 women were recruited from HK and GZ, respectively. The cytology samples were collected and tested for HPV infection. The overall and type-specific HPV prevalence and the potential risk factors for acquisition of HPV infection were studied. Women with normal cytology in the GZ cohort had significantly higher HPV prevalence (10%) than those in the HK cohort (6.2%, p<0.001). The patterns of the age-specific HPV prevalence were also different between the two cohorts. In the HK cohort, women at the age of 20–29 years old had the highest prevalence and a second peak was observed in the age of ≥60 years old. In the GZ cohort, the highest HPV prevalence was also observed in 20–29 years old but declined as the age increased and a second peak was not seen. HPV16 and HPV52 were the most common high-risk types found in the HK and GZ cohorts, respectively. Age was the most consistently observed independent risk factor for HPV infection in the HK, while the number of sexual partners had association in the GZ cohort.

Conclusions/Significance

Our study provides the current status and the epidemiological characteristics of HPV prevalence in Southern Chinese women. The results strongly suggested that population education and the effective cervical cancer screening would be vital in the prevention of cervical cancer.     

广州市花都区789例人乳头瘤病毒感染状况及其基因型研究

目的 对广州市花都区789例疑似人乳头瘤病毒( HPV)感染的妇女进行调查,研究HPV感染状况和基因亚型分布情况.方法 采用荧光定量聚合酶链式反应(Fluorescence quantitative PCR,FQ-PCR)对789例疑似HPV感染患者的宫颈分泌物进行21种人乳头瘤病毒基因亚型的检测.结果 (1)789例标本中,HPV阳性占48.42％(382/789),共检出10种基因型,其中检出单一低危型(HPV6、11、43和44型)279例,占感染者73.04％;单一高危型( HPV16、18、33、52、53、58)68例,占感染者17.80％;多重感染35例,占感染者9.16％.低危型以HPV6、11为主,高危型以HPV16、18为主.HPV6为主要致病基因型,检出率为34.0％ (P ＜0.01);(2)各年龄段间感染率差异无统计学意义(P＞0.05).结论 花都区HPV感染率较高,且多为单一轻危型感染,以HPV6为主要感染亚型,HPV基因型分布有助于确定宫颈癌发生的高危因素及筛查高危人群,对本地区HPV疫苗开发、应用具有重大意义.     

5434例女性泌尿生殖道HPV感染情况及HPV亚型分析

目的了解泰顺地区女性易感人群人乳头瘤病毒(HPV)感染率和HPV亚型分型情况。方法收集2017年1月至2017年12月于泰顺县人民医院体检及就诊的女性患者泌尿生殖道标本,共5434例。采用PCR反向点杂交法进行HPV分型检测,并对结果进行分析。结果5434例标本中HPV阳性1895例,HPV阳性1309人次。高危型HPV检出1127例,占59.4%;低危型HPV检出356例,占18.8%。入选患者中单一感染935例,占71.4%;多重感染374例,占28.6%。高危型中检出最多的是HPV52型,共210例,占11.1%;其次是HPV58型137例,占7.2%;HPV16型124例,占6.5%;HPV18型62例,占3.3%。HPV52阳性患者集中于41~50岁,HPV53阳性患者集中于31~40岁,HPV16、HPV18阳性患者集中于20~40岁及>60岁。随着患者年龄的增长各HPV亚型的阳性率也在增长,且各年龄段患者均以高危型HPV感染为主(62.36%)。结论泰顺地区女性患者HPV亚型及患者年龄分布情况与我国南方女性HPV感染情况相符,HPV感染率随患者年龄增加而增高。高危型HPV检测对子宫颈癌等相关疾病的筛查及预防具有较高的应用价值。     

Prevalence and correlation of human papillomavirus genotypes with clinical factors in cervical samples from Mexican women

In the last decade, the inclusion of HPV DNA testing in cervical cancer screening has provided one of the best strategies for the prevention and timely detection of HPV. We conducted a high-throughput HPV genotyping study based on MALDI-TOF mass spectrometry to determine the prevalence of 24 HPV genotypes, including oncogenic genotypes, in Mexican women and correlated the results with cytological findings and clinical variables. We likewise identified the risk factors in patients with the HPV infection. Our study included 1000 women from Sonora, Mexico, who participated in cervical cancer screening campaigns and who underwent a Pap smear and HPV DNA test. The results showed that the overall prevalence of HPV was 27.2%, 18.5% with single, and 8.7% multiple infections. The low-risk HPV genotype 6 (8.5%) and oncogenic genotypes 31 (8.1%) and 53 (4.4%) were the most prevalent in the study population. The number of lifetime sexual partners, previous STIs, and age at first intercourse was significantly associated with HPV infection (P ≤ 0.05). Smoking (OR = 1.5609; 95% IC 1.062–2.292) and more than three lifetime sexual partners (OR = 1.609; 95% IC = 1.124–2.303) represented risk factors for HPV infection. Cytological abnormalities were found in 3.4% of the HPV-positive samples. CIN 1–3 occurred in 0.6% of high-risk HPV cases. In general, the prevalence of the HPV genotypes is high in Mexican women with normal cytological findings. This issue highlights the importance of HPV research in seemingly healthy women and could help guide screening strategies for cervical cancer prevention in Mexico.Impact statementWe are submitting data regarding the prevalence and type distribution of the HPV infection and the risk factors associated with it, which may provide a valuable reference to reinforce screening strategies, and to maintain HPV genotype surveillance in Mexico. We discuss the overall prevalence of HPV infection as detected in normal cytological samples stratified by age, different types of infection, and oncogenic capacity. One of the most important findings was that common HPV genotypes detected in healthy women were the genotype numbers: 6, 31, 16, and 56, likewise, smoking and having a history of more than three sexual partners over their lifetime, represented the main risk factors in this study. Furthermore, we found a low frequency of cytological abnormalities and CIN 1–3 in women with HR-HPV.     

Prevalence of risk factors associated with human papillomavirus infection in women living with HIV

BACKGROUND: Concurrent infection with HIV and human papillomavirus (HPV) in women is associated with increased rates of cervical dysplasia and shorter survival following the development of cervical cancer. The authors examined risk factors for HPV infection at study entry in HIV-positive women enrolled in the Canadian Women''s HIV Study, a prospective open cohort study. METHODS: Subjects eligible for this analysis included the 375 HIV-positive women in the Canadian Women''s HIV Study for whom HPV test results were available. Questionnaires on behavioural and clinical information, Pap smears, cervicovaginal lavage specimens and vaginal tampon specimens for HPV detection and typing by polymerase chain reaction were obtained at study entry. RESULTS: Overall, 67.2% (252/375) of the women were HPV-positive; the global prevalence of intermediate- and high-risk oncogenic HPV types was 49.1% (184/375). Women with squamous cell dysplasia (32/294) were more likely to have HPV infection than those without dysplasia (90.6% v. 62.6%; p = 0.002). Multivariate logistic regression analysis, with adjustment for number of lifetime partners and history of STD, revealed that the following risk factors were independently associated with HPV infection: CD4 count of less than 0.20 x 10(9)/L (adjusted odds ratio [OR] 1.99 [95% confidence interval (Cl) 1.17-3.37 (p = 0.011)]), non-white race (adjusted OR 2.00 [95% Cl 1.17-3.42 (p = 0.011)]), inconsistent condom use in the 6 months before study entry (adjusted OR 2.02 [95% Cl 1.16-3.50 (p = 0.013)]), and lower age, with women age 30-39 years (adjusted OR 0.51 [95% Cl 0.30-0.87 (p = 0.013)]) and age 40 years or older (adjusted OR 0.52 [95% Cl 0.26-1.01 (p = 0.052)]) compared with women less than 30 years of age. INTERPRETATION: Close monitoring for HPV-related effects is warranted in all HIV-positive women, particularly younger, non-white women who do not always use condoms. Counselling for women living with HIV, particularly younger women, should emphasize the importance of regular cytological screening, with increasing frequency as the CD4 count falls.     

Association between Human Papillomavirus and Human T-Lymphotropic Virus in Indigenous Women from the Peruvian Amazon

Background

No association between the Human T-cell lymphotropic virus (HTLV), an oncogenic virus that alters host immunity, and the Human Papillomavirus (HPV) has previously been reported. Examining the association between these two viruses may permit the identification of a population at increased risk for developing cervical cancer.

Methods and Findings

Between July 2010 and February 2011, we conducted a cross-sectional study among indigenous Amazonian Peruvian women from the Shipibo-Konibo ethnic group, a group with endemic HTLV infection. We recruited women between 15 and 39 years of age who were living in the cities of Lima and Ucayali. Our objectives were to determine the association between HTLV and: (i) HPV infection of any type, and (ii) high-risk HPV type infection. Sexually active Shipibo-Konibo women were screened for HTLV-1 and HTLV-2 infections. All HTLV-1 or -2 positive women, along with two community-matched HTLV negative sexually active Shipibo-Konibo controls were later tested for the presence of HPV DNA, conventional cytology, and HIV. We screened 1,253 Shipibo-Konibo women, observing a prevalence of 5.9% (n = 74) for HTLV-1 and 3.8% (n = 47) for HTLV-2 infections. We enrolled 62 (60.8%) HTLV-1 positive women, 40 (39.2%) HTLV-2 positive women, and 205 community-matched HTLV negative controls. HTLV-1 infection was strongly associated with HPV infection of any type (43.6% vs. 29.3%; Prevalence Ratio (PR): 2.10, 95% CI: 1.53–2.87), and with high-risk HPV infection (32.3% vs. 22.4%; PR: 1.93, 95% CI: 1.04–3.59). HTLV-2 was not significantly associated with either of these HPV infections.

Conclusions

HTLV-1 infection was associated with HPV infection of any type and with high-risk HPV infection. Future longitudinal studies are needed to evaluate the incidence of high-risk HPV infection as well as the incidence of cervical neoplasia among HTLV-1 positive women.     

细菌性阴道病合并人乳头瘤病毒感染的 影响因素

目的分析细菌性阴道病(BV)合并人乳头瘤病毒(HPV)感染的影响因素,为预防BV合并HPV感染的发生提供参考依据。方法收集2017年2月至2017年12月就诊于天津中医药大学第一附属医院符合标准的妇女,观察组为HPV合并BV感染的患者,对照组为健康妇女,通过问卷调查研究两组妇女一般情况的差异性。结果共纳入204名研究对象,其中观察组78例,对照组126例。观察组中HPV感染以单型感染居多,共46例,占59.0%;观察组以高危型别感染居多,共70例,占89.7%。通过单因素回归分析可得年龄≥40岁(P=0.000,OR=3.795)、初次性生活年龄20岁(P=0.011,OR=2.914)、性伴侣数≥2(P=0.036,OR=2.005)、每周性生活次数2次(P=0.029,OR=1.927)、妊娠次数≥2(P=0.000,OR=2.920)是导致HPV合并BV感染的影响因素。多因素非条件logistic回归分析结果显示年龄≥40岁(P=0.001,OR=3.880)、初次性生活年龄20岁(P=0.018,OR=3.127)、性伴数≥2个(P=0.021,OR=2.595)、妊娠次数≥2(P=0.030,OR=2.303)是HPV合并BV的独立影响因素。结论年龄大、初次性生活年龄小、性伴侣个数多、妊娠次数多为HPV合并BV的独立危险因素,临床中应做好知识普及工作,预防HPV合并BV的发生。     

Risk Factors for Venous Thromboembolism in 1.3 Million Pregnancies: A Nationwide Prospective Cohort

Objective

To quantify risk factors for venous thromboembolism during pregnancy and the puerperal period.

Design

In a nationwide prospective cohort study we followed pregnant and puerperal women in Denmark from 1995 to 2009 for venous thromboembolism. Information on risk factors and confounders was retrieved from national registries. The diagnosis of venous thromboembolism was confirmed through medical charts. We calculated adjusted incidence rates per 10,000 women years and used Poisson regression to estimate effects during pregnancy and the puerperal period.

Results

We studied 1,297,037 pregnancies and related puerperal periods, during which there were 748 venous thromboembolisms. The incidence rate for venous thromboembolism during a pregnancy with and without hospitalization for hyperemesis was 15.2/10,000 yr and 6.3/10,000 yr, respectively, (adjusted rate ratio: 2.5 (95%-confidence interval; 1.4–4.5)). The incidence rate among women with multiple pregnancies was 18.2/10,000 yr and 6.3/10,000 yr in singletons (adjusted rate ratio: 2.8 (1.9–4.2)). Increased risk was found with hospitalization during pregnancy or the puerperal period with incidence rates of 42.1/10.000 and 54.7/10.000, respectively, (rate ratios: 12.2 (8.7–17) and 5.9 (4.0–8.8)). Women hospitalized with infections during pregnancy had incidence rates of 25.9/10,000 yr and 29.3/10,000 yr during pregnancy and the puerperal period, respectively, and of 62.7/10,000 yr if hospitalized with infection in the puerperal period. Puerperal venous thromboembolism was associated with hospitalization for preeclampsia and intrauterine growth restriction/fetal death with incidence rates of 45.8/10,000 yr and 18.3/10,000 yr, respectively (rate ratio: 5.0 (3.1–7.8) and 1.9 (0.9–4.4)). Additionally puerperal venous thromboembolism was associated with obesity, elective and acute caesarean sections and major postpartum bleeding with incidence rates of 25.5/10,000 yr, 23.2/10,000 yr, 34.0/10,000 yr and 20.3/10,000 yr, respectively (rate ratios 1.7 (1.1–2.7), 2.1 (1.4–3.1), 3.0 (2.3–4.0) and 1.4 (1.0–2.1)).

Conclusions

Important risk factors for venous thromboembolism during pregnancy or the puerperal period were hospitalization, infection, hyperemesis, multiple pregnancies, preeclampsia, obesity, caesarean section, major postpartum bleeding, and intrauterine growth restriction or fetal death.