HIV/AIDS患者宫颈HPV感染临床研究  

Investigation study of cervical HPV infection in HIV/AIDS patients

作　　者：曹立娟 张建波 况轶群 罗慧 董荣静 李玉叶[1] CAO Lijuan;ZHANG Jianbo;KUANG Yiqun;LUO Hui;DONG Rongjing;LI Yuye(Department of Dermatology,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650032;The first People's Hospital in Dali,Dali,Yunnan 671000;The second People's Hospital in Dali,Dali,Yunnan 671000)

机构地区：[1]昆明医科大学第一附属医院,云南昆明650032 [2]大理市第一人民医院,云南大理671000 [3]大理市第二人民医院,云南大理671000

出　　处：《皮肤病与性病》2025年第1期6-10,共5页Dermatology and Venereology

基　　金：云南省防治艾滋病局项目;云南省“万人计划”名医专项(YNWR-MY-2018-039);云南省皮肤与免疫性疾病临床医学中心(ZX2019-03-02);曾毅院士工作站(2014IC027)。

摘　　要：目的了解HIV/AIDS患者宫颈HPV的感染状况及其影响因素,为HIV/AIDS患者宫颈HPV感染及宫颈癌的防治提供依据。方法整群抽样抽取2015~2017年在大理市第二人民医院接受抗病毒治疗的HIV/AIDS患者,采集宫颈分泌物并保存,按照试剂盒说明书进行样本处理、PCR扩增、杂交检测。并采集患者的人口学资料、流行病学资料、临床特征及实验室检查等相关指标。结果306例女性HIV/AIDS患者中23.2%的患者宫颈HPV阳性,其中18.3%为高危型HPV感染,4.9%为低危型HPV感染;8.2%为HPV多重感染,15.0%为HPV单一感染;1.0%确诊宫颈癌。年龄>50岁、首次CD4^(+)T淋巴细胞计数<200 cells/μL、治疗后CD4^(+)T淋巴细胞上升<200 cells/μL、治疗后HIV病毒载量不降、ART治疗时间<1年、曾患过带状疱疹是HIV/AIDS患者发生宫颈HPV感染的高危因素。结论HIV/AIDS患者宫颈高危型HPV感染率高、多重感染发生率高。对于年龄>50岁、首次CD4^(+)T淋巴细胞计数<200 cells/μL、治疗后CD4^(+)T淋巴细胞上升数<200 cells/μL、治疗后HIV病毒载量不降、ART治疗时间<1年、曾患过带状疱疹的HIV/AIDS患者需要进行宫颈HPV的密切监测,建议对HIV/AIDS患者进行宫颈癌筛查。Objective To research the infection status and its influencing factors of cervical HPV in HIV/AIDS patients,and to provide evidence for cervical HPV infection and cervical cancer prevention in HIV/AIDS patients.Methods A cluster sampling of HIV/AIDS patients who received ART treatment at the Second People's Hospital of Dali from 2015 to 2017 was involved.The inclusion criteria were HIV/AIDS female patients who had had sex and had never been diagnosed with cervical cancer and the general population.Patients'cervical secretions were collected and preserved,and sample processing,PCR amplification,and hybridization testing were performed according to the kit instructions.The patients'demographic data,epidemiological data,clinical features,and related indicators of laboratory tests were collected.Results Among the 306 female HIV/AIDS patients,71 patients were cervical HPV positive,with a prevalence rate of 23.2%,including 56 patients with high-risk HPV infection(infection rate of 18.3%)and 15 patients with low-risk HPV infection(infection rate of 4.9%);25 patients with multiple HPV infection(infection rate of 8.2%)and 46 patients with single HPV infection(infection rate of 15.0%).And 3 patients with final diagnosis of cervical cancer(infection rate of 1.0%).The incidence of cervical HPV infection was higher in patients with HIV/AIDS who were>50 years old,inital CD4^(+)T lymphocyte counts<200cells/μL,the number of CD4^(+)T lymphocyte counts rised after ART<200 cells/μL after ART,had a non-decreasing HIV viral load after ART,ART treatment<1 year,and had herpes zoster.Conclusion The HPV infection rate of HIV/AIDS patients is significantly higher than that of non-HIV/AIDS patients,and the incidence of high-risk infections and multiple infections is higher than that of the general population.Especially for the age over 50 years old,the initial CD4^(+)T lymphocyte counts less than 200cells/μL,the CD4^(+)T lymphocyte counts rises less than 200 cells/μL after treatment,the HIV viral load not decreased after ART,ART time l

关 键 词：HIV/AIDS 宫颈HPV感染 分型 免疫状况 

分 类 号：R512.91[医药卫生—内科学]