多重感染尖锐湿疣皮损HPV基因型别回顾性分析  

Retrospective analysis of the genotypes distribution of HPV multiple infection incondyloma acuminatum lesions

作　　者：杨戈[1] 崔凡 雍刚[2] 杨建文[1] 谢震[1] 沈柱 林昭春[1] YANG Ge;CUI Fan;YONG Gang;YANG Jianwen;XIE Zhen;SHEN Zhu;LIN Zhaochun(Institute of Dermatology and Venereology,Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital,Chengdu 610072,China;Department of Clinical Laboratory,Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital,Chengdu 610072)

机构地区：[1]四川省医学科学院四川省人民医院皮肤病性病研究所,成都610072 [2]四川省医学科学院四川省人民医院检验科,成都610072

出　　处：《中国艾滋病性病》2019年第7期718-721,共4页Chinese Journal of Aids & STD

基　　金：四川省医学科学院·四川省人民医院皮肤病性病研究所苗圃课题(201308)~~

摘　　要：目的回顾性分析本地区多重感染尖锐湿疣(CA)皮损人乳头瘤病毒(HPV)基因型别分布情况,比较4价和9价HPV疫苗对HPV多重感染覆盖率的差异,为防治HPV多重感染提供一定的研究数据。方法对2016年7月至2017年9月在四川省医学科学院四川省人民医院皮肤病性病研究所门诊确诊的CA患者皮损采取快速分子导流杂交聚合酶链式反应检测HPV基因型的21种亚型,选取基因型别数≥2型的患者进行统计分析。结果355例入选患者中,男性68.17%(242例),女性31.83%(113例);检出率居前五位的亚型分别为:6型52.11%(185例),11型39.44%(140例),CP8304型21.69%(77例),16型21.13%(75例),58型16.34%(58例);高危型检出率居前5位者为:16型21.13%(75例),58型16.34%(58例),39/51型15.49%(55例),52型15.21%(54例),53型13.24%(47例);仅高危型、仅低危型和高危型混合低危型感染分别占11.83%、14.65%和73.52%;2重、3重、4重及≥5重感染的检出率分别为55.49%,25.35%,11.27%,7.89%。≤20岁、21~30岁、31~40岁、41~50岁和≥51岁各年龄组所占比例分别为5.92%、43.94%、20.00%、18.59%、11.55%。4价和9价HPV疫苗有效覆盖率分别为14.08%(50例)和30.42%(108例),差异有统计学意义(χ^2=27.385,P=0.000)。结论本地区多重感染CA患者中以2重感染及高危型混合低危型感染模式多见,低危型以6型、11型多见,高危型以16型、58型多见,9价HPV疫苗比4价疫苗对多重感染CA患者具有更好的有效覆盖率。Objective To retrospectively analyze the genotypes distribution of human papillomavirus(HPV) multiple infection(MI) in condyloma acuminatum(CA) lesions, and compare the coverage difference between 4-valent and 9-valent HPV vaccine for HPV MI. Methods 21 subtypes of HPV were detected by the flow-through hybridization technique in the lesions of CA patients diagnosed in our department from Jul 2016 to Sep 2017. The patients with HPV genotypes ≥2 were selected for statistical analysis. Results 355 selected patients included 242 male(68.17%) and 113 female(31.83%). The top five HPV genotypes were 6 genotype(52.11%), 11 genotype(39.44%), CP8304 genotype(21.69%), 16 genotype(21.13%), and 58 genotype(16.34%). The top five high-risk HPV genotypes were 16 genotype(21.13%), 58 genotype(16.34%), 39/51 genotype(15.49%), 52 genotype(15.21%), and 53 genotype(13.24%). Only high-risk, low-risk and high-risk mixed low-risk genotypes infections accounted for 11.83%, 14.65% and 73.52% respectively. The detection rates of 2, 3, 4 and ≥5 genotypes infections were 55.49%, 25.35%, 11.27% and 7.89% respectively, while the ones among the age groups of ≤20, 21-30, 31-40, 41-50 and ≥51 years were 5.92%, 43.94%, 20.00%, 18.59% and 11.55% respectively. The effective coverage rates of 4-valent and 9-valent HPV vaccine were 14.08%(50 cases) and 30.42%(108 cases) respectively. There was a significant difference between them(χ^2=27.385, P=0.000). Conclusion Among the CA patients with HPV MI in this area, the major infection modes are two genotypes infections and high-risk mixed low-risk genotypes infections. 6 and 11 genotypes are the most common in low-risk HPV subtypes, while 16 and 58 genotypes in high-risk ones. The 9-valent HPV vaccine has a much more coverage rate of CA patients with HPV MI than the 4-valent one.

关 键 词：尖锐湿疣 人乳头瘤病毒 多重感染 导流杂交 基因型 

分 类 号：R752.53[医药卫生—皮肤病学与性病学]