Cervical Cytology Specimen Stability in Surepath Preservative and Analytical Sensitivity for HPV Testing with the cobas and Hybrid Capture 2 Tests

None of the commercial HPV tests are U.S. FDA-approved for testing of cervical cytology specimens in SurePath preservative. Still, ~30% of HPV testing is performed on specimens in this formalin-containing preservative. Formalin-induced DNA fragmentation and cross-linking may interfere with HPV detection. We evaluated analytical sensitivity and specimen stability of the cobas 4800 HPV (Roche) and Hybrid Capture 2 HPV (HC2, Qiagen) tests with residual cervical cytology samples in SurePath preservative available within 1 week of collection. Cobas testing was performed with and without heating samples at 120°C for 20 min diluted 1:1 in an alkaline environment (pretreatment) to revert DNA crosslinking. Stability was tested after 2 weeks of storage at ambient temperature followed by ≤10 weeks at 4°C. Analytical sensitivity and positivity rates (HC2, 18%; cobas pretreated, 46%; cobas untreated, 47%) were greater for cobas than HC2 (n = 682). After 6 weeks of storage, mean HC2 ratios were lower (mean 0.9, SD 6.3) but high variability limited statistical power to detect trends. Cobas threshold cycles (Ct’s) increased in untreated (mean 2.1) but not pretreated samples (mean 0.3; n = 110; p≤0.0001). Overall, cobas had greater analytical sensitivity for samples in SurePath preservative. Although pretreatment introduced a manual sample transfer step and 30 min of incubation times, it improved stability without negatively affecting analytical sensitivity. While awaiting results of large trials to evaluate the clinical performance of cobas, the addition of the pretreatment step may improve the detection of HPV, especially after prolonged sample storage.     

Comparing the Cervista HPV HR Test and Hybrid Capture 2 Assay in a Dutch Screening Population: Improved Specificity of the Cervista HPV HR Test by Changing the Cut-Off

The diagnostic performance of the widely-used Cervista HPV HR test was compared to the Hybrid Capture 2 (HC2) test in a Dutch population-based cervical cancer screening program. In 900 scrapings of women with normal cytomorphology, specificity was 90% (95%CI: 87.84–91.87) for the Cervista HPV HR test and 96% (95%CI: 94.76–97.37) for the HC2 test with 93% agreement between both tests (κ = 0.5, p<0.001). The sensitivity for CIN2+ using 65 scrapings of women with histological-confirmed CIN2+ was 91% (95%CI: 80.97–96.51) for the Cervista HPV HR test and 92% (95%CI: 82.94–97.43) for the HC2 test with 95% agreement between both tests (κ = 0.7, p<0.001). Fifty-seven of 60 HC2 negative/Cervista positive cases tested HPV-negative with PCR-based HPV assays; of these cases 56% were defined as Cervista triple-positive with FOZ values in all 3 mixes higher than the second cut-off of 1.93 (as set by manufacturer). By setting this cut-off at 5.0, specificity improved significantly without affecting sensitivity. External validation of this new cut-off at 5.0 in triple-positive scrapings of women selected from the SHENCCASTII database revealed that 22/24 histological normal cases now tested HPV-negative in the Cervista HPV HR test, while CIN2+ lesions remained HPV-positive. The intra-laboratory reproducibility of the Cervista HPV HR test (n = 510) showed a concordance of 92% and 93% for cut-off 1.93 and 5.0 (κ = 0.83 and κ = 0.84, p<0.001) and inter-laboratory agreement of the Cervista HPV HR test was 90% and 93% for cut-off 1.93 and 5.0 (κ = 0.80 and κ = 0.85, p<0.001). In conclusion, the specificity of the Cervista HPV HR test could be improved significantly by increasing the second cut-off from 1.93 to 5.0, without affecting the sensitivity of the test in a population-based screening setting.     

HPV Serology Testing Confirms High HPV Immunisation Coverage in England

Background

Reported human papillomavirus (HPV) vaccination coverage in England is high, particularly in girls offered routine immunisation at age 12 years. Serological surveillance can be used to validate reported coverage and explore variations within it and changes in serological markers over time.

Methods

Residual serum specimens collected from females aged 15–19 years in 2010–2011 were tested for anti-HPV16 and HPV18 IgG by ELISA. Based on these results, females were classified as follows: seronegative, probable natural infection, probable vaccine-induced seropositivity, or possible natural infection/possible vaccine-induced seropositivity. The proportion of females with vaccine-induced seropositivity was compared to the reported vaccination coverage.

Results

Of 2146 specimens tested, 1380 (64%) were seropositive for both types HPV16 and HPV18 and 159 (7.4%) positive for only one HPV type. The IgG concentrations were far higher for those positive for both HPV types than those positive for only one HPV type. 1320 (62%) females were considered to have probable vaccine-induced seropositivity. Among vaccine-induced seropositives, antibody concentrations declined with increasing age at vaccination and increasing time since vaccination.

Conclusions

The proportion of females with vaccine-induced seropositivity was closest to the reported 3-dose coverage in those offered the vaccination at younger ages, with a greater discrepancy in the older females. This suggests either some under-reporting of immunisations of older females and/or that partial vaccination (i.e. one- or two-doses) has provided high antibody responses in 13–17 year olds.     

Population as a Test System

Comparison of the concept that the population is a wave of life with the results of specific studies opens the possibility for the estimation of destructive human activities and their plausible consequences. Specifically, it was noted that radioactive contamination of territories as a result of the accident at the Chernobyl Nuclear Power Station could create prerequisites for the mass reproduction of pests and the expression of diseases dangerous for man and domestic animals.     

Dietary Intake of Metals by the Population of Tarragona County (Catalonia,Spain): Results from a Duplicate Diet Study

The daily intakes of arsenic (As), beryllium, cadmium (Cd), cobalt, chromium, copper, mercury (Hg), manganese, nickel, lead (Pb), antimony, tin, thallium, uranium, vanadium, and zinc by an adult population living in Tarragona County (Catalonia, Spain) were determined by the duplicate diet method with a 10-day sampling period. Duplicate diet samples, prepared as per consumption, were collected during September 2010 in 20 restaurants offering a variety of daily menus (breakfast, lunch, and dinner). A total of 200 composite samples, corresponding to 600 individual samples, were prepared for trace elements analyses, which were carried out by inductively coupled plasma mass spectrometry. The results were compared with data from previous total diet studies (TDS) recently performed in the same geographical area. Notable differences in the intake of the toxic elements As, Cd, Hg, and Pb were found depending on the method used. It is concluded that both the duplicate diet method and the TDS may provide important and useful information to estimate human exposure to metals through the diet and their derived health risks. However, for comparison between surveys or for establishing temporal trends in the intake of metals, it seems to be recommendable to use always the same method. Notwithstanding, if the interest is only to know whether the intake of a certain element is below the tolerable intake, both methods are useful.     

薄层液基细胞学检测及HPV检测对宫颈癌筛查价值的系统评价

目的：系统评价薄层液基细胞学检查（TCT）及人类乳头状病毒（HPV）检查在子宫颈癌筛查中的应用价值。方法：检索收集2000年以来,Cochrane数据库、Pubmed、MEDLINE、Webofscience、EMBASE、万方数据库、清华同方数据库、维普数据库中与TCT及HPv检测在宫颈癌筛查（癌前病变及早期宫颈癌）诊断方面的相关文献,参照Cochrane系统评价的方法对资料进行统计分析。结果：共有12篇文献纳入研究,TCT合并的敏感性0．65（95％CI,0．62-0．68）,特异性0．93（95％CI,0．92-4）．93）,阳性预测值8．25（95％CI,5．65-12．04）,阴性预测值0．27（95％CI,0．18-0．41）,合并SROC曲线下面积AUC=0．889,Q值0．819。HPV合并敏感性0．69（95％CI,O．67~0．71）,特异性O．91（95％CI,0．90-0．91）,阳性预测值3．93（95％CI,2．99-5．18）,阴性预测值0．17（95％CI,0．09～0_31）,合并SROC曲线下面积AUC=0．871,Q值0．801。结论：薄层液基细胞学检查在宫颈癌筛查中具有较高的诊断准确度,与HPV联合检测可提高诊断的准确性。     

HPV16 Seropositivity and Subsequent HPV16 Infection Risk in a Naturally Infected Population: Comparison of Serological Assays

Background

Several serological assays have been developed to detect antibodies elicited against infections with oncogenic human papillomavirus (HPV) type 16. The association between antibody levels measured by various assays and subsequent HPV infection risk may differ. We compared HPV16-specific antibody levels previously measured by a virus-like particle (VLP)-based direct enzyme-linked immunoassay (ELISA) with levels measured by additional assays and evaluated the protection against HPV16 infection conferred at different levels of the assays.

Methodology/Principal Findings

Replicate enrollment serum aliquots from 388 unvaccinated women in the control arm of the Costa Rica HPV vaccine trial were measured for HPV16 seropositivity using three serological assays: a VLP-based direct ELISA; a VLP-based competitive Luminex immunoassay (cLIA); and a secreted alkaline phosphatase protein neutralization assay (SEAP-NA). We assessed the association of assay seropositivity and risk of subsequent HPV16 infection over four years of follow-up by calculating sampling-adjusted odds ratios (OR) and HPV16 seropositivity based on standard cutoff from the cLIA was significantly associated with protection from subsequent HPV16 infection (OR = 0.48, CI = 0.27–0.86, compared with seronegatives). Compared with seronegatives, the highest seropositive tertile antibody levels from the direct ELISA (OR = 0.53, CI = 0.28–0.90) as well as the SEAP-NA (OR = 0.20, CI = 0.06, 0.64) were also significantly associated with protection from HPV16 infection.

Conclusions/Significance

Enrollment HPV16 seropositivity by any of the three serological assays evaluated was associated with protection from subsequent infection, although cutoffs for immune protection were different. We defined the assays and seropositivity levels after natural infection that better measure and translate to protective immunity.     

Testing for Associations of Opposite Directionality in a Heterogeneous Population

In gene networks, it is possible that the patterns of gene co-expression may exist only in a subset of the sample. In studies of relationships between genotypes and expressions of genes over multiple tissues, there may be associations in some tissues but not in the others. Despite the importance of the problem in genomic applications, it is challenging to identify relationships between two variables when the correlation may only exist in a subset of the sample. The situation becomes even less tractable when there exist two subsets in which correlations are in opposite directions. By ranking subset relationships according to Kendall’s tau, a tau-path can be derived to facilitate the identification of correlated subsets, if such subsets exist. However, the current tau-path methodology only considers the situation in which there is association in a subsample; the more complex scenario depicting the existence of two subsets with opposite directionality of associations was not addressed. Further, existing algorithms for finding tau-paths may be suboptimal given their greedy nature. In this paper, we extend the tau-path methodology to accommodate the situation in which the sample may be drawn from a heterogeneous population composed of subpopulations portraying positive and negative associations. We also propose the use of a cross entropy Monte Carlo procedure to obtain an optimal tau-path, CEMC\(_{tp}\). The algorithm not only can provide simultaneous detection of positive and negative correlations in the same sample, but also can lead to the identification of subsamples that provide evidence for the detected associations. An extensive simulation study shows the aptness of CEMC\(_{tp}\) for detecting associations under various scenarios. Compared with two standard tests for detecting associations, CEMC\(_{tp}\) is seen to be more powerful when there are indeed complex subset associations with well-controlled type-I error rates. We applied CEMC\(_{tp}\) to the NCI-60 gene expression data to illustrate its utility for uncovering network relationships that were missed with standard methods.     

The Homozygosity Test after a Change in Population Size

The homozygosity of a population will be influenced by any recent change in the population size. The "homozygosity test" of the neutral mutation hypothesis might also be influenced by a population change. A computer simulation method is described that establishes the significance levels of observed homozygosities after a change in population size. Some numerical examples are given.     

In a Safety Net Population HPV4 Vaccine Adherence Worsens as BMI Increases

Objectives

Obesity adversely inhibits antibody response to vaccination. Three doses of HPV4 may or may not provide adequate long term protection against HPV 16/18 in obese females. The aim of this study was to determine whether adherence to HPV4 vaccination in a safety net population was reduced with increasing body mass index (BMI).

Methods

We designed a historical prospective study evaluating the number and dates of HPV4 dosing that occurred from July 1, 2006 through October 1, 2009 by the demographic characteristics of the 10–26 year old recipient females. The defined dosing intervals were adapted from the literature and obesity categories were defined by the WHO.

Results

1240 females with BMI measurements received at least one dose of HPV4; 38% were obese (class I, II and III) and 25% were overweight. Females with normal BMI received on-time triplet dosing significantly more often than did the obese class II and III females (30% vs. 18%, p<0.001). Obese class II/III females have a significant 45% less chance of completing the on-time triplet HPV4 series than normal women (OR = 0.55, 95% CI: 0.37, 0.83). Pregnancy history has a significant influence on BMI and HPV4 dosing compliance in this safety net population where 71% had been gravid. Hispanic females were less likely to complete HPV4 dosing regardless of BMI (aOR = 0.39, 95% CI: 0.16, 0.95).

Conclusions

Obesity, as well as gravidity and Hispanic race, are risk factors for lack of HPV4 vaccine adherence among young females in a safety net population.     

Dietary Intake of Arsenic, Cadmium, Mercury, and Lead by the Population of Catalonia, Spain

The concentrations of arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) were determined in samples of food items widely consumed by the population of Catalonia, Spain. All samples were randomly acquired in 12 cities of Catalonia between March and June of 2006 and analyzed by inductively coupled plasma mass spectrometry. The dietary intake of these elements was estimated for various age–gender groups of population: children, adolescents, adults, and seniors. In order to determine the temporal trend on the dietary exposure to As, Cd, Hg, and Pb, the current results were compared with those of a previous survey (2000). In the present market basket study, for a standard male adult of 70-kg body weight living in Catalonia, the dietary intakes of As, Cd, Hg, and Pb were 261.01, 9.80, 12.61, and 45.13 μg/day, respectively, while in the 2000 survey, these intakes were 223.59, 15.73, 21.22, and 28.37 μg/day, for As, Cd, Hg, and Pb, respectively. For As, the only food groups currently contributing with measurable amounts to intake of total As were fish and shellfish and cereals, while for Cd the highest contribution to total intake corresponded to pulses, tubers, and cereals. For Hg, the contribution was only due to fish and shellfish, while cereals were the group with the highest contribution to total Pb intake. The estimated intakes of As, Cd, Hg, and Pb are notably lower than the respective provisional tolerable weekly intakes, which indicate that these intakes should not mean additional health risks for the consumers.     

Missed Opportunities: Barriers to HIV Testing during Pregnancy from a Population Based Cohort Study in Rural Uganda

The aim was to assess population-level HIV-testing uptake among pregnant women, key for access to prevention-of mother to child transmission (PMTCT) services, and to identify risk factors for not being HIV tested,The study was conducted May 2008–May 2010 in the Iganga/Mayuge Health and Demographic Surveillance Site (HDSS), Eastern Uganda, during regular surveillance of 68,000 individuals. All women identified to be pregnant May–July 2008 (n = 881) were interviewed about pregnancy-related issues and linked to the HDSS database for socio-demographic data. Women were followed-up via antenatal care (ANC) register reviews at the health facilities to collect data related to ANC services received, including HIV testing. Adjusted relative risk (aRR), and 95% confidence intervals (CI) for not being HIV tested were calculated using multivariable binomial regression among the 544 women who remained after record review.Despite high ANC attendance (96%), the coverage of HIV testing was 64%. Only 6% of pregnant women who sought ANC at a facility without HIV testing services were referred for testing and only 20% received counseling regarding HIV. At ANC facilities with HIV testing services, 85% were tested. Only 4% of the women tested had been couple tested for HIV. Living more than three kilometers away from a health facility with HIV testing services was associated with not being tested both among the poorest (aRR,CI; 1.44,1.02–2.04) and the least poor women (aRR,CI;1.72,1.12–2.63).The lack of onsite HIV testing services and distant ANC facilities lead to missed opportunities for PMTCT, especially for the poorest women. Referral systems for HIV testing need to be improved and testing should be expanded to lower level health facilities. This is in order to ensure that the policy of HIV testing during pregnancy is implemented more effectively and that testing is accessible for all.     

Validity and Reliability of Using a Self-Lavaging Device for Cytology and HPV Testing for Cervical Cancer Screening: Findings from a Pilot Study

Self-sampling could increase cervical cancer screening uptake. While methods have been identified for human papillomavirus (HPV) testing, to date, self-sampling has not provided adequate specimens for cytology. We piloted the validity and reliability of using a self-lavaging device for cervical cytology and HPV testing. We enrolled 198 women in New York City in 2008–2009 from three ambulatory clinics where they received cervical cancer screening. All were asked to use the Delphi Screener™ to self-lavage 1–3 months after clinician-collected index cytological smear (100 normal; 98 abnormal). Women with abnormal cytology results from either specimen underwent colposcopy; 10 women with normal results from both specimens also underwent colposcopy. We calculated sensitivity of self-collected cytology to detect histologically confirmed high grade lesions (cervical intraepithelial neoplasia, CIN, 2+); specificity for histology-negative (CIN 1 or lower), paired cytology negative, or a third cytology negative; and kappa for paired results. One hundred and ninety-seven (99.5%) women self-collected a lavage. Seventy-five percent had moderate to excellent cellularity, two specimens were unsatisfactory for cytology. Seven of 167 (4%) women with definitive results had CIN2+; one had normal and six abnormal cytology results with the self-lavage (sensitivity = 86%, 95% Confidence Interval, CI: 42, 100). The kappa for paired cytology was low (0.36; 95% CI: 0.25, 0.47) primarily due to clinician specimens with atypical squamous cells of undetermined significance (ASC-US) and low grade squamous intraepithelial lesion (LSIL) coded as normal using Screener specimens. However, three cases of HSIL were coded as ASC-US and one as normal using Screener specimens. Seventy-three women had paired high-risk HPV tests with a kappa of 0.66 (95% CI: 0.49, 0.84). Based on these preliminary findings, a larger study to estimate the performance of the Screener for co-testing cytology and HPV or for HPV testing with cytology triage is warranted.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00702208","term_id":"NCT00702208"}}NCT00702208     

Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake

Background

Vaccines against HPV16/18 are approved for use in females and males but most countries currently have female-only programs. Cultural and geographic factors associated with HPV vaccine uptake might also influence sexual partner choice; this might impact post-vaccination outcomes. Our aims were to examine the population-level impact of adding males to HPV vaccination programs if factors influencing vaccine uptake also influence partner choice, and additionally to quantify how this changes the post-vaccination distribution of disease between subgroups, using incident infections as the outcome measure.

Methods

A dynamic model simulated vaccination of pre-adolescents in two scenarios: 1) vaccine uptake was correlated with factors which also affect sexual partner choice (“correlated”); 2) vaccine uptake was unrelated to these factors (“unrelated”). Coverage and degree of heterogeneity in uptake were informed by observed data from Australia and the USA. Population impact was examined via the effect on incident HPV16 infections. The rate ratio for post-vaccination incident HPV16 in the lowest compared to the highest coverage subgroup (RR_L) was calculated to quantify between-group differences in outcomes.

Results

The population-level incremental impact of adding males was lower if vaccine uptake was “correlated”, however the difference in population-level impact was extremely small (<1%) in the Australia and USA scenarios, even under the conservative and extreme assumption that subgroups according to coverage did not mix at all sexually. At the subgroup level, “correlated” female-only vaccination resulted in RR_L = 1.9 (Australia) and 1.5 (USA) in females, and RR_L = 1.5 and 1.3 in males. “Correlated” both-sex vaccination increased RR_L to 4.2 and 2.1 in females and 3.9 and 2.0 in males in the Australia and USA scenarios respectively.

Conclusions

The population-level incremental impact of male vaccination is unlikely to be substantially impacted by feasible levels of heterogeneity in uptake. However, these findings emphasize the continuing importance of prioritizing high coverage across all groups in HPV vaccination programs in terms of achieving equality of outcomes.     

Testing Multivariate Normality in Series Experiments of Incomplete Blocks by Generalized Shapiro-Wilk Test

In this paper, we verify our assumption about multivariate normality in series experiments of incomplete blocks by the generalized Shapiro-Wilk test. This test utilizes transformations of mean yields of the investigated varieties and the generated random variables according to Durbin's randomization principle.     

Dietary reconstruction from historical information and trace elements analysis in a medieval population from Catalonia (Spain)

The analysis of Trace Elements in bone and its application to the determination of ancient human population's ecology and adaptation is focussed. The Sr/Ca and Zn/Ca indexes of the medieval population of L'Esquerda, (Barcelona, Spain) by time periods are compared with other independent information available for the same site. The results obtained with the Trace Element Analysis greatly agree with what was expected from the historical and archeological information. The results must be considered carefully, though, because of the relatively small sample size involved when dividing the sample into time periods. Nevertheless, the technique used may provide a good ecological and adaptive information of ancient human populations, that can be used for comparing populations from different areas.     

高危型HPV检测在宫颈ASCUS分流及随访中的应用

目的:分析高危型人乳头瘤病毒(HPV)检测对宫颈非典型鳞状上皮细胞(ASCUS)患者分流管理的作用,提高分流管理合理性。方法:对200例经液基薄层细胞学(TCT)检查确诊为ASCUS患者采用荧光定量聚合酶链反应技术(FQPCR)检测HPV分型,并进行病理活检。观察高位型HPV阳性率及分型及其与宫颈病变的关系。结果:200例患者中有101例检出高危型HPV阳性,阳性率为50.50%;病理活检确诊正常或炎症、宫颈上皮内瘤变(CIN)Ⅰ级、CINⅡ~Ⅲ级、鳞状细胞癌各有114例、32例、51例、3例,分别占57.00%、16.00%、25.50%、1.50%,高危型HPV阳性率分别为18.42%、87.50%、96.08%、100.00%,≥CINII级病变患者高危型HPV阳性率高于CINⅡ级组,差异比较有显著性(P0.05)。结论:高危型HPV检测可为宫颈ASCUS的合理分流提供可靠依据。     

Prevalence of the Metabolic Syndrome in a Bulgarian Female Population Referred for Bone Density Testing

Objective: To investigate the prevalence of the metabolic syndrome in Bulgarian women referred for bone density screening. Research Methods and Procedures: This was a cross‐sectional clinical study. Subjects were 444 consecutive 30‐ to 75‐year‐old Bulgarian women recruited from the outpatients referred for bone density testing (mean age, 52.67 ± 15.19 years; mean BMI, 26.10 ± 5.71 kg/m²). Height (centimeters), weight (kilograms), and blood pressure were measured. BMI and waist‐to‐hip ratio were calculated. Fasting plasma glucose, blood lipids, and immunoreactive insulinemia (Bayer Corp.‐Diagnostics Div., Tarrytown, NY) were determined. Body composition was analyzed by bioimpedance on a leg‐to‐leg analyser (Tanita TBF‐215; Tanita Corporation, Tokyo, Japan). Results: Of all women, 56.76% had a BMI > 25 kg/m², 45.95% had a waist circumference > 88 cm, and 64.64% had a waist‐to‐hip ratio > 0.8; 59.90% had hypertension; 4.05% had fasting plasma glucose > 7.0 mM, and 42.79% had fasting morning immunoreactive insulinemia = 16 UI/liter; 23.65% had hypercholesterolemia; and 26.35% had hypertriglyceridemia. The prevalence of the metabolic syndrome in this sample, as defined by the National Cholesterol and Education Program‐Adult Treatment Panel III, was 34.91%, and by the modified World Health Organization definition was 37.16%. Discussion: We concluded that Bulgarian women 30 to 75 years old referred for bone density testing have a high prevalence of the metabolic syndrome. Therefore, large‐scale prevention programs are needed in this field.     

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。