郑州地区女性宫颈HPV持续感染的流行病学研究

段海霞; 钱进; 张瑶; 任志敏; 赵国红; 洪钧言; 李新敏

doi:10.3971/j.issn.1000-8578.2025.25.0162

郑州地区女性宫颈HPV持续感染的流行病学研究

Persistent HPV Infection Among Women in Zhengzhou, China: A Prevalence Study

摘要

摘要:
目的分析郑州地区宫颈人乳头瘤病毒（HPV）持续感染状况及其亚型分布特征。
方法收集2018—2024年郑州市妇幼保健院55 239例HPV-DNA分型检测患者的临床相关资料，根据复诊结果分为三组：同一型别HPV感染组（849例）、非同一型别HPV感染组（255例）及HPV一过性感染组（857例）。
结果初筛9 232例HPV阳性患者中，高危型HPV（HR-HPV）阳性率为84.6%（7 813/9 232），主要亚型为HPV-16（20.8%）、HPV-52（17.2%）及HPV-53（9.6%）；低危型HPV（LR-HPV）阳性率为15.4%（1 419/9 232），以HPV-81（28.1%）和HPV-42（27.0%）为主。在1 961例复诊患者中，35.7%（701/1 961）为同一型别HPV持续感染，7.5%（148/1 961）为同一型别HPV非持续性感染；10.9%（214/1 961）为非同一型别HPV持续感染，2.1%（41/1 961）为非同一型别HPV非持续感染；43.7%（857/1 961）复诊转阴。同一型别HPV持续感染组中，HR-HPV占85.7%（601/701），LR-HPV占14.3%（100/701）；非同一型别HPV持续感染组中，高危型别转换占89.7%（192/214），低危型别转换占10.3%（22/214）。无论是否同一型别感染，HR-HPV均较LR-HPV更易发生持续感染。60%以上HR-HPV持续感染患者在18个月内转阴，30%进展为持续感染，超过15%的患者持续感染超过24个月。
结论郑州地区HPV持续感染以高危型为主，大部分患者在18个月内可自然清除，约30%发展为持续感染，其中15%以上的患者感染持续时间超过24个月，不同年龄组HR-HPV持续感染率无显著差异。

Abstract:
Objective To analyze the status of persistent human papillomavirus (HPV) infection and the distribution of viral subtypes in the Zhengzhou region.
Methods Clinical data of 55239 patients who underwent HPV-DNA genotyping tests from 2018 to 2024 were collected. On the basis of HPV follow-up results, patients were divided into three groups: 849 cases of infection with the same HPV type, 255 cases of persistent infection with different HPV types, and 857 cases of transient HPV infection.
Results Among the 9232 initially-screened patients who were positive with HPV, the high-risk HPV (HR-HPV) positive rate was 84.6% (7813/9232), and predominant subtypes were HPV-16 (20.8%), HPV-52 (17.2%), and HPV-53 (9.6%). The low-risk HPV (LR-HPV) positive rate was 15.4% (1419/9232), mainly HPV-81 (28.1%) and HPV-42 (27.0%). Among the 1961 follow-up cases, the rates of persistent and non-persistent infections with the same HPV type were 35.7% (701/1961) and 7.5% (148/1961), respectively. The rates of persistent and non-persistent infections with different HPV types were 10.9% (214/1961) and 2.1% (41/1961), respectively. Meanwhile, 43.7% (857/1961) tested negative upon follow-up. Among the 701 cases of persistent infection with the same HPV type, HR-HPV accounted for 85.7% (601/701), and LR-HPV accounted for 14.3% (100/701). Among the 214 cases of persistent infection with different HPV types, 89.7% (192/214) were high-risk transitions, and 10.3% (22/214) were low-risk transitions. Regardless of HPV types, HR-HPV was more likely to cause persistent infection than LR-HPV. In addition, over 60% of HR-HPV persistent infections resolved within 18 months, 30% developed into persistent infections, and only 15% of patients had persistent infections that last more than 24 months.
Conclusion Persistent HPV infections are predominantly high-risk types. Most patients clear the infection within 18 months, approximately 30% develop persistent infections, and about 15% of patients have persistent infections that last more than 24 months. However, the HR-HPV persistent infection rates across different age groups slightly differ.

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