The Epidemiology Study Of High-risk Human Papillomavirus In Cervical Disease Combined With Bacterial Vaginosis

Objectives: Based on the analysis of risk factors of high-risk HPV infection with BV and characteristic of high-risk HPV type in cervical intraepithelial neoplasia,thus to assess the epidemiology of HPV with BV and provide evidence for further studies of the mechanism on cervical cancer and cervical intraepithelial neoplasia.Methods:?Women were recruited in this study all received same standardized-questionnaire interviews,gynecologic examination and laboratory examination.?Women with CIN confirmed by biopsy of cervical tissue were enrolled in this study.All the recruited individuals were divided into three groups as follows: CIN grading I,II and III.?Cytological examination was based on TCT and determined by TBS.?HPV types were determined by PCR and fast flow hybridization of gene chip array at enrollment.?Statistical analysis were done using SPSS 20.0 for unconditioned Logistic regression analysis,the chi-square test was used for comparison between groups,Values of P<0.05 were considered statistically significant.Results:Part I The analysis of risk factors on HPV infection with BV?The prevalence of BV was 9.56%,the major risk factors were oral health habits,more born-pregnancy,low-levels education,low income,cervical erosion tobacco,menopausal status and so on,there were correlations among HPV infection and BV.Part II Characteristics of human papillomavirus distribution in cervical cervical intraepithelial neoplasia?The distribution of HPV types and its overall infection conditionsThe prevalence of HPV infection in 551 women was 81.13%,among the HPV positive cases,the high-risk HPV was 98.88% and the low-risk HPV was 1.12%.The common types of HPV infection in descending order were HPV 16(41.4%),HPV 58(15.26 %),HPV 52(8.44 %),HPV 33(12.66 %),HPV 31(6.82 %)and HPV 18(4.87%).The common types of HPV infection in different levels of CIN were listed as follows: HPV 16(16.22%),HPV 52(16.22%),HPV 58(13.51%),HPV 33(9.46%),HPV 31(8.11%)and HPV 53(6.76%)in CIN I,HPV 16(33.67%),HPV 58(17.00%),HPV 52(14.33%),HPV 33(13.00%)and HPV 31(9.33%)in CIN II,HPV 16(56.50%),HPV 58(16.38%),HPV 33(12.99%),HPV 18(10.73%)and HPV 52(6.78%)in CIN III,respectively.?The relationship between HPV infection and CINThe HPV types in different grade CIN were as follows: rate of CIN I,CIN II,CIN III was 62.16%,82.67%,86.44%,single HPV infection rate was 58.70%,69.76%,70.59%,respectively.The positive rate of HPV 16 was the highest in all CIN increasing with the level of cervical lesions and its rate was 16.22%,33.67%,56.50%,respectively.?The characteristic of single HPV infection and multiple infectionThe single HPV infection was most common in CIN women and 308 cases(68.90%)were single infection while 111 cases(24.83%)were double infection and 28 cases(6.27%)were multiple infection in total 551 cases.The rate of single,double and multiple HPV infection were 58.70%(27 cases),30.43%(14 cases),10.87%(5 cases)in CIN I;69.76%(173 cases),25.40%(63 cases),4.84%(12 cases)in CIN II;70.59%(108 cases),22.22%(34 cases),7.19%(11 cases)in CIN III,respectively.The proportion of single infection was high and was increased with the CIN levels while the proportion of the double or multiple infection was not.?Characteristics of age distribution in HPV positive womenAccording to different age,they were divided into three age groups: less than 30 years old,30-40 years old and more than 40 years old.The HPV infection rate of the three groups were 75.36%,75.48%,86.86%,respectively.There was a significant difference between the age groups(P< 0.003)and age group with the highest HPV positive rate was more than 40 years old.?The combination of HPV testing with TCTIn 551 CIN women,74 women with CIN I,300 women with CIN II and 177 women with CIN III,The prevalence of HPV infection in 551 women was 81.13%,447 cases(81.13%)were HPV positive,318 cases(57.71%)were TCT positive.The positive rate of TCT and HPV in different grade CIN were as follows: rate of CIN I,CIN II,CIN III was 39.19%,54.33% and 71.19% and 62.16%,82.67%,86.44%,respectively.There was a significant difference between the positive rate and the testing method(P< 0.001).Conclusion:?BV appeared to be the result of multiple-comprehensive infection,thus it is important to enhance the knowledge of risk factors,prevention and treatment of BV,and to improve women reproductive health.?The common HPV types of CIN women in this area were HPV 16,HPV 58,HPV 33,HPV 52,HPV 31 and HPV 18,the risk HPV was predominated,especially HPV 16 was the highest in all CIN,the HPV infection rate was increasing with the level of cervical lesions,which evidently demonstrated the risk-HP infection was the major cause of the CIN and cervical cancer.?The single HPV infection was most common in different grade CIN and was increased with the CIN levels while the proportion of the double or multiple infection was not,which suggested multiple infection was not positively correlate with the development and progression of CIN,and the severity of CIN was not dependent on the number of HPV infection.?The peak age of HPV infection was the middle-aged women(>40 years),thus it was necessary to enhance the HPV screening and health education for older women(>40 years)in the region.?HPV testing combined with TCT had higher sensitivity for diagnosing cervical lesions,which was more effectively to screen CIN and cervical cancer.?Analysis about HPV infection prevalence of CIN women in this area provided a basis for stratified and individual management of patients,development of regional HPV vaccine and primary prevention of cervical cancer in this region.